The Hindu Business Line : Stretch your resolve

Scene 1: You eat a meal and round it off with an ice-cream. This is what happens: Glucose, a simple sugar from the ice-cream gets absorbed directly into your bloodstream. Simultaneously, your digestive system extracts glucose from the complex carbos you've eaten. And this glucose too slips into the bloodstream. The presence of glucose in the blood stimulates the pancreas, a six-inch organ behind the stomach, to release the hormone insulin. Insulin carries the glucose right into your cells and helps them ignite energy with it. These beautifully co-ordinated actions reflect in your medical report - your blood-fasting sugar level read between 60 to 98 mg/dl. That's great. You are not diabetic.

Scene 2: But, if you have insufficient or inefficient insulin and it cannot penetrate your cells, several uncomfortable things happen. The cells starved of glucose make you feel hungry, thirsty and weak for prolonged periods. Some unused glucose dissolves into your body fluids. The kidneys busily filter this sugary solution and you urinate often. More. The glucose hanging heavily in your blood shows up in your report. A reading between 99-109 mg/dl means you are heading to Diabetes District. While 110 mg/dl and over means you've reached Destination Diabetes.

Be aware, not alarmed

Please understand that diabetes is dangerous if neglected. Wounds don't heal, eyes weaken, kidneys deteriorate, nerves in the feet get damaged, and arteries get blocked leading to heart attacks or strokes. It's in your interest to be aware, but never feel doomed.

"Don't label yourself as having this chronic illness and colour everything," says Dr Paula Hartman-Stein, an American psychologist with a special focus on diabetes. She's right. You are not a 'case', you are a strong-willed person who can and will lower your blood sugar and maintain it thereafter. In fact, with the measures you take, you will be fitter, healthier and stronger than you ever were.

With this inspirational thought in mind, go immediately on a_

* Sweet fast: Cut out sugar, honey, jaggery, molasses, dried fruit (dates, apricots), soft aerated drinks, ice-creams, cakes, etc. These simple sugars hit your bloodstream like bullets from a gun. Try low-calorie alternative sweeteners.

* Understand insulin: Insulin does not just aid your cells to burn sugar, it also helps to deposit fat in your cells. So, if you eat fatty foods, the insulin gets so busy ferrying fat, it neglects its sugar-burning duty.

That is why, a diabetic must opt for_

* Weight control: Cut down fats to a minimum or opt for fatless food and lose weight. The less fat you have in your food and body, the more effective the insulin. Avoid cholesterol-laden foods like egg-yolk and organs meats. It's worth investing in a weighing machine. Even the loss of the first five kg will reduce your blood sugar level.

So, what can you eat?

* Food containing fibre: Whole wheat, oats, cereal, leafy vegetables, fruits (orange, apple, papaya, jamun, water melon, musk melon, plums, pear, methi sprouts, and karela. And drink 1.5 litres of water daily. "The water-soluble fibres found in legumes, oats and fruit, when eaten in a low-fat diet, lower blood fat levels," says Marion Franz, a diabetes educator. "Because they form a gel in the gastrointestinal tract, they cause the sugar in food to be absorbed at a slower rate giving your insulin a chance to keep your blood sugar balanced."

Incidentally, rice, potatoes, peas considered as complex carbohydrates can be eaten in small quantities - unless specifically banned by your doctor.

* Exercise helps insulin: Walking, cycling or swimming does more than make you lose fat-weight. It increases insulin-receptors (doorways) on the cells. Thus, the insulin gets an easy passage to deposit the glucose and spark cellular energy. Diabetes specialist, Dr Henry Dolger advises, "Start brisk walking. It's the safest, least stressful and most productive of all exercises. It improves the efficiency of every unit of insulin taken in or produced by the body. You get more effectiveness out of every gram of food you eat than you would without exercise."

How much exercise?

Start with 1.6 km daily. Increase it gradually until you touch 4.8 km.

* When to exercise: Anytime. Leave a two-hour gap between a solid meal and exercising. Have a papaya or watermelon about half hour before your walk. Check with your doctor how soon after your insulin dosage you can stride out. Keep orange or sweet-lime juice handy for quick glycogen-intake in case you become hypoglycaemic. This happens when your blood sugar drops too low and you may feel disoriented, weak, dizzy, numb in the mouth, damp-skinned, a fluttering in the chest or hungry. To avoid this, have regular meals - small portions four to six times a day. And schedule one meal immediately after exercise.

* No heavy weight-training: Pushing and pulling heavy weights or even furniture for that matter is a definite 'No.' The effort precipitates more sugar into your blood and raises your blood pressure. This can cause or aggravate diabetic eye problems.

* Do a balancing act: Until your blood sugar levels out to a healthy balance, use humour to dissipate any sense of deprivation and keep your perspective.

As Dr Hartman-Stein says, "Stress and anxiety can destabilise diabetic control." Rather than give in to a fit of frustration and binge on cream-biscuits, decide not to make food your focus in life. Read a good book. Paint a wall or picture. Plant a tree. Make a scrapbook of inspirational quotations.

Remember_ you are not just healing your body; you are re-creating it. As the English writer Thomas H. Huxley says, "The most valuable result of all education is the ability to make yourself do the thing you have to do, when it ought to be done..."

Picture by A. Roy Chowdhury

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