Diabetes Any disorder of  the metabolism with excessive thirst and the production of large amount of urine, caused by the deficiency of insulin in which sugar and starch are not properly metabolized. Symptoms of Diabetes There are two  types of diabetes which have signs and symptoms are more likely to be similar as the blood sugar is high, either due to less or no production of insulin, or insulin resistance. In any case, if there is inadequate glucose in the cells, it is identifiable through certain signs and symptoms. These symptoms are quickly relieved once the Diabetes is treated and also reduce the chances of developing serious health problems. Diabetes Type 1: In type 1, the pancreas stop producing insulin due to autuimmune response or possibly viral attack on pancreas. In absence of insulin, body cells don’t get the required glucose for producing ATP (Adenosin Triphosphate) units which results into primary symptom in the form of nausea and vomiting. In later stage, which leads to ketoacidosis, the body starts breaking down the muscle tissue and fat for producing energy hence, causing fast weight loss. Dehydration is also usually observed due to electrolyte disturbance. In advanced stages, coma and death is witnessed. Diabetes Type 2: Increased fatigue : Due to inefficiency of the cell to metabolize glucose, reserve fat of body is metabolized to gain energy. When fat is broken down in the body, it uses more energy as compared to glucose, hence body goes in negative calorie effect, which results in fatigue. Polydipsia : As the concentration of glucose increases in the blood, brain receives signal for diluting it and, in its counteraction we feel thirsty. Polyuria: Increase in urine production is due to excess glucose present in body. Body gets rid of the extra sugar in the blood by excreting it through urine. This leads to dehydration because along with the sugar, a large amount of water is excreted out of the body. Polyphegia : The hormone insulin is also responsible for stimulating hunger. In order to cope up with high sugar levels in blood, body produces insulin which leads to increased hunger. Weight flactuation : Factors like loss of water (polyuria), glucosuria , metabolism of body fat and protein may lead to weight loss. Few cases may show weight gain due to increased appetite. Blurry vision : Hyperosmolar hyperglycemia nonketotic syndrome is the condition when body fluid is pulled out of tissues including lenses of the eye, which affects its ability to focus, resulting blurry vision. Irritability : It is a sign of high blood sugar because of the inefficient glucose supply to the brain and other body organs, which makes us feel tired and uneasy. Infections : The body gives few signals whenever there is fluctuation in blood sugar (due to suppression of immune system) by frequent skin infections like fungal or bacterial or UTI (urinary tract infection). Poor wound healing : High blood sugar resists the flourishing of WBC, (white blood cell) which are responsible for body immune system. When these cells do not function accordingly, wound healing is not at good pace. Secondly, long standing diabetes leads to thickening of blood vessels which affect proper circulation of blood in different body parts.     Diabetes Diet Diet plays a significant role in controlling the diabetes. The diabetic diet may be used alone or else in combination with insulin doses or with oral hypoglycemic drugs. Main objective of diabetic diet is to maintain ideal body weight, by providing adequate nutrition along with normal blood sugar levels in blood. The diet plan for a diabetic is based on height, weight, age, sex, physical activity and nature of diabetes. While planning diet, the dietician has to consider complications such as high blood pressure, high cholesterol levels. With respect to the above factors, a dietician will assess calories to be given, like scheming the carbohydrates, proteins, fats, type of carbohydrate, amount of fiber and so on. Exchange meal plan is a diet program which balances the amount of carbohydrate that we intake per day. Glucose is a sugar released from carbohydrate so, if we want to control blood sugar we have to limit the consumption of simple carbohydrate. Carbohydrate foods are given as value per portion, known as the exchange. This plan helps us to decide on the type of food to be taken, the amount of food and also the time to eat. You can plan for more flexible meals as you get more knowledge about the diet for a diabetic, may be like the counting carbohydrate meal plan or constant carbohydrate. But there is no common diet that works for everyone. Nor is there any particular diet that works perfectly for any diabetic over a long period. While planning diabetes diet we should adhere to certain important factors, they are as follows: Fiber