Merlin Thomas tries to decode diabetes in new book

Merlin Thomas. Courtesy Merlin C Thomas

In his latest book, Merlin Thomas, a clinical scientist at the Melbourne-based Baker IDI Heart and Diabetes Institute, attempts to “decode” diabetes so that managing the disease becomes a lot easier.

First, the facts.

The world has more than 387 million people living with diabetes and, by 2035, this figure will rise to 592 million, according to the latest report by the International Diabetes Federation.

Living with diabetes is not easy, because several factors – from obesity and a sedentary lifestyle to genes and ageing – come into play. However, its management need not be complex or complicated, says Thomas.

Once diagnosed, manage it well with three easy-to-follow steps: physical activity, balanced diet and medication.

“Of all the things that can be done to manage your diabetes, getting more physical activity is the most important,” Thomas writes.

Exercise offsets insulin as muscles take up a large amount of fat and glucose from the bloodstream to replenish their fuel stores. For example, Type 2 diabetes can lead to reduced blood flow to your feet.

“Regular exercise demands better blood flow to the legs to allow the muscles to work better. The blood vessels supplying your legs progressively adapt to regular exercise to improve the blood flow,” Thomas explains.

“Accumulate” moderately intense physical activity by focusing on everyday tasks such as walking the kids to school, walking or cycling to work, taking the stairs, parking a little farther away from markets and breaking the sitting cycle at the workplace.

What happens in Type 2 diabetes is that there is not always enough insulin to keep glucose under control, especially after meals. For this, it is important to reduce carbohydrate intake. Instead of biryani or dal, a burger and fries, or a shawarma plate, opt for a low-fat curry, tandoori platter or a healthy salad with protein. Substitute non-starchy vegetables such as okra and aubergine for potatoes and rice.

“A good place to start is to limit your carb intake to no more than three or four servings [45-60 grams] in each meal or no more than 10 servings [150 grams] a day,” Thomas advises.

There are approximately 15 grams of net carbohydrates in one slice of naan, one tablespoon of jam/jelly/sugar/honey, one piece of fresh fruit, a cup of yogurt, two or three biscuits, one muffin, a cup of rice or a large baked potato.

For fibre, eat breakfast cereal that lists “wholegrain” or bran as the main ingredient.

Switch white bread for whole­grain or wholemeal bread. Shun white rice and go for brown rice.

While making fruit juice, do not get rid of the skin and the pulp. For snacks, instead of processed carbs, eat fruits with edible (whole) seeds.

According to Thomas, “for some people with diabetes, changing to a diet with large amount of wholegrain, bran and legumes is a major shift”.

If you cannot resist sugary drinks, opt for “diet” beverages with artificial sweeteners.

“When used in recommended amounts, artificial sweeteners appear to have no adverse effects on human health,” Thomas writes.

Most people with Type 2 diabetes will reach a point where some medicines are needed to prevent their glucose levels from rising dangerously. This is simply the nature of the disease.

The simple formula is: coordinate your medications with your diet and lifestyle to ensure the maximum effectiveness of each.

“Just remember that medicines are not an alternative to good diet and regular exercise, and will work better if all are combined,” says Thomas, who has written more than 250 book chapters and books on diabetes management.

* IANS