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How Should Diabetes Be Managed? World Health Organization (WHO) warns that a diabetes epidemic is underway. In 1985, about 30 million people worldwide had diabetes. By 1995, the number had shot up to 135 million. The latest WHO estimate is 177 million in 2000 and will increase to at least 300 million by 2025. The number of deaths attributed to diabetes was previously estimated at just over 800,000. But a more realistic figure is around 4 million deaths per year, which is about 9 percent of the global total. It is expected that the epidemic will continue to grow without primary prevention. Experts estimated that diabetes mellitus would become one of the world’s leading disablers and killers within the next 25 years. That is why WHO urges immediate action to be taken to curb the tide and to introduce cost-effective treatment strategies to reverse the trend. Diabetes mellitus, or simply diabetes, is a condition in which a person has high blood glucose (blood sugar), either because the body does not produce adequate insulin or because the body's cells do not respond properly to insulin, or both. Patients with high blood sugar will typically experience frequent urination, become increasingly thirsty and hungry. Diabetics have a higher chance of developing many chronic diseases including heart disease, high blood pressure, stroke, gum disease, peripheral arterial disease, kidney disease and getting eye, skin and foot complications. One way to manage diabetes is to avoid certain foods like refined carbohydrates, and added sugars and sweeteners that could eventually lead to weight gain, insulin resistance, and diabetes. In fact, besides diabetes, many of the health disorders are actually linked to overconsumption of carbohydrates.
Being authored by more than 24 international experts, a critical review provided major evidence proving that low-carbohydrate diets should be the first approach for Type-2 diabetes and the most effective adjunct to medications for Type-1 diabetes. The paper was published online July 16, 2014 in journal ‘Nutrition’. Authors of the paper argued that such restricted diets reduce high blood glucose and reduce or simply eliminate the need for medications that often lead to side effects. While losing weight is always part of managing diabetes, the benefit of low-carbohydrate diets does not require patients to lose weight. They further stressed that low-carbohydrate diets have little risk and good compliance, comparing to low-fat diet that have generally been found to be ineffective. They suggested replacing carbohydrate with fat or protein because of better glycemic control, weight loss, cardiovascular-risk markers and reduction in medication. This can benefit both Type-1 and Type-2 diabetes. Many variations of low-carbohydrate diets are available. One strategy mentioned is Paleo Diet that emphasizes meat, vegetables, nuts, and extra-virgin olive oil, with just a moderate amount of fruit. It is similar to a Mediterranean Diet without all the pasta, rice, bread, and sugar. Avoiding processed foods is a main part of this approach. Glycemic index, a guide to how carbohydrates break down in the body and affect the blood glucose level, is a good measurement tool for deciding what is good food and what is not so good food. The American Diabetes Association advises people should apply glycemic index to those they eat in addition to reduction on carbohydrates. People should choose foods that are low on the index, like oatmeal, sweet potatoes, corn, lima beans, carrots, legumes and greens. Foods like white bread and bagels, instant oatmeal, white rice, macaroni, pretzels, rice cakes, popcorn, and saltine crackers should be avoided. Fruits rich in fructose (natural sugar) like watermelon, pineapple, mangos, papayas and dried fruits should also be kept away. Instead, people should eat berries, apricots and apples that are some of the lowest fruit on the index. Intake of sugar and high fructose corn syrup should be minimized, too. Meanwhile, it is best for people to consume at least a couple of servings of raw vegetables a day as they are packed with natural enzymes, antioxidants, minerals and insulin regulating fiber.
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