should be at least 1.4 oz / day Instead of 3 heavy meals, we should go for 4-5 small mid intervals Replace bakery products and fast foods by simple whole cooked cereals, and don't eat carbohydrates 2 hours before bedtime Consume fresh fruit and vegetables at least 5 exchange/ day Diabetics always need to take care of their diet and also about the food they eat. Care has to be taken because all foods contain not only carbohydrate, but also some energy value. Protein and fat available in the food are converted to glucose in the body. This glucose has some effect on the blood sugar level, which has to be taken care of. Furthermore, you needn’t have to eat only the bland boring diet. Instead, you can eat more fruits, vegetables and whole grains. All it means is that you need to select foods that are high in nutrition and low in calories. Diabetic Diet may include the following  Fats (Limit to 1 serving per meal) A serving can be:- 10 Peanuts. 1 Tbsp Salad Dresssing 2 Tbsp light salad dressing or saur cream. 1 Tsp margarine, Oil or mayonnaise. 1/8 Avocado. Sweets (Substitute for starch or fruit serving occasionally) A serving can be:- 2 Small Cookies. 1 Small Cupcake or Muffin ½ Cup Ice cream. 1/3 Cup Frozen Yoghurt. ¼ Cup Sherbet. 1 tsp Syrup or Honey. Milk (2-3 Servings per day) A serving can be: 1 cup Milk. 1 Cup Low Fat. 1 Cup Artificially Sweetened yogurt (No sugar) Meat / Fish/Chicken (2-3 Serving per day) A serving can be: 2 oz Cooked Lean Meat/Poultry/Fish. ½ - ¾ Cup Tuna or Cottage Cheese. 1 Egg or 4 oz Tofu or 1 oz cheese. 2 Tbsp peanut Butter. Vegetables (3-5 Serving Per day) A Serving can be: 1 Cup Raw Vegetables. ½ Cup Cooked Vegetables. ½ Cup Tomato or Vegetable Juice. Fruits (3 Serving per Day) A Serving Can be: 70 gm small fruit. ½ Cup canned fruit. ¼ cup Dried Fruit. ½ Cup Fruit Juice. (No sugar) Grains, Starchy Vegetables and Beans. (6 plus Servings Per Day) A Serving Can be:- 1 Slice of 1 oz bread or ½ (1 oz) Bagel or 5 Crackers or 1 Granola bar. ½ Hamburger or Hot dog Bun or a tortilla of 6 inch or 2 tacos. ½ Cup Cooked Cereal, Cooked beans, Lentils, Corn, Peas, S. Potato, Potato or Pasta. 1 Cup winter Squash, 1 Cup Soup. 1/3 Cup Rice or 3 Cup Plain Popcorn (Fat free)   Sample Diabetic Diet - Diabetes Plate Method   A simple step to eat low carbohydrate and low fat diet is to follow Sample Diabetic Diet or Diabetes Plate Method. In order to follow the food guide pyramid for diabetes in all the meals it is essential to visualize the diabetes plate. A sample diabetic diet produces a picture in our brain for the ideal proportion of nutrient intake. This lies especially true for type 2 diabetics, who are in most cases overweight. The problem does not lie is what you eat but off course in the quantity you eat. The diabetes portion plate helps a diabetic to see how much quantity/space the particular food group should occupy on his meal plate. It is nothing but a balanced diabetes diet. This Diet can be used by all the individuals who are overweight and willing to keep diabetes and other heart problems at bay. How to make Diabetic Portion/Sample Plate 1. Divide your plate in ½, and the second half into two equal ¼. 2. Fill the first half with your favorite non starchy Veggies like Lettuce, Broccoli, Spinach, Peppers, Carrots, Green beans, Tomatoes, Celery, Cabbage, and Mushrooms etc. (Note: Restrict the quantity of corn, peas, potatoes, yams and winter squash.) 3. The ¼ of plate with Meat/Protein like Chicken, Beef, fish, Eggs, Tofu, Cottage cheese, Lamb, Turkey etc. 4. The remaining ¼ with brown rice, bread, Potatoes, Crackers, Peas Soup, Cereal, Tortillas, Beans, Yams, Lentils etc. 5. One serving of non fat, sugar-free yoghurt or milk. 6. One serving of fruit like Guava, Apple, Berries or any Citrus. Why Sample Diabetic Diet? Even Distribution of carbohydrate throughout the day to maintain your blood sugar level in target range. It helps to lower down the intake of carbohydrate i.e starches, fat/cholesterol. Contains more Fibre, antioxidants, photochemical s and quality protein which are essential part of nutritionally sound diet. This would eventually show complete breakdown of starches. It is an easy way to promote weight loss with no extra efforts. Weight loss leads to increase insulin sensitivity. Sample Diabetic Diet or Diabetes plate method can be beneficial for :- Working professionals with busy lifestyles. Adult or Senior citizens Newly diagnosed diabetics or diabetics with depression. Low literate diabetics who understand only thumb rule. A diabetic with uncontrolled or dancing blood sugar levels. Overweight, obese or anyone willing to loss body weight. Person with Cognitive difficulty or mentally challenged. Rigid or stubborn person who don’t believe in diet planning. Diet Management During Diabetes   Most of the food items contain carbohydrate, protein