Alarmingly, over half of these individuals remain unaware of their diabetic status, potentially leading to severe health complications, if left undetected and untreated but diabetes is more than just controlling blood sugar levels; it is a complicated confluence of many elements and diabetes care goes beyond the prescription pad with a holistic approach. Recent research has found a link between poor sleep and decreased glucose metabolism while two other very important pillars of comprehensive diabetic management is mental well-being and nutrition as mindfulness practices, stress reduction strategies diet and nutrition and psychological support can be just as important as insulin prescriptions.

In an interview with HT Lifestyle, Dt Nisha, Consultant Dietician and Nutritionist at Motherhood Hospitals in Gurgaon, explained, “Diabetes is classified into majorly two types: type 1 and type 2. Type 1 diabetes occurs when the immune system destroys pancreatic beta cells, which are the only cells in the body that produce insulin, a hormone that regulates blood sugar levels. People with type 1 diabetes require daily insulin injections or pumps. Type 1 diabetes mostly affects children and young adults, accounting for around 5% of diabetes in the adult population. The remaining 95% of diabetes cases in the adult population are Type 2, which is thought to be caused by a mix of genetics and environmental factors (think food, lack of exercise, obesity and chronic stress). It usually begins with insulin resistance, in which cells are unable to properly use insulin, and progresses to diabetes.”

She added, “Another type of diabetes that affects pregnant women is gestational diabetes. There has ben a study growth in the number of women getting gestational diabetes over the years. Gestational diabetes is characterized by high blood sugar levels throughout pregnancy. During pregnancy, a woman's body will adjust how she eats glucose in order to offer more energy to the growing fetus. While some women's bodies can adjust by manufacturing extra insulin, others may not be able to keep up with the demand. Gestational diabetes can be harmful both during and after pregnancy. People who have gestational diabetes are more likely to have high blood pressure during pregnancy, which raises their risk of developing the potentially fatal illness preeclampsia.”

As diabetes is an illness that requires a holistic approach to care, in order to avoid both acute and long-term consequences, nutritional care for diabetic patients is crucial. Dt Nisha simplified the dietary and nutritional intervention that help manage blood sugar levels -

• Food right in fibre: Fiber moderates how your body digests food and helps control blood sugar levels. Foods high in fiber include vegetables, fruits, nuts, legumes and whole grains. Keep away from processed fruit juices and smoothies as it might have a lot of sugar which can be harmful for your health.
• Healthy carbohydrates:

Carbohydrates and sugar is broken down into blood glucose during digestion. Sugars are classified as simple carbohydrates, whereas starches are classified as complex carbs. Concentrate on nutritious and comple carbs such as whole grains, pulses, quinoa, oats and beans.

• Omega 3: Omega-3 fatty acids were effective in reducing the triglyceride significantly and is beneficial for diabetic patients to include in their diet. Fish such as salmon, mackerel, tuna and sardines are rich in omega-3 fatty acids. Also, walnuts, chia seeds, edamame are good source of Omega- 3 fatty acids.
• Healthy Fats: Foods high in monounsaturated and polyunsaturated fats can help decrease cholesterol. Some foods with healthy fats include avocados, nuts, seeds, live oil.Ensure not to go overboard because all fats are high in calories.

Dt Nisha said, “Apart from including your diet has a balanced mix of high fibre, healthy fats, healthy carbs and Omega 3 fatty acids, it is important for women with gestational diabetes should include iron, calcium, folate and other supplements that the doctor recommends. During digestion, sugars and starches break down into blood glucose. Sugars also are known as simple carbohydrates, and starches also are known as complex carbohydrates.” Focus on healthy carbohydrates, such as:

• Fruits.
• Vegetables.
• Whole grains.
• Legumes, such as beans and peas.
• Low-fat dairy products, such as milk and cheese.

Avoid less healthy carbohydrates, such as foods or drinks with added fats, sugars and sodium.

• Heart-healthy fish: Eat heart-healthy fish at least twice a week. Fish such as salmon, mackerel, tuna and sardines are rich in omega-3 fatty acids. These omega-3s may prevent heart disease. Avoid fried fish and fish with high levels of mercury, such as cod.
• 'Good' fats: Foods containing monounsaturated and polyunsaturated fats can help lower your cholesterol levels. These include:
• Avocados.
• Nuts.
• Canola, olive and peanut oils.

Don't overdo it, as all fats are high in calories. Alakesh Das, PhD, Research Scientist-Cell Biologist at HaystackAnalytics, suggested, “To manage their overall well-being, it is essential for people to adopt certain lifestyle practices to curb the long term risk associated with lifestyle disorders like diabetes. Studies suggest that fundamental lifestyle practice you can incorporate into your daily routine is physical activities like walking, exercising, jogging, swimming or Yoga for at least 150 minutes a week. This will not only help you in weight management but also regulate hormone levels, enhance insulin sensitivity, and improve the immune system.”

He concluded, “As per The Department of Health and Human Services in the United States ensuring approximately 7 hours of sleep every night is essential to keep your mind and body relaxed. This will not only help you keep yourself relaxed but also manage stress levels and cognitive health, which are one of the root causes of diabetes. Beyond these lifestyle practices, it is suggested to opt for regular health screenings to monitor any emerging health issues like diabetes. Furthermore, opting for genetic testing is recommended to understand the blueprint of your DNA and your genetic predisposition towards certain lifestyle diseases like diabetes. This enables the doctors to give you a personalized care regime which can help you manage your overall well-being in a more effective way.”