Diabetes - My New Teacher Date:-03-03-2015
“Where there is a will there is a way” If you work relentlessly, you will get a reward for it albeit a bit late. If regularity is made the way of your life, then path to success always stays within your reach. We always read or hear these proverbs or sayings of eminent persons but we often turn a blind eye to them. In other words, I have observed that we overlook good advice and behave indifferently or with lethargy.
In my case, I observed that if I live a disciplined and regular life, I can achieve tremendous success. The case in point wasmy “Diabetes” and I decided to pen down my experience for readers like you. It is estimated that India has more than 300 lakh diabetes patients and there are about 100 lakh persons who are on the threshold of becoming diabetic. Out of these people, there must be about 400 thousand diabetic patients in Maharashtra itself where I stay and I thought it prudent to write my experineces for these people. Hence I wrote an article in Marathi on 9th June 2011 and modified it in 2012 with few additions. This article was widely accepted on internet blogs and I got so many querries and calls from different persons from all walks of life. There were suggestions that I should write this article in English so that it reaches to a larger population. This article is my effort to write my experience in English. My fluency in English is questionable and hence at the outset let me set your expectations right on that note.
It was 22nd of February 2010 and it was evening. It was about 1930 hours when my daughterinlaw gave me a machine that measures blood sugar accurately. She then requested me to check my blood sugar. Accordingly, she checked my post prandial (meaning two hours after meals ) blood sugar. It was 238 mg/dl. I was shocked. As per the world standards and as per Indian Standard, the post prandial blood sugar should have been ideally less that 140 units. I told her that I had a feeling that I can not get this disease in which unused blood sugar remains in blood and you are then described as a diabetic patient. After seeing the results, I found that it was my prejudiced mind. My daughter in law told me “ Baba, you have to now admit that you have become diabetic.
That night till going to bed, I started thinking about myself for more than 2 to 3 hours with sadness fully engulfing my mind. I had a feeling that I will not get diabetes as I used to eat lot of sugar in various forms such as sweet meat, milk products with sugar or jaggery in it , in my life. I used to eat ghee and sugar or ghee and jaggery with Chapati as is called for indian bread, I used to eat bananas & sugar crushed in milk and I relished sweet things. I had a complacent feeling that my body must be secreting lot of insulin and hence I will not get diabetes ever. Next day I checked my blood sugar with empty stomach. (This means you dine at night and till next morning upto 12 hours you don’t eat anything. ) It was showing a reading of 138 mg/dl. For a normal healthy person this reading should be equal to or less than 80 mg/dl and the permisible limit for empty stomach sugar is upto 110 mg/dl. This again confirmed that I did have diabetes .
Now the first and formost thing was to go to a good doctor. I went to an eminent doctor of Pune who is M.D. gold medalist and a diabetes specialist . He asked me to perform various test such as Glyco HB, lipid profile, urine culture and standarc urine test for sugar residue if any and eye test and other necessary tests. I underwent those tests and collected the results. I went to the diabetologist and after studying my reports, he told me that I am a diabetic patient and I have to take 1 glycomet tablet of 250 mg strength in the morning and one tablet in the evening . My age at that point of time was 62 years and I was already a high blood pressure patient. I was taking two tablets in the morning and one tablet in the evening for controlling my blood pressure. Actually I was detected for high B.P. when I was 54 years old and I had started with one tablet in the morning for controlling B.P. In course of next 7 years, the dosage of tablets had increased from one tablet to 3 tablets per day. Further I had seen my office collegue whose B.P. tablet intake not only increased in numbers but also with higher and more powerful dosages as the years passed by. Hence I was determined that I will do whatever excercises and dietary disciplines that are required to control diabetes with proper diet but will not take even a single tablet to control diabetes.
I told the doctor that I do not wish to take any tablet. He said that it will be against medical principles and he will always suggest to take tablets. However in order to control diabetes , he gave me his own book on “controlling diabetes”. He told me that the key to success is moderate food intake and exercise that will be suitable for my age. He advised me to walk briskly for atleast 6 to 7 kms with 6 km per hour speed. He told me to eat measure my food intake so that as per the tables given in his books, I shall be able to count how many calories I am consuming. He told me not to eat more than 1800 calories per day.
I read the book given by doctor, atleast two times in details. I came to know that any food that you eat is turned into sugar by our body. A human body can not use anything else than sugar for living. Bread, vegetables, ghee, honey, milk, curd, rice, ground nuts, coconut, all types of edible oils, mutton, chicken, eggs etc. turn into sugar when our digestive system digests it. This sugar (Glucose, suckrose, maltose, fructose etc. ) is sucked by buds in the intestine and mixes with blood. Blood acts as a carrier to this sugar and muscles of our body absorb this sugar and the sugar is transformed into energy with the help of insuline. Muscles become strong to undertake their work. When you do ample physical work, this sugar is utilised completely and the blood does not retain
any extra sugar. When one gets older and older, the capacity to utilise all the sugar formed in the body decreases. As we are aging, after 60s less insuline gets produced and secreted from the pancreas. At this time some unutilised sugar from your blood starts increasing. This sugar is seen in empty stomach and full stomach blood samples. If the figure for empty stomach is around 80 to 85 and with full stomach is around 100, the doctor says that you are normal and you don’t have diabetes. However if it goes beyond limits (120 for empty stomach and 140 for full stomach ) then doctor diagnoses you as diabetic or on the verge of Diabetes.