and fat. Cereals are rich in carbohydrate, lentils, lean meat, chicken and fish are rich in protein while oils, nuts and milk creams are rich in fat. Fat foods are high in calories; 1g of it provides 9 calories, while 1g carbohydrate or 1g protein gives only 4 calories. Carbohydrate is easily digested than fat and protein. The rise in blood glucose after a meal is due to absorption of glucose from a carbohydrate digestion and increase in production of glucose by liver. Sucrose (cane sugar), sweets and syrups cause a rapid rise in blood glucose than whole cereals like finger millet and wheat products. In people with no diabetes, the rise in blood glucose after a meal comes down to the pre-meal level with in 2 hrs. In diabetes, the rise in blood glucose after a meal is not only higher but the fall to pre-meal level is slower (3-4 hrs). Therefore, snacks in between meals or frequent meals at short intervals tend to cause progressive increase in blood glucose in people with diabetes. Glucose is constantly needed to provide ready energy for the proper functioning of brain, heart, kidneys, liver and blood cells. When glucose is not available from ingested food, our liver produces from its store of carbohydrate (glycocen) and body stores of fats and proteins. The liver produces about 0.1058 oz of glucose/lbs body weight in a day. For example the liver of a man or woman weighing 154 lbs produces 7.0547 oz of glucose in a day. The production of glucose by the liver is kept in a check by small amounts of insulin secreted by the pancreas. These considerations and the modality of your treatment (tablets/insulin) are taken into account for formulating your diet management during diabetes and meal timings. The dietician would give your information on your diet. The general guidelines on diet are: In a typical day’s meals and snacks, you should have 1500-1800 calories with – 60% contribution from the carbohydrate, 20% from fat and 20% from proteins. You may need extra weight reduction. If you are on calorie-restricted diet, make sure to take 50-60% of calories as complex carbohydrate (whole cereals) to prevent any feeling of weakness. You should eat a variety of food items everyday. Do not skip meals. Avoid snacks, unless you are advised to (example during insulin treatment). Don’t over eat. Eat fruits and vegetables. Use less oil in cooking. Avoid fried foods, milk cream or food items cooked in coconut milk. Avoid ready to eat food preparations, sweets and sugary drinks (canned beverages) that provide empty calories (no vitamin or essential minerals). Keep a regular check on your weight – maintain it within the estimated limit. Check your hemoglobin and proteins in blood samples at 6 months or 1 year’s interval, Suitable correction in diet format or supplementation may become necessary. Despite a good control of blood glucose, if your blood lipids are high, you will need lipid lowering drugs regularly. Some times your doctor may advice you lipid-lowering drugs from the beginning of your diabetes treatment. Match your mealtime to the form of insulin and insulin injection schedules as explained by your doctor or the diabetes nurse.                 Diabetes Care   Eat food at fixed hours Do not overeat Do not eat immediately after a workout Make sure you have three proper meals & light snacks in between Eat about the same amounts of food each day Eat your meals and snacks at about the same times each day Make sure the gaps between your meals are short Do not eat fast; masticate and munch your food well before you swallow Drink a lot of water that will help flush the toxins off your system Avoid fried foods and sweetmeats Include fresh vegetable salad in every meal Include sprouts in the diet Take your medicines at the same times each day Exercise at about the same times each day Avoid smoking. Smoking leads to heart disease and poor circulation Check your feet for cuts, blisters, and swelling which are likely to result from diabetes-related nerve damage Take good sleep daily Check your blood sugar level regularly Try to stick up to the plan made up for sugar control Check the other tests such as kidney function, liver function, heart function, ketone level etc Check your weight periodically and maintain ideal body weight     Diabetic Diet Dos   For breakfast, take cholesterol-lowering oatmeal Have nuts rich in mono unsaturated fat, such as pecans, walnuts, and almonds Eat pasta, stews and leafy salads along with beans-- kidney beans, chick peas, and dry beans, navy beans and peas which can reduce LDL "bad"; cholesterol Fat free milk, yogurt, and cheese to be taken Eggs whites to be included White meat chicken and Fish and shellfish (not battered) are good Increase intake of dry beans and peas Have at least 20 to 25 grams of raw onion daily Add wheat bran to your wheat