Prevention is key in Diabetes
August 2004
By Aalif Surti
Exercise, healthy diet, regular lifestyle can help save us from falling prey to diabetes
Diabetes Mellitus, commonly called diabetes, is a life-long disease marked by high levels of sugar in the blood. It is a condition that makes many people worry about the quality and longevity of their life after being diagnosed with it.
India has the dubious distinction of being home to the largest number of people suffering from diabetes in any country. Having turned into a huge public problem today, it is growing astronomically year after year. Today, nearly 20 million people in the country are suspected to have the disease.
The term diabetes refers either to a deficiency of insulin or to the body’s decreased ability to use insulin. Insulin, a hormone secreted by the pancreas, allows glucose (sugar) to enter body cells and be converted to energy.
There are two main types of diabetes: Insulin dependent (Type-1) and non-Insulin dependent (Type-2). Non-insulin dependent diabetes, which usually appears after the age of 40, is the most common type. Insulin-dependent diabetes affects below-40 people. Although this type of diabetes can occur at any age, it most often appears in childhood or during the teen years.
Anyone can get diabetes but almost all of them can lead a full, active life with regular control of their diet and medicines. Let us see what different medicinal systems have to say about diabetes.
INSULINE-DEPENDENT (TYPE I)
Ayurveda
It is known as madhumeha in Ayurveda. According to some Ayurvedic physicians, ancient scriptures describe 20 types of Prameha (derived from the root Mih, which means to pass urine, and Pra, means in excess) which, if continue to be neglected, lead to madhumeha.
Diabetes is difficult to treat as it leads to many complications. The natural, soft, simple ayurvedic remedies cannot often cure it, especially if the disease starts at a younger age. They, however, can relieve many side effects and improve the quality of your life.
Broadly, ayurveda describes three types of diabetes. They are:
• Vatika: When vata dosha accumulates in the intestines and affects the function of the pancreas. This type is generally considered to be incurable.
• Paittika: When pitta dosha accumulates in the small intestines. It affects liver and ultimately disturbs the function of the pancreas. It can be controlled with appropiate medicines and changes in lifestyle.
• Kaphaja: It occurs when kaphogenic foods such as excessive intake of sweets-sour-salty (madhur-amla-lavan) foods are taken. These foods increase kapha dosha in the last part of the stomach. The condition results in weight gain. Ayurveda indicates that this condition can be managed with effective lifestyle changes, balanced diet and medicines.
Based on this information, the ancient ayurveda surgeon Sushruta classified Prameha into two types: Hereditary (Kulaja Sahaja) and acquired (Apathyaja). Similarly, another famous ayurvedic physician Charaka classified people with diabetes into two groups: obese (Atishaulya) and asthenic (Krisha).
Treatment
Ayurveda recommends innumerable single medicines, simple preparations, compound preparations and dietary modifications for treatment of this ailment. Food recommended include barley seeds, wheat, kodrava (a kind of grain), Italian millet, mudga (phaselous bean), kulattha (dolichos bean) and Adhaki (Pigeon grain); fruit and leaf of patola and Sigru (horse radish), fruits of karvellaka (bitter gourd), udumbara (gular-fig), kapittha (wood apple) and jambu; leaf and stem of guduchi and triphala.
Foods to be avoided include sour, sweet and excessive salt, freshly harvested grain, rice, sweet drinks, jaggery, curd, excessive ghee and oil.
In addition to this, one should avoid sedentary lifestyle, sleeping during the day, spppressing the urge to pass urine and eating excessive food.
Homoeopathy
Homoeopathic medicines are not recommended for Insulin Dependent or Type I diabetes. Yet, there are three main aims of homoeopathic treatment:
• To control the blood sugar levels;
• To reduce the dose of allopathic medicines for diabetes; and
• Prevent complications of diabetes on other parts of the body such as eyes, kidney and nerves.
A homoeopath first asks for a detailed case history before embarking on the treatment. It is important to tell the doctor any physical or mental stress that may have been present when the symptoms first appeared. It is likely that these stresses might have precipitated diabetes. Homoeopathy offers a wide range of medicines beneficial to these stressed people.
