Early Detection to Prevent Diabetes Mellitus

Diabetes Mellitus is a silent chronic disorder in which we see blood sugar levels raised above normal, fasting above 120 mg/dl and post prandial above 140 mg/dl. This may be due to defective insulin secretion or defective insulin action or a combination of both. The result is an alteration in the digestion and utilization of carbohydrates, fats and proteins that we eat. Raised blood sugar levels cause changes in the blood vessels and thus can affect the eyes, kidneys, nerves, heart, skin, brain and feet.

It is estimated that there are over 32 million diabetics in India and it could become 57 million by as the years go by, says WHO. India is thus called the Diabetic Capital of the World. Our mission as Dieticians and Nutritionists is to advise and educate not only present diabetics but all family members of diabetics so that they prevent and protect themselves from becoming diabetics.

All adult Indians should have their blood sugar levels tested especially if anybody in their family has diabetes or if they are overweight. If both parents are diabetic, you have a 99% chance of getting diabetes. If one parent is diabetic and any other relative of the non-diabetic parent is also diabetic 75% chance. If one parent is diabetic 50% chance. If any other close relative is diabetic 25% chance.

Prevention:

Diabetes is mostly silent.

Don't wait to see symptoms like thirst, excessive urination, excessive hunger and loss of weight, or sudden weight gain, these symptoms may show up only later.

Early identification can help prevent diabetes. Those with a family history of diabetes should do a routine blood test after age 25. Young girls who have irregular periods must also check for diabetes.

Prevention of diabetes is possible by lifestyle modifications - weight reduction, regular walking and even if thin avoiding binge eating (over eating) or excess alcohol consumption.

Now we have a blood test which helps you to check serum insulin levels and this can give you a clearer picture of whether you are prone to becoming diabetic or not.

Diabetes is classified into Type 1, Type 2, Gestational diabetes and Secondary diabetes.

Type 1 diabetes (previously called Insulin Dependent Diabetes Mellitus or IDDM) is usually seen in young children though it can occur at any age. It is caused by a damage in the beta cells of the pancreas resulting in insufficient production of insulin. The person will require insulin injections throughout.

Type 2 diabetes (previously called Non- Insulin Dependent Diabetes or NIDDM) is mostly seen in adults and is believed to have a strong genetic influence. The main defect here is that the insulins action is affected. It occurs more frequently in obese individuals and responds well to oral medication

Gestational Diabetes Mellitus (GDM) appears first during pregnancy. Such women usually have to be put on insulin along with diet for control of blood sugar, as oral hypoglycaemic agents have not yet been proved to be safe for use during pregnancy. Diabetes may settle after delivery in many cases but some women may continue to have diabetes even after delivery. In general, women who develop gestational diabetes are at higher risk of developing type 2 diabetes later in life.

Secondary forms of diabetes are rare and these usually develop following other disorders like certain genetic abnormalities, alcoholic pancreatitis, infections and intake of certain drugs such as steroids, diuretics and certain psychiatric drugs.

Glycogen Loading to Store Energy before a Game or Sport Event

Today we have research which shows that besides your God given ability and talent to play a game and your training by professional coaches, what goes into your body as food plays a very important role. Food eaten on a long-term basis as well as exactly what you eat 3 days before your event and throughout and after the event have a tremendous influence on your performance. It is very important for all Sports people to concentrate on a high carbohydrate diet from 3 days before an event, game or match. 60-70% of the food should be carbohydrate food. (fruits, sugars, vegetables and cereals-rice, wheat, etc.) This gets converted to glycogen and is stored in the muscles. During a cricket match one has to be able to endure long hours as well as have muscle glycogen, which is where energy is taken from for the spurts of high intensity activity that occurs when you make quick sport moves such as bowl, bat, take a run or run for the ball.

For this we recommend that you make a conscious effort to cut down on all fatty food from 3 days prior to the event. During event and after event replace those calories with large quantities of carbohydrate foods. Use skimmed or low-fat milk, do not apply butter on bread or ghee on roti, avoid coconut chutney and any fried items like vada, masala dosa, etc. in breakfast. Ideally your breakfast should be a glass of skimmed milk with bread and jam, or idli and sambar. or oats porridge or cereal and milk. A boiled egg may be eaten but sausages, bacon, etc. must be avoided. Top up the breakfast with fruits or fruit juice.

Carry with you dilute juice with glucose or other juices but avoid any concentrated drinks and aerated drinks during your event. Between events frequently snack on fruits - banana, dates, raisins, etc. Jelly and crackers may also be eaten. Chocolates and nuts are a definite no as they are high fat and will feel heavy in the stomach without doing the needful.

Lunch too should be a high carbohydrate and moderate protein meal but low in fat. Curd rice, dry roti with dhal, veg sandwiches, macaroni and tomato sauce with a little cheese added. But try to increase your rice or roti intake and control intake of non-veg. Many eat less during the event saying they don't want to feel heavy. Please note, if you fill up on carbs you will not be heavy as they get digested fast. Only if your eat fat then fat takes 6-8 hours to get digested and it feels heavy in the stomach. After the event too do not neglect you're eating. For a player every day is important every event is important and you should take care to replenish your muscle glycogen stores which would have got emptied by the end of your game.

It is recommended that you give 100 gms of carbohydrate with 5-10 gms protein within half an hour after event. This can be got from a milk shake or lassi plus 4 slices bread & jam or 5-6 idli with sambar and some fruits. Later that night's dinner too must be a high carbohydrate meal with lots of rice, dhal, yougurt, but definitely low on fat. Fruit and milk at bed time too is a good way to load carbohydrates. Rich biriyani, poori, paratha and Chinese food are best avoided after a match as they are too high in fat.