Diabetes describes a condition in which the body cannot make proper use of carbohydrate in food and is characterized by high sugar levels in the blood. This could happen because the pancreas does not produce enough insulin, or the insulin produced is ineffective, or a combination of both. Insulin is the hormone that helps glucose, sugar produced from the digestion of carbohydrates, move into the body’s cells inorder to be used for energy. When insulin is not present or is ineffective, glucose builds up in the blood.

There are two main types of Diabetes :

Type 1 Diabetes

Type 2 Diabetes

Type 1 Diabetes

Type 1 Diabetes is an autoimmune disease. In this case the body’s immune system turns against a part of the body. Hence the pancreas produce little or no insulin. Most often developed in children and young adults but can appear at any age. Symptoms may include increased thirst and urination, extreme fatigue, loss of weight, constant hunger, blurring of vision etc.

Type 2 Diabetes

This is the most common form of Diabetes . About 90 to 95 percent of people with Diabetes have type 2. This form of Diabetes is most often associated with older age, obesity, family history of Diabetes, previous history of gestational Diabetes and more common in some ethnicities.

About 80 percent of people with type 2 Diabetes are overweight.

Type 2 Diabetes is increasingly being diagnosed in children and adolescents. When type 2 Diabetes is diagnosed, the pancreas may produce enough insulin, but the body cannot use the insulin effectively, a condition called insulin resistance.

Symptoms : Similar to Type 1 or some people have no symptoms.

Gestational and other type of Diabetes

Sometimes women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy. Although this form of Diabetes usually disappears after the birth of the baby, women who have had gestational Diabetes have a chance of developing type 2 Diabetes within 5 to 10 years. Maintaining a healthy body weight and excercising may help prevent development of type 2 Diabetes.

Besides the above mentioned types a number of other diabetes may exist.

How is Diabetes diagnosed?

The tests used to measure the presence of blood sugar problems are the direct measurement of glucose levels in the blood during an overnight fast and measurement of the body's ability to appropriately handle the excess sugar presented after drinking a high glucose drink.

The fasting blood glucose test is the preferred test for diagnosing Diabetes in children and nonpregnant adults. The test is most reliable when done in the morning. However, a diagnosis of Diabetes can be made based on any of the following test results, confirmed by retesting on a different day:

A blood glucose level of 126 milli grams per deciliter (mg/dL) or higher after an

8-hour fast. This test is called the fasting blood glucose test.

A blood glucose level of 200 mg/dL or higher 2 hours after drinking a beverage

containing 75 grams of glucose dissolved in water. This test is called the oral glucose tolerance test (OGTT).

A random—taken at any time of day—blood glucose level of 200 mg/dL or

higher, along with the presence of Diabetes symptoms.

Gestational Diabetes is diagnosed based on blood glucose levels measured during the OGTT.

Pre-Diabetes is a condition where the blood glucose levels are higher than those considered normal, yet they are not high enough for a diagnosis of Diabetes. Pre-diabetes raises the risk of developing type 2 Diabetes and heart disease.

Depending upon the test used to diagnose it, Pre-Diabetes is also called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Some people have both IFG and IGT.

IFG is a condition in which the blood glucose level is high—100 to 125 mg/dL —

after an overnight fast, but is not high enough to be classified as Diabetes. The former definition of IFG was 110 mg/dL to 125 mg/dL.

IGT is a condition in which the blood glucose level is high—140 to 199 mg/dL —

after a 2-hour OGTT, but is not high enough to be classified as Diabetes.

Thankfully, people with pre-Diabetes can definitely do a lot to prevent or delay Diabetes. Studies have clearly shown that people can lower their risk of developing Diabetes by losing 5 to 7 percent of their body weight through increased physical activity and balanced diet.

Glycemic Index

The Glycemic Index is a rating system that enables you to judge how certain

foods or food groups affect the person’s blood sugar levels.

Thus with the help of the Glycemic Index, one can figure out the best foods

that should go in your diet plan.

The Index rates foods on a scale of 1 to 100, with 100 representing the effects

of a glucose tablet, which very quickly raises blood sugar levels.

Glycemic Index measures levels of carbohydrates in foods for how quickly they

affect blood sugar levels.

For example, honey measures 91 while table sugar is 64. Some low Glycemic

Index foods include barley at 22, soy at 14 and apples at 38. Using the Glycemic Index can be a useful tool in helping a diabetic to plan his diet.

General guidelines for Diabetes Diet

Reduce consumption of starchy foods like potatoes, white bread and pasta.