Diabetes tends to run in families. There are several homoeopathic medicines that are effective in such cases like Thuja,Tuberculinum and Medorrhinum.
The doctor also tries to find out the individual symptoms like eating habits, likes and dislikes, digestion, bowel movements and sleep patterns. After this, he would recommend tests to determine the blood and urine levels.
Treatment
There are several homoeopathic medicines that are specific to diabetes and aim at reducing the blood sugar levels. These medicines act directly on the defence mechanism of the body and enhance the body’s natural ability to fight disease. For example, Syzygium, Jaborandi, Gymnema sylvestre, uranium nitrate, phosphoric acid, lactic acid, acetic acid, phosphorus, etc.
Homoeopathy also recommends the patient to follow restricted diet, excercise and relaxation techniques like yoga and meditation to help deal with stress better and to maintain normal blood sugar levels.
Nature Cure
Nature Cure opines that the treatment of diabetes includes measures to improve the function of liver and pancreas.
Treatment
It recommends four approaches for the management of the ailment. Dietary modifications which include regular meals, water, salad and a high-fibre diet; water therapy and mud therapy to improve functioning of the pancreas and the liver and to remove toxins from the body; exercises including deep breathing, yoga, brisk walking, jogging; and a regular lifestyle that is in harmony with nature and its principles such as regular dietary timings and regime. According to this system, medicines cannot help until lifestyle changes are incorporated.
Allopathy
According to allopathy, diabetes is a disorder of the chemical reactions that are necessary for proper utilisation of carbohydrates, fats and protein from the diet along with inadequate or lack of insulin.
All cells in our body need energy in order to function normally. This energy is derived from the food we eat which is made up of carbohydrates, proteins and fats. The food is converted into glucose, the main source of energy, for all the body cells. The excess glucose is stored in the liver and muscles as a compound called glycogen. When the insulin is inadequate, absent, or abnormal, it is difficult for the glucose to enter the cells and provide energy.
Normally, pancreas releases insulin proportional to the amount of food we eat. In diabetes, pancreas either does not produce insulin or produces too little or produces defective insulin that cannot be used by the body. Thus, the blood glucose cannot be used effectively by the cells and excess glucose cannot be stored in the liver.
The main symptoms of diabetes include increased thirst, increased hunger and increased frequency of passing the urine.
Listed below are predisposing factors that increase the risk of getting diabetes:
Hereditary: Blood relatives of people with diabetes are more likely to develop diabetes than those who do not have it in their family. There is five percent risk of developing diabetes if your parents or siblings have diabetes.
Obesity: The risk may increase to 50 per cent if you are overweight. Excess weight increases the body’s demand for insulin.
Age: The risk of diabetes increases with age, especially after 40 years as the ability to produce insulin decreases as age advances.
Gender: Both men and women have the same risk of developing diabetes till early adulthood. After 30, women are at higher risk as compared to men.
Viral infections: Some viral infections may destroy the beta cells, thus leading to diabetes.
Injury: An accident or injury that damages the pancreas and therefore causes diabetes.
Stress: Some hormones released during stress may block the effect of insulin on the cells, thus leading to diabetes.
Sedentary life: Some of the recent studies indicate that people with sedentary lifestyles are more likely to have diabetes as compared to those who lead an active life.
Diabetes can be diagnosed by blood and urine tests. Until some years ago, urine tests were routinely recommended for diagnosis of diabetes. However, it is not recommended anymore because several other health conditions and medicines may give false positive results. Occasionally, an oral glucose test is necessary to confirm diagnosis but it is not recommended to people who are on bed rest or suffering from some disease, especially infections.
Complications
Complications of diabetes can be either acute because of insulin deficiency, which increases blood sugar to very high levels and chronic because of changes in the blood vessels of various parts of the body. Acute complications include diabetic ketoacidosis and repeated infections.
People with diabetes are more likely to have diseases of the heart, blood vessels, kidneys, eyes and the nerves.
However, these complications are preventable through the following measures:
• Always maintain good control over blood sugar levels.
• Maintain normal blood pressure. If you have high blood pressure, take medicines prescribed by your doctor regularly.
