Living with Diabetes Mellitus
Diabetes is associated with an overly high blood glucose (or blood sugar). Blood glucose is our main source of energy and comes from the food we eat.
Food →Blood Glucose → Insulin → Cells → Energy
Insulin, a hormone made by the pancreas, helps glucose from food get into our cells. This glucose is then converted into energy to be used by our body.
Diabetes is a disease where our body doesn’t make enough insulin or doesn’t use insulin well. As a result, glucose stays in our blood and doesn’t reach our cells. Over time, having too much glucose in our blood can cause health problems.
Common types of diabetes:
- Type 1 Diabetes : This is inherited and usually occurs in children or teenagers.
- Type 2 Diabetes : Most common form of diabetes worldwide, affecting middle-aged and older people due to lifestyle ( e.g. unhealthy diet, lack of exercise, obesity)
- Gestational Diabetes : Occurs during pregnancy and usually goes away after baby is born
Type 2 diabetes is the most common type that affects people worldwide, where the body does not make or use insulin well. Singapore has the second-highest proportion of diabetics among developed nations, a report in 2015, by the International Diabetes Federation (IDF) revealed. Many people are unaware that they are diabetic, and those who are aware, may be controlling their condition poorly.
Learn how to manage Diabetes with our easy to read infographics.
Health Problems From Poorly Controlled Diabetes
Over time, high blood glucose leads to problems such as:
- Heart disease
- Kidney disease
- Eye problems
- Nerve damage
- Foot problems (eg. Foot Ulcers)
- Dental disease
It may be easy to overlook the complications that occur in poorly treated diabetes. This is because diabetes is a long term disease, and many people assume that the symptoms are simply due to the ageing process. However, without proper control, problems can slowly creep up unnoticed and can have a major effect on your loved ones life once an incident occurs.
Complications such as blindness, serious foot problems which require amputation, frequent hospitalisations from hypoglycemia or kidney failure is not only distressing for the person, but also their carers and family members.
If your loved one is living with diabetes, simple steps can be taken to manage their condition and stay healthy.
The role of Nutrition in Diabetes
Good nutrition can help to:
- Achieve near normal blood sugar levels
- Achieve a good HbA1c reading *
- Avoid hypoglycemia
- Prevent/slow the onset of long term diabetes complications such as retinopathy (eye disease) or kidney disease
*HbA1c is the average blood glucose levels for the last two to three months. This can be checked at the clinic/medical centre by the Nurse.
Monitoring blood glucose & HbA1c
You can help your loved ones by checking to see how their food, exercise, medication or insulin and even stress affects their blood glucose levels. Knowing their blood glucose and glycated haemoglobin ( HbA1c) levels can help them make necessary changes to their lifestyle.
Healthy eating prevents sugar in the blood from skyrocketing or dipping too low. Both scenarios are dangerous for your loved one. As we know, people who are overweight or have obesity have added pressure on their body’s ability to use insulin to properly control blood sugar levels, so, by encouraging healthy eating, you can help keep your loved ones’ weight down and prevent complications from diabetes. There are several ways to plan what and how they should eat. Make sure that they:
Your Diet Should Include More:
- Complex starches. Complex Starches take longer time to break down in our body so they raise our blood sugar gradually instead of causing sugar spikes e.g. Whole grain and complex starchy foods are brown rice and noodles, multigrain bread, potatoes and whole wheat roti.
- Low Glycemic Index (GI) foods. The GI is a ranking of carbohydrates in foods according to how they affect blood glucose levels. The lower the GI of a food, the slower and lesser the rise in blood glucose levels. Foods such as multigrain bread, bran, barley, semolina, all types of beans, sweet potato, yam, apples, pears, plums, orange, kiwi and peaches are lower in GI. 1
- Fibre. High fiber foods and supplements help lower cholesterol and keep our blood sugar low. Sunfiber is one of the world’s most well-researched fiber supplement. It is a multi-function dietary fiber supplement that works as a prebiotic to keep the gut healthy, relieves constipation and diarrhoea, lowers cholesterol, and lower the glycemic index (GI) of foods. These benefit diabetics greatly, and can be added to any food/beverage. 2
- Vegetables.They are naturally low in fat and in calories and full of vitamins, minerals and fibre. Vegetables include: spinach, broccoli, cabbage, bok choy, kai lan, kai lan, carrots, tomatoes, cucumbers and lettuce. 3
- Foods in moderate amounts of protein such as fish and skinless chicken, eggs, beans, lentils (dhaal), tofu, tempeh, nuts and low fat milk and cheese. 4
- Use more whole spices, lemon juice or natural seasonings such as shallots, onions, garlic and parsley to spice up the meals instead of adding table salt.