Avoid sugars such as honey , table sugar, some fruits and desserts made with

sugar or honey.

Choose whole grains, such as brown rice and multigrain bread, over their

refined counterparts.

Drink plenty of fluids.

Limit / avoid artificially sweetened juices.

Avoid alcohol, caffeine and smoking.

Drastically reduce fried and processed foods.

Limit salt intake.

One of the crucial things in Diabetes management is to go ‘off sugar’.

If you have Diabetes, you do need to watch your sugar and carbohydrate intake to properly manage your blood sugar level with the help of your Registered Dietician.

Desserts can be added to a diabetic menu, but they must be exchanged for other foods in your eating plan or counted as part of your total carbohydrate choice for the day.

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Defining Overweight and Obesity

Overweight and obesity are conditions where the weight of a person is higher than what is generally considered healthy for their height. Being overweight and obese has been shown to increase the likelihood of certain diseases and other health problems

Definitions for Adults

For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the "body mass Index" (BMI). For most people, BMI correlates with their amount of body fat.

A BMI between 25 and 29.9 for an adult is considered overweight.

A BMI of 30 or higher for an adult is considered obese.

See the following table for an example.

Height	Weight Range	BMI	Considered
5' 9"	124 lbs or less	Below 18.5	Underweight
	125 lbs to 168 lbs	18.5 to 24.9	Healthy weight
	169 lbs to 202 lbs	25.0 to 29.9	Overweight
	203 lbs or more	30 or higher	Obese

Who’s at risk ?

Everyone needs to ensure they maintain a healthy weight or as close to it as possible.

Currently, over half of women, and about two-thirds of men are either overweight or obese.

Being overweight or obese increases the risk of developing high blood pressure, osteoarthritis heart disease and Type 2 Diabetes.

Obesity in children:

Unhealthy food choices, lack of physical activity and a shift in ‘entertainment programs’ in children have caused an exponential rise of overweight and obese children across the globe.

Overweight/ obesity leads to health problems and can cause social problems including affecting their self-esteem. Overweight children are likely to be teased by their peers and eventually may develop body image problems and in some cases depression. Once children are overweight, it is very difficult and requires a lot of effort for them to return to a healthy weight.

Overweight and obesity in children are among the most important risks to children’s long and short-term health. And logically so, overweight children are highly likely to become overweight adults.

Risk factors for childhood obesity

The food we eat comprises of fat, carbohydrates, protein, fibre and nutrients. These provide the body with energy. When our food gets digested the body stores unused/ excess energy (kilojoules / Kilocalories) as body fat. To maintain a healthy weight, you need to use (or ‘burn’) the energy from the foods you eat as well as the stored fat. If you eat more than you use, your body will store the extra energy as fat and that adds on weight to our bodies.

Factors that may cause children to become overweight and obese include:

Unhealthy food

High fat and sugary foods instead of healthier options.

Lack of physical activity

Since the fat in the body is not getting used and additional fat is getting accumulated, lack of exercise is one of the greatest reasons for the condition.

Spending a lot of time on sedentary pursuits

Children watch, on average, around 2½ hours of television a day, as well as have replaced active field physical games with electronic ones.

Overweight parents

a family’s eating patterns also has a major influence on whether a child maintains a healthy weight.

Overweight parents may be less concerned about their children also being.

overweight than parents who have a healthy weight.

Genetics

some rare gene disorders have been associated with childhood obesity. Also, particular genes acting together may make some children more susceptible to obesity. Should there be a family tendency to become overweight, parents need to be aware of it, make children aware and help the child by introducing healthy food choices and lifestyle changes for the whole family.

Did you know ?

A global warning that needs to reach all parents is that should we carry on as we are, nine out of ten of today’s kids will grow up with dangerous levels of fat in their bodies. This would put them at a greater risk of illnesses such as diabetes, heart disease, hypertension in later life.

Tips for healthy kids

Small tummies need small portions of food. Do not overfeed your infant, such

that the kid’s apetitie grows much bigger than the body’s need. The stomach is an elastic bag and can enlarge to a really big size. And should you feed it excessively, it will get used to large portions of food. Serve kids, kid’s size portions.

Keep dinners small and light. This small change can bring in big effects.

Serve dinner atleast two hours before bedtime.

Switch to healthy snacks for TV viewing.

Replace sugary desserts and snacks with delightfully light desserts especially.

for kids.

What dietary advice is there?

The simple trick to maintaining healthy bodyweights

1. Wise eating plus

2. Adequate physical excercise

Physical activity exhibits benefits not only for controlling weight, but also in controlling appetite.