Diabetes is a silent epidemic that claims more lives each year than HIV/ AIDS. In 2007, diabetes caused n estimated 3.5 million deaths across the world, according to the World Diabetes Foundation. Diabetes is a condition in which the amount of glucose (sugar) in the blood is higher than it should be because the body cannot use it properly. Glucose comes from the digestion of foods such as bread, rice, potatoes and from sugar and other sweet foods. Diabetes mellitus is commonly referred to as diabetes. The name is derived from the fact that glucose “spills over” into the urine when the blood glucose level is too high. Mellitus means “honey” or “sweet”, references to the sweet taste of urine.
Type of Diabetes
There are two major types of diabetes- type1, which is rare, and type 2, which is common.
- Type 1 diabetes
develops due to the destruction of the insulin- producing cell of the pancreas. Therefore, the pancreas no longer produes insulin or produces very little. This is thought to be the result of the body attacking and destroying its own cells in the pancreas- known as an autoimmune reaction. It’s not clear why this happens, but it could be sue to genetic reasons or as a result of viral infection. Type 1 diabetes is the least common type. It can develop at any age, but it usually seen in younger age groups.
- Type 2 diabetes
develops when the body cab still make insulin, but either it is not enough, or when the quantity of insulin that is produces is enough but it does not work properly ( known as insulin resistance). This type is most likely to affect people over age 35, who are inactive, have a family history of diabetes, are overweight, or have a particular racial or geographical variation. In Cambodia half of type 2 diabetes patients do not produce enough insulin, are not overweight, while the other half are overweight and insulin resistant. It usually develops gradually and is often undiagnosed for many years. Many people can control this type of diabetes through a programme of diet and exercise.
Who is more likely to develop diabetes?
Diabetes is not contagious. People can not “catch” it from each other. However, certain factors can increase the risk of developing diabetes. People with a family history of type 1 diabetes are at an increase risk of developing the condition. Things that put a person at greater risk of developing type 2 diabetes are:
- being Asian
Cambodian, like Indians and other Asians, are genetically disposed to developing diabetes.
- being inactive
People who do little physical exercise are more likely to develop diabetes.
- being overweight
Obesity is a major risk factor but slim people can also develop diabetes.
- being older
Diabetes is more likely in people over the age of 35, but now younger people are developing the disease.
- being a woman who has given birth to a large of baby or has had gestational diabetes
Many women develop form diabetes during pregnancy. Those that do, often give birth to larger babies and are more likely to develop diabetes later in life.
Recognizing Diabetes
Both types of diabetes have obvious symptoms. Among them are: tiredness, drowsiness, blurred vision (intermittent or constant), dry mouth, excessive hunger, excessive thirst, excessive urination.
Management of Diabetes
Diabetes is a chronic disease that can not be cured, but good compliance of lifestyle and medical prescription can delay the onset of complications.
- Type 1
Diabetes is treated by insulin injections and diet, and regular exercise is recommended.
- Type 2
Diabetes is treated with lifestyle changes such as a healthier diet, weight loss and increased physical exercise resulting in a healthier body weight. Tablets and/ or insulin may also be required to achieve normal blood glucose levels.
Healthy Diet
Eating a healthy diet is key to diabetes management.
A diabetic diet is not seen as a “diet”. It is rather a healthy eating plan. The basic principles of a healthy eating plan are:
- To balance energy intake to energy expenditure
- To maintain or achieve ideal body weight gradually
- To achieve and maintain blood glucose control by eating food with low glucose
- To help prevent and treat complications.
People with diabetes do not need to eat special food, but they should cut down on white rice which contains a lot of glucose, and eat more fruit and vegetable. The glucose of brown rice is more slowly absorbed by the body, thus avoiding the typical blood glucose peaks that are seen after people eat white rice, white bread or pure sugar.
Ten Steps to Eating Well
- Eat a variety of foods at each meal and aim to eat three regular meals a day.
- Eat a small bowl of white rice. Brown rice is better or mix brown rice with white rice.
- Eat lots of vegetables (except potatoes). Increase the amount of fruit (except sweet fruit: durian, longan, pineapple, mangoes). Eat one or two serves of fruit per day.
- Reduce saturated fat and high fat foods such as fried foods (e.g.: deep fried banana), prohok and pork fat.
- Avoid foods with high amounts of sugar such as sweet drinks, sweets or condensed milk.
- Use sunflower, safflower or corn oil during cooking, rather than plam oil or coconut oil or pork fat. Cut fat off meat before cooking.
- Decrease salt intake, e.g. less prohok, MSG, fish sauce, soy sauce and salted meat or fish. Use other flavors (e.g. lemon juice, pepper) and herbs.
- Reduce alcohol, especially strong alcohol like rice wine, whisky.
- Carbohydrates, such as rice and bread should be not more than a quarter of every meal. Vegetables should make up half of each meal.
- Increase the amount of protein in the diet. Good sources of protein include tofu, beans such as kidney bean and soybean, white of eggs and chicken, pork and beef.