• If you are obese, reduce your weight through proper diet control and regular exercise.
• Reduce intake of fats and cholesterol in your diet.
• Develop a routine of regular exercise after consulting with your doctor.
• Do not smoke.
Treatment
Diabetes cannot be cured but can be controlled through several ways. These mainly include insulin, medicines, diet control and exercise. For the Type I diabetes, a regimen of insulin injections, diet and exercise are recommended.
The insulin injection regimen for the patient is based on:
• blood sugar levels
• desired degree of diabetic control
• extent to which the insulin produced by the pancreas can fill the gap left by the insulin injections
• lifestyle
• ability to adjust to insulin injections.
There may be certain complications that may emerge during insulin therapy, like low blood sugar, insulin allergy and resistance, local reactions at injection site and swelling of the body.
Unani
This system defines diabetes as a condition in which there is excessive thirst and increased volume and frequency of passing urine. It is caused due to the ‘hot’ temperamental derangement of the liver. Diabetes is thus called Ghair Maddi disease in which the temperament of the liver is altered.
Treatment
The main aim of the treatment is to restore the normal temperament of the liver. The aim can be achieved through diet, medicines and exercise. Single medicines recommended for the ailment include tabasheer, karela, jamun, kashneez, kateera, khashkash, shaznaj, gulnar and gurmar, while compound medicines include tabasheer, sharbat anar, safoof khisht, majoon falasfa and kushta qalai. non-insulin dependent
NON – INSULINE DEPENDENT (TYPE – II)
It is a condition where insulin injections are not essential to maintain normal blood sugar levels. It is more common in the 40 plus age group, and among the obese.
Hereditary factors, obesity, malnutrition, prolonged intake of medicines, etc. can lead to Type II diabetes.
Treatment
There are three approaches to the management of non-insulin dependent diabetes: diet, exercise and medicines. Weight-loss is associated with immediate and long-term benefits in people with non-insulin dependent diabetes. Your doctor will recommend an ideal diet based on factors such as your current eating habits, lifestyle, age, sex, occupation, blood cholesterol levels, presence of high blood pressure and other health problems.
Food exchange is an important factor in managing Type II people. Here, one can substitute an equivalent amount of calorie in the same group of food. For example, one can substitute one chapatti with other cereals such as rice, potato or bread in the amount that gives approximately the same calories as one chapatti.
Type II people may be treated with oral medicines, like sulphonylurea, biguanides, alpha-glucoside inhibitors, etc., insulin injections or a combination of both.
If diabetes is not controlled effectively by sulphonylurea, then the doctor is likely to either recommend adding metformin or insulin therapy.
Important thing for Type II people is to make finer adjustments in the medicines, diet or exercise.(Compiled by Nishant Arora from Health Update).
Contact: Dr Savitri Ramaiah, Email: savitri_ramiah@vsnl.com
• Increased frequency of passing the urine, including at night • Excessive thirst • Excessive hunger • Feeling tired and weak most of the time • Loss of weight • Slow healing of cuts and wounds • Numbness or tingling in the feet • Skin infections • Blurred vision • Dry or itchy skin Box on page no. 20 Types of diabetes • Insulin dependent diabetes • Non-Insulin diabetes • Malnutrition related diabetes • Due to diseases of the pancreas • Due to protein deficiency • Diabetes associated with other conditions • Cancer of the pancreas • Abnormalities of other hormones • Due to medicines such as steroids • Abnormalities of insulin or its receptors Some hereditary conditions of diabetes
Diabetes cannot be cured but can be controlled through several ways. These mainly include insulin, medicines, diet control and exercise
Guidelines for dietary intake in Type II diabetes • Avoid biscuits, cake, or other bakery products as snacks between meals. • Use fats and oils that are low in saturated fatty acids. • Drink large volumes of water, skimmed milk and other low-calorie beverages in between meals. • Eat regular meals. • Avoid fried and sweet foods. • Increase intake of vegetables by two times in every meal. • Have rice, chapatti, bread, potato, or other cereals. • Drink water or sugar-free drinks whenever you are thirsty. • Eat smaller portions of meat or eggs. • Eat smaller portions of pulses.