When I read the book given by the diabetologist, I understood that I have to eat controlled diet. I was 62 years old at that time and hence even though the doctor had aked me to limit my calories to 1800 per day, I decided that I shall eat only 1200 to 1400 calories per day. The doctor in his book had also advised to eat 300 to 350 calories at a time for five times a day. The reason was that the body shall at all times have not more than 350 calories to burn. As per his advice, I started eating following diet.
1)Get up in the morning and take a cup of tea with 2 to 3 small biscuits or 1 or 2 ready made toasts.
2)For breakfast, eat 350 to 400 grams of salad. (My salad included all chopped vegetables ( 1 carrot + 1 tomato +1 cucumber + one small beet root of 6 to 7 cm diameter +optionallly 1 Raddish (instead of beet root) or cabbage.) at 09.00 hours .
3)At 12.30 hours noon, take meals consisting of 2 chapatis (20 gram wt. of each chapati ) , one small bowl of vegetable cooked at home plus 50 to 75 grams of cooked rice with Dal or sambar . (It gives around 350 calories ) If the chapati or Roti is of more wt. i.e more than 20 grams then it will give more calories )
4)At 16.00 hours in the afternoon, take one cup of tea with 2-3 biscuits or 2 toasts.
5) At 20.30 hours at night , take 1 chapati of 20 gram weight with little vegetable plus 50 to 75 grams of cooked rice with dal or curd or butter milk .
6)At night 22.00 hours, if possible and if one feels hunger, then take one apple or one orange or one sweet lemon. (Fruits such as apple, orange, water melon or sweet lemon give very less amount of calories but ample vitamins and minerals.
(This was my diet. The reader should adjust his or her menu as per availability but with a view of not eating more than 350 calories at a time and not eating more than 5 times a day.)
If a person does mental work and earns money, then he consumes less calories because he or she do not exert. A labour or farmer or a worker from factory exerts more and consumes more calories hence he needs to eat more calories.
Now the basic question for any person is how to count calories of different food articles. For this purpose one should see and make by heart, following table.
1)Cereals, Pulses, skimmed milk, curd give 4 calories per gram of raw seed or 4 calories per mililitre of liquid. (Even pure sugar or jaggery gives 4 calories per gram. This may look ridiculous but it is true and proven fact. )
2) Coconut, Ground Nut, sesum kardai, soyabean and other types of grains yielding oil from it give 6 calories per gram of that seed.
3) pure Ghee, Vanaspati Ghee, all vegetable oils such as ground oil, coconut oil, sesum oil, soyabean oil, sunflower oil, olive oil, rice bran oil, butter, margarin, butter oil etc. give 9 calories per gram of oil.
If you keep this firmly in mind, then it becomes simple to remember that a diabetic patient must limit his oil and ghee intake to the minimum followed by less ground nut or sesum consumption.
Thus we come to a conclusion that we must eat anything and everything by counting its calories for first one month. After one month’s experience one becomes accustomed with the calorie counting and then he or she come to know as to how many calories he or she is eating. When we eat chapati or roti or bhakari as it is called in Marathi, we can not tell its calories because if the one chapati weighs 20 grams then another chapati might weigh 30 or 35 grams. Then chapati weighing 20 grams shall give you 80 calories whereas 30 or 35 gram chapati shall give 120 or 140 calories. Hence merely saying, I eat only two or three chapatis does not explain whether you are eating 80 or 120 calories each of a chapati. This is true for bread, roti, bhakari etc. Hence merely saying that I eat only 3 chapatis in the morning and 2 in the night does not make sense.
One bowl of Dal or vegetable with rich oil use gives more than 150 calories. Similarly one bowl of Upama or Kandepohe gives more than 300 calories. If we eat Groundnut measuring100 grams at a time then you consume whopping 570 calories. Hence it becomes necessary to weigh the food that we intend to eat.
If we continue the practice of weighing for continuously 15 to 20 days, we become able to guess the exact calory intake . (This comment is based on home cooked food that you eat and not restaurant food or ready to eat food)
Accordingly I purchased a simple spring balance having a flat round surface at the top and a dial giving measurement of weight with a calibration of 2 grams per line upto a maximum of 500 grams. The cost was 350 Rs. in 2010 which may be at the most Rs. 400 today. Then I used to weigh toasts, biscuits, cooked rice, chapati , sambar, cooked vegetables etc. before eating. (Liquid should be weighed with the bowl and then after the bowl is empty without liquid. Thus we get net weight of liquid ) . I made it a point not to eat more than 300 to 350 calories at the most at a time. Further I always kept a gap of atleast 3 to 4 hours between each food consumption. ( See my table given above. ) . I also purchased blood sugar test meter of a reputed company. On this meter I used to check my empty stomach blood sugar and full stomach (2 hours after meals) blood sugar.