Your Diet Should Include Less:
- Trans fats from partially hydrogenated or deep-fried foods, especially those high in sugar, baked goods, sweets, chips, desserts.
- White bread, sugary cereals, refined pastas or rice.
- Sweets, cakes, condensed milk, soft drinks, and iced teas which are very high in sugar.
- Processed meat and red meat.
- Low-fat products that use sugar to replace fat, such as fat-free yogurt. Help your loved one read the packaging on foods to see how much sugar is in the product.
- High-fat foods such as butter, cream, whole milk, ghee, cooking oils such as palm and coconut oil, and lard. In diabetes, any extra weight your loved one puts on, puts them at risk for heart disease. So limiting fats – including chicken skin, fatty meat, and full-fat dairy foods – is important.
- Deep fried foods, instead, have more steamed, stir-fried or baked foods.
- Salty foods such as salted chips, soups and gravies, canned, preserved and processed foods ( hot dogs, preserved ham, luncheon meat, dried salted plums, salted cabbage, instant noodles with their powdered seasoning), stock cubes, seasonings and sauces. Too much salt in our diet can increase the risk of hypertension, stroke and cardiovascular disease.
* Please note that if your loved one is eating poorly and losing a lot of weight, then such diet restrictions do not apply to them. They should instead have smaller, more frequent meals which are packed with protein and calories, and include snacks to prevent their blood sugar levels from dropping. 5
Eat at the right time
The timing of meals can affect our blood sugar levels. If we go hungry for too long, our sugar levels can be too low. If we eat meals too close together, or snack throughout the day, our sugar level can be too high. It is important to eat after taking medicine or insulin to make sure sugar levels don’t fall too low. Make sure your loved one does not skip meals.
Eat the right amount
The amount of food that we eat will also affect our blood sugar levels. Encourage small, frequent meals rather than big meals. If you are helping your loved one check the sugar in their blood, make sure you help them to write these readings down. This way, when they have their next doctor/nurse check up, it can be easier to see where changes need to be made.
Keeping active in later life helps to strengthen muscles, maintain mobility and balance and improves our bodies insulin levels. It can help your loved one to continue to be independent for as long as possible. Exercise also improves their mental well-being and prevents falls. Older people, including those are frail, have been shown to benefit from light resistance and balance training such as Tai Chi or climbing small steps of stairs. Strength and flexibility exercises for those who are housebound and confined to a bed or chair can be taught by a physiotherapist and supported by you. Remember to check with their Doctor before starting any new exercise.
It is important to stick to the same dosage and timing for diabetes medications or insulin to keep blood glucose levels consistent. When your loved one feels okay, it doesn’t mean they can stop taking their medicine or change the dosage. It means the medicine is working and they need to keep on taking it. If they feel worse, they should talk to their doctor and change to a different medicine or dosage until their condition improves.
Talk to your loved one’s doctor if you notice any changes in personality, such as moodiness, irritability, change in eating or sleeping habits, or loss of energy.
Keep in mind that as they age, their memory becomes weaker, they may not be able to move around as before, and they may have trouble with taking medication, using insulin injections or doing blood glucose finger pricks which can take their toll on diabetes self-care.
Hypoglycemia can happen when the level of sugar in a diabetic person’s blood is too low. This happens if they:
Your loved one may be having a hypoglycemic episode (Hypo) if they are:
The consequences of untreated hypoglycemia can be severe and life-threatening. You will need to act fast and help them to increase their blood sugar levels if they are having a Hypo episode by following these steps:
About Health Food Matters
At Health Food Matters the team of healthcare experts, chef, and food technologist develop scrumptious Delisoft Easy Meals which are nutritious and they come in different textures. We also carry a range of snacks and desserts from Our Special Pantry to provide a much needed boost for those who struggle with getting enough nutrition daily.
Health Food Matters carries a large selection of nourishing snacks, desserts and thickeners which can be grabbed off the shelf anytime. Visit their website for more information about their wide variety of food options to satisfy your loved ones taste buds.
At Jaga-Me, we believe in making healthcare accessible and available to everyone. We provide personalised and curated care for your loved ones. If you need a trained medical escort to accompany your loved ones for their medical appointments or a trained nurse to do nursing procedures in the comfort of your home, let Jaga-Me share your caregiving responsibility.
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