Diabetes is more famous as ‘Blood Sugar’ in common parlance-
Even doctors may also ask- Do you have Blood Sugar? But little do we know that
Diabetes is a lot more than just rise in Blood Sugar levels. Diabetes actually
is more about Energy storage and use- about growth and development. As one of
the hypothesis of development of Diabetes goes- ‘the thrifty genes theory’- our
ancestors were too dependent on the vagaries of weather, rain, floods , famines
for food ; During the times of a good harvest they would eat well and their
bodies make huge stores of energy inside ( as fats) - which would help them
survive famines and floods. But with the onset of farming, food security
increased – food became available throughout the year to all, but the body is
still working in its old ways- conserving energy and depositing it as fat.
Fats are the most concentrated form of energy in our body, 1
gm of fat
provides 9 kcals, more than twice as much as 1 gm of
glucose. A 60 kg male may have upto 15 Kg of fat
while a female of same weight may have up to 20 kg of fat. 20 Kg of fat can provide
sufficient heat to boil 1800 litres of water or make
9000 cups of tea!
Hormone insulin has a pivotal role to play in the process of
fat storage and utilization. After intake of meals Insulin not only decreases
blood glucose but also promotes storage of digested fats into fat cells ( storage department of fat). During absence of fats in the
blood insulin promotes their utilization from fat stores. This is why many Diabetics are obese
(specifically those suffering from type 2 Diabetes). This type of Diabetes is
caused due to insulin resistance i.e.. body cells
become resistant to the actions of insulin- hence more and more of insulin is
required to bring about the same glucose lowering - the excessive insulin
results in large fat deposits- which themselves cause more insulin resistance
and destroy the insulin producing beta cells in pancreas because of toxic effects of
fat; this forms a vicious cycle which ends up in clinical Diabetes and its
numerous side effects.
Insulin also encourages protein formation – proteins are the
building blocks of our body. Presence of insulin in blood stimulates, whereas
its deficiency causes destruction of proteins- This is the reason that mothers
with Pregnancy induced Diabetes have large babies ( Due to excessive insulin
because of insulin resistance) whereas Type I Diabetics are generally thin (
since they do not have insulin of their own).
Its
not necessary for a Diabetic to completely stop eating sweets, bread, rice etc.Whats more important is the how the food gets
digested and absorbed by intestines. Partially cooked foods would not be
immediately absorbed and slowly increase blood glucose, Long grain rice like
Basmati also gives slower rise in glucose, Breads with dietary fibre and whole grains may also prevent sudden rise of
glucose levels, Green vegetables and fruits are also slowly absorbed. A
diabetic has to be innovative and find things suitable both for the palate and
the body, this is not difficult- leave alone impossible.
Exercise perhaps is one of the boons that a Diabetic enjoys.
Perhaps there would be very few conditions afflicting the human body where a pleasant
stroll could double up as treatment. Exercise not only helps consume the excess
glucose and fat it increases blood flow to heart, muscles of legs, kidneys,
decreases blood cholesterol, increases protective cholesterol. Exercise works
as a medicine- it increases insulin sensitivity, which helps the body to more
avidly respond to insulin and decreases its total quantity.
Every Diabetic’s foremost need and responsibility is to
understand the disease, this condition requires continuous attention, application
of the patients creative mind, innovation- what to eat? When to eat? How to
prepare? How to increase physical activity? These questions have to be answered
by each Diabetic individually, off course with the help of a Doctor or a
trained professional.
Diabetes requires Total control- for total success.
Wishing all Diabetics Good control over Diabetes, Healthy
and happy life on the occasion of World Diabetes day.
Dr. Rajesh Kesari M.D