In the morning, I made it compulsory for myself a walk of 7 kilometers every day. For this too , I started with 1 kilometer on first day and increased half a kilometer every day till I attained 7 km. goal. At first I required about 1 and half hour for walking 7 kms. However after 2 months, I could finish the same distance in 1 hour 10 minutes. I always made it a point that I will not do excessive exertion. I never got cramps in my legs. If you walk 6 kms per hour, then you burn atleast 350 calories. If you walk 3 kms per hour, then you burn 200 calories. Thus I started burning 400 calories every day. I also made one resolution for myself. The resolution was that I will skip one meal if I do not walk 7 kms on a particular day. This resolution served as a deterent for not walking on a particular day. In summer and rainy season, I used to bathe with cold water after the walk. I avoided Upma, Shira (Rava Kesari), Idli Sambhar, kande pohe etc. Instead of that I made a practice of eating 400 to500 grams of salad in the breakfast. My salad consists of Cucumbar, Red Carrot, Tomatos and or beet root or radish . I used to add 4 to 5 grams of salt and one tea spoon of sugar in this salad. As mentioned earlier upama or shira gives 350 calories per bowl but 400 to 400 grams of green salad gives only 150 calories. Further salad is a fibrous food with more than 50 percent water content. Hence you feel full stomach after eating that much salad. I then ate 2 chapatis (weighing 20 grams each ) with 50 to 75 grams of cooked vegetables. I used to eat one small bowl of steamed rice. Similarly I used to eat one chapati and one small bowl of cooked rice at night for supper. I used to take tea two times a day (one cup in the morning and one cup in the afternoon with either 2 toasts or 2-3 biscuits.
I avoided Farsan, Shev, Chivda, potatovada, potato wafers, panipuri, shevpuri etc. I stopped eating ground nut almost totally. If I found myself hungry, I used to eat watermelon, papaya, orange or sweet lemon to satisfy my hunger. (These fruits give hardly 25 calories per 100 gram weight yet your stomach becomes full ) . Let me confess that I have sweet tooth and hence with chapati I used to eat little dudhi halva or shrikhand or rabdi. (My doctor never told me to stop these sweet things as he told me that I should only take care to measure calorific value of these sweet meats. I took care to eat sweet meat very little just for taste . )
After 3 months, I found that my empty stomach blood sugar reading which was 138 at start came down to 110 and full stomach (post prandial) blood sugar from 240 to 175. I was elated. My vigour to continue my exercise, increased. After 6 months, my empty stomach blood sugar came down to 95-100 and post prandial blood sugar to 140. I was very very happy and felt like dancing with joy. After six months whoever met me, started asking me whether I was on weight loss programme or so. This was because of my walking. I reduced my weight from 70 kg to 64 kg. I also observed during Lord Ganesh’s festival and Diwali festival that my blood sugar increased more sharply when I ate more than stipulated calories in the form of sweet meat. This reminded me my doctor’s advice. He had told me that now that I have diabetes, it will never be cured. I can control it but never overcome it. Hence I have to be calorie consious . I had tabulated my blood sugar reports in a tabular form .
After one year, I went to the doctor and showed him my complete blood sugar test chart. I told the doctor that I have not taken a single tablet of glycomet as prescribed by him during whole last year. The doctor was happy that the blood sugar reports were encouraging . He told me that the results show that I have a good control on my diabetes but I must keep in mind that I have to live disciplined life till I am alive as diabetes in not totally curable.
I have continued my daily routine for last 5 years. There were some problems during this period. I had done bridges for my molars and premolars as well as front teeth. In November 2010, I dislocated my top dental bridge of left side and bottom dental bridge of right side simultaneously, resulting in inability to chew from either sides. Now eating salad became impossible. Still I did not loose heart. I started grinding my salad using grinder-mixer into a slurry and engulp it for next 2 years till my bridges were restored by the dentist. I did implants for my bridges. I used to eat chapati by dipping it in curry or milk so that I could chew it.
Secondly my left knee started aching after 1 and half years. Hence doctor told me to stop walking and advised me to swim it possible. Thus instead of walking, I started swimming. Initially I started with 500 metres swimming and increased it gradually by 100 metres after every couple of days. I thus reached 1.6 kilometers swimming every day. I swam 1.6 km. every day for next one year. Then I increased my daily target to 2 kms every day. Last 3 years I swim 2 kms. every day. Swimming consumes 400 calories per hour. I swim for more than 2 hours every day as my speed is very slow due to my age. ( I am 66 years complete by now. ) Thus I consume 800 calories per day .
In last 5 years, I have controlled my blood sugar level and maintained my weight within 64 kg range. Except walking or swimming , I did not do any other exercise but one can definitely add yogasan or Surya Namaskars. If we minimise our scooter journey and instead walk for bringing groceries or vegetables etc., it will add to your good health.
This is my story. After reading it, if one gets inspired and starts practising it scrupulously, he or she is ought to get amazing results. However please bear in mind that you have to follow your doctor always. I shall be most happy if anybody gets inspiration reading my article. One thing is sure. You are bound to get good results if you act accordingly.
Author: Shambhunath D.Ganu,
Retired Deputy Chief Engineer.