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Diabetes: No Sugar Coating It

Amardeep Chetha, M.D.

The number of Canadians with diabetes in in 2015 was 3.4 million and is expected to grow to 5 million in 2025, according to the Canadian Diabetes Association (CDA).Some populations are at higher risk of type 2 diabetes, such as those of South Asian, Asian, African, Hispanic or Aboriginal descent, those who are overweight, older or have low income. Additionally, fifty-seven percent of Canadians with diabetes reported they could not adhere to prescribed treatment due to the high out-of-pocket cost of needed medications, devices and supplies. These facts provided by the CDA makes preventative care of utmost importance.
Diabetes in the South Asian community is growing and will continue to grow, but we can prevent diabetes to a certain extent by understanding what diabetes is and how someone can start to take better care of themselves. Many South Asians understand diabetes in the limited context of “high sugar” when there is additional consequences that are vital to understand; I have seen most Punjabis with the condition will still eat a ladoo here and there but just try to watch sugar intake for the remainder of the day. You may assume that one ladoo is insignificant in the grand scheme of your day; after all, it’s just a little bit of sugar right? Wrong. What may be most shocking is that the percentage of children and adolescents who are overweight or obese now accounts for almost one third of the current population.  These overweight or obese children will most likely get diabetes earlier in life, more specifically due to eating foods with a high sugar content. It is important to understand the different types of diabetes and what this could mean for an individual.
Please note that this article focuses on two of the most prevalent and relevant categories of diabetes for the South Asian community:
•    Type 1 Diabetes is typically genetic, with little room for prevention with environmental factors such as exercise and a healthy diet. It is an autoimmune condition in which the body does not allow the pancreas to produce insulin. Insulin is a hormone that regulates the amount of glucose (or naturally occurring sugars) in our blood. Symptoms include:
-Increased thirst
-Increased urination
-Increased Hunger
-Rapid unexplained weight loss
•    Type 2 Diabetescan also be inherited, but environmental factors tend to play a larger role in causing this. This is where the pancreas is not producing enough insulin to move glucose out of the blood stream, causing a build up. This build up of glucose is problematic and leads to the following types of symptoms:
-Increased thirst
-Increased hunger
-Increased urination
-Blurry vision

In particular, theSouth Asian population is at higher risk of developing type 2 diabetes due to the lack of muscle mass and more abdominal fat, which increases insulin resistance. Lack of daily physical activity, smoking, diets high in white flour and rice, refined grains and cooking oils and butters that are commonly used in South Asian cooking are major contributors to type 2 diabetes.Having type 2 Diabetes can lead to other health issues such as:
1)    Cardiovascular: Heart disease and stroke.
2)    Kidney: Protein loss in urine, which can be detected by a physician through urine analysis.
3)    Eye: severe vision loss, blindness, cataracts, glaucoma.
4)    Nerve damage: Numbness or tingling in hands, toes or feet.
Other types of diabetes include gestational (diabetes during pregnancy) and juvenile (young individuals with diabetes). If there are any concerns about the possibility of any of these, please consult a doctor as soon as possible.
There are a variety of precautions that can be taken to avoid diabetes or to take better take of an individual with diabetes. Some simple but easylifestyle modifications include:
–    Diet: avoid saturated fats & added and refined sugars. Foods high in these include: cookies, sodas, white flour (atta), ghee (clarified butter) and white basmati rice. Instead, you can use: brown basmati rice, cornmeal (aka makki di roti), gram flour besan or whole-wheat flour (whole wheat atta). These are readily available in local Indian stores as well and offer a great alternative without drastic sacrifices in diet.
–    Exercise: moderate intensity exercise for 30 minutes, 5 days per week.  Try to take the stairs instead of the elevator if health conditions permit and take a daily walk to start with.
–    Weight loss (being overweight increases the chances of diabetes). Regular exercise and a healthy diet as mentioned above helps to achieve this.
–    Blood pressure monitoring. Individual blood pressure monitors are available at local health stores. If possible, keep track of times of day and blood pressure in a journal.
–    Blood glucose monitoring devices. These are also available in local health stores and can be administered at home.
–    Cholesterol level monitoring, which can be checked by the doctor during annual physicals.
–    Yearly eye exams. Visiting the optometrist should not be neglected because poor eye health can be an indication of other internal issues.
–    Kidney exams. This can also be performed by a physician
–    Diabetic foot exams, as nerve loss usually begins in the feet.

If you are diagnosed with any type of diabetes, the doctor will go throughan individual treatment plan that is most conducive to success.

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