flour (50% wheat flour + 50% wheat bran). This helps increase fiber in your diet You can also add flaxseed and fenugreek seeds into the wheat flour Increase fiber intake in the form of raw fruits, vegetables, whole cereals etc Intake of cinnamon, garlic, onion, bitter melon, guar gum is known to considerably reduce blood glucose level Diabetic Diet Don'ts   Don't fry foods instead bake, boil, poach or sauté in a nonstick pan. Steam or microwave vegetables. Buy tuna packed in water, not oil Eat less high-fat red meat and more low-fat turkey and fish. Avoid organ meats Limit the use of condiments such as ketchup, mustard and salad dress ion--they're high in salt and can be high in sugar, too Rinse processed foods in water and, wherever possible, choose fresh foods over canned Limit your salt (sodium content) Read labels carefully. Soy sauce, brine and MSG, for example, contain a lot of sodium Don't select ready to eat and junk foods items available to you Don't smoke and stop alcohol consumption Don't skip meals and medicine times All About Insulin The failure to make insulin or insufficiency of insulin is termed as Diabetes mellitus. Insulin is a natural hormone which controls the level of the sugar glucose in the blood. Insulin allows cells to use glucose for energy. Cells cannot utilize glucose without insulin. Excess glucose builds up in the bloodstream, increasing the risk of diabetes. Glucose is the body's primary source of fuel. Insulin enables the body cells to take glucose from the bloodstream. The cells might use glucose for production of energy if required, or it is sent to the liver to preserve it, in the form of glycogen. Functions of Insulin In addition to its role of regulating glucose metabolism, insulin also Stimulates lipogenesis Diminishes lipolysis Increases amino acid transport into cells Modulates transcription Altering the cell content of numerous mRNAs Stimulates growth DNA synthesis Cell replication Blood Sugar Levels   Diabetes is a disease characterized by abnormal metabolism of blood sugar and defective insulin production. Blood sugar levels are an important parameter for the diagnosis, treatment and prognosis of diabetes. Blood sugar level is the level of sugar circulating in blood at a given time. Blood glucose levels vary at different time on various part of the day. Some factors that affect blood sugar levels are body composition, age, physical activity and sex. Males and females may also have differing blood sugar level. Normal guidelines for blood sugar: Blood Sugar Range : Level of Blood sugar on waking up with an empty stomach should be normally between 80 to 120 mg/dl. Thereafter normal blood sugar should be between 120 to 160 mg/dl two hours after having food and during bedtime the blood sugar values should be between 100 to 140 mg/dl. Any variations from the above mentioned value range of blood sugar is suggestive of diabetes, if the value of an individual’s blood sugar tends to be more than the upper limit. Repeated blood sugar test is necessary to confirm diabetes. Conditions wherein blood sugar level will be higher other than diabetes: There are certain conditions where blood sugar level of an individual will differ from the normal range and repeated medical tests are necessary to confirm it as diabetes. The various conditions are pregnancy and lactation, fasting, after severe binge eating, fever, severe injuries, after severe physical exertion, severe dehydration, for patients undergoing certain medical therapeutic procedures, etc. In such cases blood sugar level changes are normal and not linked to regular diabetes. Measures to control Blood sugar level: Diabetes can be controlled to a great extent by controlling blood sugar levels. For controlling blood sugar levels it is mandatory for an individual to undergo periodic monitoring of blood sugar levels under the guidelines of the physician. There are many methods to control blood sugar levels. They are- Have proper balanced diet Maintain an active lifestyle Do regular exercises Avoid smoking and intake of alcohol Take proper medications Do skipping meals or eat unhealthy food. A properly controlled blood sugar level will keep the diabetes in check. Adverse effects of blood sugar levels on diabetes patients: While in most of the cases, blood sugar levels will be high in case of diabetes patients, its level can have adverse effect on the patient depending upon its severity and complications. A severely high level of blood sugar may result in various symptoms like breathlessness. It may also lead to complications involving the circulatory system and the blood vessels. A severely low blood sugar level may lead to unconsciousness. So blood sugar level should be kept in proper control for control of diabetes. It is necessary to monitor blood sugar levels at regular intervals.