For diabetics, managing their diet can be much like a long term scientific experiment. Regular measurements, learning through trial and error and planned exercise all pay off, especially when you make a point of diligently observing the effect these things have on your body, says Consultant Dietician S. Ramya Devi.

Regular monitoring is important

Dealing with diabetes is a lifelong commitment, Ramya says. Adhering to your diet and exercise routine and taking your medication as prescribed is essential.

While dieticians like Ramya strive to bring their patients to a point where they can self manage, “it puts a lot of stress and strain on a patient, though we don’t always realise it,” she says. This week MediScene speaks with her on how to find the balance that allows you to thrive in spite of diabetes.

Finding your own rhythm

At the heart of this approach is the importance of patients being able to understand their own bodies. Explaining that the same foods can have a disparate effect on different people, Ramya says it can take an individual a few years of living with the disease to settle on their own specific regime – “it takes a lot of trial and error for a patient to identify what works for them and at what time they should be eating.” Of even more consideration than what you eat can be the quantity and the time at which you sit down to your meal, with elements like your stress and activity levels also playing a role.

Fans of the ‘three square meals a day’ approach might find that their sugar levels can rollercoaster – with a heavy meal creating a high, paving the way for a plunge a few hours later when the food is all digested. You can prevent this with small snacks in between meals, or you can have six or seven light meals instead of three chunky meals. Such an approach is particularly useful for patients who complain of frequent attacks of hypoglycaemia (abnormally low blood sugar levels).

Vegetables and fruits are recommended because they are rich in fibre and regulate weight gain

They should not wait to pass the three hour mark, says Ramya, explaining that sometimes patients wait until they start really feeling the symptoms before they try to rectify the situation. This see-saw takes its toll on the body. Daily or at least weekly monitoring of your sugar levels is recommended to help you settle into a steady pattern.

“Try to eat in a way where you don’t overeat at every meal,” says Ramya, “this way your blood sugar levels are more or less the same throughout the day.” She also recommends eating at the same time and finishing up with an early dinner. “Streamline your current eating habits,” she advises, explaining that one of the first things a dietician will do will be to go over your daily meal plan and help you eliminate the extra calories.

If you’ve developed Gestational diabetes, remember that the foetus is sensitive to fluctuations in sugar levels. It means you need to be even more consistent in monitoring yourself for fluctuations. Stressing the importance of regular check-ups, Ramya says a gynaecologist is likely to recommend expectant mothers with diabetes also take some mild exercise.

To eat or not to eat?

What can you eat? Diabetics are often told to eat anything which is red in colour (with the notable exception of red meat) simply because foods like red rice are associated with higher fibre content. Three to four servings of whole grain cereals like kurakkan are recommended because such fibre rich foods boast the twin benefits of stabilising your blood sugar over the course of the day and regulating weight gain. Vegetables and fruits that can be consumed with their skin also serve a similar purpose.

Too much tea has been known to have an adverse effect on the kidneys

Diabetics sometimes think they mustn’t include fruit in their diet, but that needn’t be the case. “A normal person is allowed 300-400 grams of fruit a day. When it comes to a diabetic, we make that half.”

Certain fruits like bananas, however, can be relied upon to immediately raise your blood sugar levels. Over ripe fruits too are high in sucrose. The idea then is to choose fruits that are just ripe enough. “I also tell patients not to take bananas after dinner and to eat them instead in the morning...that’s true of all fruits really,” says Ramya.

Another common worry is that potatoes are bad for you, and while it’s true that they come loaded with carbs, you can still include them in your diet – just watch the quantities. While going vegetarian does work for some people, it’s considered acceptable to eat up to three ounces of meat a day - providing that it is not deep fried or cooked in too much oil.

The sugar habit

In some cases, the consequences of consuming a particular food are quite clear, but occasionally you might be surprised. Artificial sweeteners, for instance, serve as great substitutes for sugar. They do not damage your system and help you cut out extra calories, which in turn helps you manage your weight, when taken in recommended amounts.

Artificial sweeteners, serve as great substitutes for sugarz	Be conscious of quantity

The occasional chef will even use these to make a large dessert. But when Ramya’s patients find themselves in a situation where sweeteners are not available, they end up consuming too much sugar. “When you get used to taking sweeteners you’re not being weaned off your sugar habit,” she says, though using them for a cup or two of tea is fine.

Caffeine itself is another addiction you can do without. “You’re replacing your water intake with a liquid that’s a diuretic,” she says. Too much tea has been known to have an adverse effect on the kidneys. On the other hand you can drink over two litres of water and accomplish the opposite. Water helps maintain a steady blood sugar level, helps flush your system clean and lubricates bowel movements.

Dropping those extra pounds

Frequent exercise does wonderful things for your body, but take care not to exercise on an empty stomach. Have a light snack in the morning before you set out. If you can, though, try and save your exertions for the evening.

Then there’s food in your stomach and sugar in your body that can give you the energy to exercise properly. Why worry about your weight? Vanity aside, Type 2 Diabetes in particular is closely linked with obesity. Though eating fatty foods, for instance, doesn’t directly affect your sugar levels, it does add cholesterol and weight. Weight gain, in turn, can lead to hormonal imbalances, which have direct impact on your sugar.

Water helps maintain a steady blood sugar level, helps flush your system clean and lubricates bowel movements.

When considering what to buy at the supermarket, play the sceptic. Every product with a label that promises it is low fat or sugar free might not be good for you. “Check with a professional or call the company to make sure it’s recommended for diabetics.”

If you want to lose weight, it might also be a good idea to avoid processed meat such as sausages and luncheon meat. Ramya offers another tip – “Don’t use more than 6 teaspoons of oil for a day, and this includes things like butter.

Seasonal feasting

“There is nothing you cannot eat, you only have to focus on the quantity and the timing,” says Ramya. As you prepare to welcome the New Year, perhaps you could consider making moderation one of your new resolutions. For those who are particularly dedicated, Ramya recommends compensating for over eating with a little extra exercise over these few days.

While it might be hard to muster up the energy over the holidays, Ramya offers one last final word of advice - “even when you’re eating out during the season, try to eat at the same time.” Such small concessions are will help you find the balance that allows you to lead a full, yet healthy life.