World Diabetes Day 2018: The family and diabetes

Dr. Th. Premchand Singh *

The prevalence of diabetes is increasing all over the globe with an estimated 425 million people currently living with diabetes in the world and India according to International Diabetes Federation (IDF)has 72,946,400 people with diabetes, a prevalence of 8.8%. A recent Indian Council of Medical Research sponsored study suggests the widespread seriousness of this condition across rural and urban areas of India with some areas showing prevalence as high as 13%. It has also been seen that diabetes in India is different with onset at a younger age, higher risk even at lower body mass index, higher abdominal adiposity, higher cardiovascular disease and stroke.

Every year Nov 14 is observed as World Diabetes Day. It marks the birthday of Frederick Banting, who, along with Charles Best, had the idea that the pancreas’ internal secretion, which regulates blood sugar, might hold the key to the treatment of diabetes. They were right, and insulin was discovered in 1922. World Diabetes Day was launched in 1991 by the International Diabetes Federation (IDF) and World Health Organisation (WHO) in response to concerns about the escalating health threat from diabetes.

Each year a new theme is chosen by the IDF to address issues facing the global diabetes community. The theme for World Diabetes Day 2018 and 2019 is ”The Family and Diabetes”. A two-year timeframe has been chosen by IDF to best facilitate planning, development, promotion and participation. Materials and actions that IDF will develop over the two years of the campaign will aim to raise awareness of the impact that diabetes has on the family and support network of those affected; and promote the role of the family in the management, care, prevention and education of diabetes.

IDF beliefs that families have a key role to play in addressing the modifiable risk factors for type 2 diabetes and must be provided with education, resources and environments to live a healthy lifestyle. Most of the cases of diabetes are type 2 diabetes, which can be prevented or delayed by some changes in life style. Life style modification is reduction of weight, a healthy and balanced diet, regular physical activity, and the promotion of healthy living environments.

It has been observed that only half of all the cases with diabetes is diagnosed diabetic, the other half remains undiagnosed. Family has a role in screening and early diagnosis of diabetes and treatment. Modification of the lifestyle of the family will help to achieve healthy outcomes and prevent complications of diabetes .

It is therefore important that ongoing diabetes self-management education and support be accessible to all people with diabetes and their families to facilitate blood sugar control, prevent the present and long term complications. It reduces the emotional impact of the disease that can result in a negative quality of life. Improving access to affordable diabetes medicines and care is also necessary to avoid increased costs for the individual and family, which impact on health outcomes.

Life style modification:

Life style modification helps to prevent or delay the development of diabetes. A little change in life style for the better is simply a good nutritious diet, exercise and loss of weight in obese people.

Diabetic Diet: The nutritional requirements of the person with diabetes are same as for non-diabetic persons. It is a balanced diet consisting of all the macronutrients like carbohydrate, protein and fat as well as micronutrients like vitamins and minerals necessary for a healthy person in right proportions.

The plate method:

The plate method of foods to be consumed by people with diabetes was designed by the IDF.

Vegetables: In the plate half be filled by vegetables. Vegetables are full of vitamins, minerals, fibre, and low in fat. Vegetables that should be at the top of your food list should be dark green and deep yellow vegetables, such as spinach, kale, broccoli, romaine lettuce, carrots, cucumbers, chillies and peppers.

Grains and Starches: Half of the remaining half or one quarter plate be filled with grains and starches. These foods contain mostly carbohydrates. Bread, chapattis, cereal, rice are food in this group made of grains, such as wheat, rye, and oats.

Proteins: The remaining quarter is filled with foods containing proteins. Whole dals, pulses and legumes, tofu, soy products , dried beans, milk , curd or yogurt, eggs, fish, chicken, turkey, meat, are good sources of protein. Fish and poultry are best chosen than red meat like pork and beef, because it has less fat. Baking, roasting or grilling is preferable to frying.

Fruits: Fruits provide important vitamins, minerals, and fiber. Fruits also contain carbohydrates. Whole fruits with skins are preferable than fruit juices because of the fiber content. This group includes lemon, oranges, apples, blackberries, grapefruit and peaches, pears, and apricots, tangerines, cantaloupe, strawberries. It is recommended that one should have 2 – 4 servings per day.

Fats: Small amount of fat in the form of cooking oil is allowed in a healthy diet. All vegetable oils except for coconut oil are unsaturated fat and allowed. Saturated fats like butter, cheese, ghee, those oils which freeze in cold are best avoided. Foods to be avoided: Foods to be avoided are sugar, jaggery, ,glucose, cream, cheese, rolls, cakes, pastries ,fried chicken and mutton, pork, pizza, burger as well as potatoes, sweet potatoes, arbi and fruits like banana, pineapple, litchi, chikoo, grapes and frozen fruits.

Exercise: Physical activity is another important part of diabetes management plan. Exercise not only burns calories, which can help with weight reduction, but it also can improve the body’s response to the hormone insulin, helps control blood glucose levels. The more strenuous is the workout, the longer the effect lasts. But even light activities, such as housework, gardening or being on feet for extended periods are helpful in the control of diabetes mellitus.

Aerobic exercises are often recommended which burns glucose and fat. It makes the heart and bones strong, relieves stress, improves blood circulation, and reduces risk for heart disease by lowering blood glucose and blood pressure and improving cholesterol levels People of all ages should include a minimum of 30 minutes of physical activity of moderate intensity on most, if not all, days of the week.

Examples of aerobic exercise include walking, jogging, cycling, swimming, rowing or playing tennis and badminton. Brisk walking is often advocated because it is simple, inexpensive and needs only a pair of walking shoes. It may be break up into bouts of 10 or 15 minutes two or three times a day . Research has shown that the health benefits are similar.

Conclusion:

Family has an important place in the early detection and management of diabetes. Simple modification of the life style of the whole family may prevent or delay the onset of diabetes. Life style modification is simply a good nutritious healthy diet and regular exercise. Walking is one of the best aerobic exercise which everybody can do, inexpensive needing only a pair of good walking shoes.