Diabetics can take control of lives

Diabetics can take control of lives

Maria Endah Hulupi, The Jakarta Post, Jakarta

For people with diabetes, the disorder is not the end of the
world -- they have the power to help prevent the onset of
possible health complications.

These include hypertension and heart disease, and even
blindness, gangrene or kidney problems, nerve damage or
impotence.

According to experts, people with diabetes can help prevent
the complications by adopting four preventive pillars --
exercise, proper diet, education and medication.

"It is important to prevent the health complications of
diabetes by adopting the four preventive pillars. However, before
they adopt an adjusted lifestyle, diabetics should obtain
comprehensive information on the disease from their physician,"
said Aris Wibudi, an internist from the Gatot Subroto Army
hospital.

Most Indonesians with the disorder, Aries explained, suffer
from type II diabetes, an inherited non-insulin dependency that
is the most common form of the condition.

Type I diabetes, he added, is an insulin-dependent disease
that usually develops from childhood or teenage years.

Some people, he said, develop diabetes after taking certain
medication or steroids, while women may develop gestational
diabetes during pregnancy.

"Gestational diabetes only occurs during pregnancy. However,
studies show that 30 percent of women who develop it become real
diabetics within six to 12 years," Aris said.

Diabetes is characterized by a chronic hyperglycemic condition
(excess sugar in the blood) due to the body's failure to produce
sufficient insulin or the body's resistance to it.

A proper and balanced diet plan, with a percentage of 60:20:20
carbohydrate, protein and fat respectively, needs to be
introduced immediately.

"It is also advisable to ensure an adequate fiber intake, with
a fiber-to-starch ratio of 3 to 1," Aris explained.

To avoid a sudden increase in blood-sugar level, he advised
diabetics to focus on slow and sustainable released sugar like
brown rice or corn, instead of white rice or white bread, for
example.

The fat, he added, can best be obtained from mono-unsaturated
fat sources like olive oil, sesame seed and certain types of
bean. Protein can be supplied from lean meat, fish, eggs and
tofu, for example.

Maintaining normal body weight is important and men especially
need to avoid fat accumulation in the stomach.

"A big stomach may indicate insulinemia (abnormally high
levels of insulin in the blood) and people with a big stomach are
liable to develop diabetes in the next 10 to 20 years, because
the body grows resistant to insulin," he warned.

A diet high in carbohydrates can also induce fat accumulation
in the stomach and such a diet will also put an extra burden on
the body to produce higher levels of insulin to balance the
glucose level; this may lead to pancreas fatigue and/or insulin
resistance.

Exercise is important to maintain or attain normal body weight
and stave off possible complications such as cardiovascular
diseases. Other sources have also said that exercise improves the
utilization of insulin.

As part of efforts to maintain normal glucose levels and
normal body weight, diabetics need to reduce their sugar intake
and reduce consumption of sugar-loaded food and drink, like
carbonated drinks.

Food expert from the Bogor Institute of Agriculture (IPB) Made
Astawan explained that low-calorie synthetic sweeteners like
saccharine, acesulfame potassium or aspartame can be used to
enhance a sweet taste.

"Aspartame can be used to provide a sweet taste; it is about
200 times sweeter than sugar, but only 4 calories per gram," he
said.

He also dismissed reports that aspartame poses health risks
like lupus or blindness and affects brain function.

Aspartame, he added, has secured approvals from the U.S. Food
and Drug Administration (FDA), the Joint Expert Committee on Food
Additives (JECFA), the American Medical Association (AMA) and the
American Diabetes Association (ADA) and has been added to various
diet food and drinks, bread spreads, dairy products and
multivitamins, several items in the long list of aspartame
containing food.

He said that aspartame is safe except for people with a very
rare inherited disease, phenylketonuria. According to Webster's
Medical Desk Dictionary, this is an inherited metabolic disease
in man that is characterized by inability to oxidize a metabolic
product of phenylalanine and by severe mental deficiency.

"People with the disease need to avoid phenylalanine not only
from aspartame-containing food but also from other sources, such
as milk, eggs and salmon, for example," said the expert from the
institute's department of food technology and human nutrition.