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A Diabetics guide to fasting – by A Diabetologist & Dietician

For Diabetics, managing diet in normal day-to-day life is no child’s play; add to that the twist of fasting is an even very risky affair. Diabetics in general are advised not to do fasting. However, if you still want to venture into fasting there are some important precautions & guideline which diabetics need to follow. As we have highlight in this article. First, we talk about who absolutely cannot do fasting & who can. Followed by the right way to plan fasting with the help of your diabetologist and finally what a diabetic should eat and when. So, let’s get started

Diabetics who should absolutely and Definitely NOT do Fasting

1. Diabetic people who are on insulin treatment should not even think about fasting as they need constant monitoring and any drop or increase in blood sugar can prove fatal.
2. Type 1 diabetics who are inherently dependent on insulin should not fast, sorry but its for your own good.
3. Diabetics who have other medical conditions like cardiac, renal problems need to avoid fasting aswell.
4. Diabetics who are at a risk or prone to both hypo & hyper glycemia should not do fasting.
5. Senior Citizens who are diabetic are advised not to.

Diabetics who can do fasting under the observation of a diabetologist:

Diabetics who fall in the following category of patients can think of fasting but only if their diabetologist clears them to do so:

1. Diabetics who have good control on their blood sugar and are not on any high dose of medication can opt for fasting.
2. Diabetics who do not have much fluctuations in their sugar levels can think of fasting.
3. Diabetics who are not at a high risk of hypo-glycemia can fast.

How to go about fasting if you are diabetic:

1. Consult your Diabetologist & get your medications in order: As there will be a change in the food intake there will be a significant change in the blood sugar levels compared to your normal routine. Hence, the dosage of diabetes medications needs to change according. For example, your main medication needs to be shifted according to the time when you will have the proper fasting meal of the day (details below). This change can only be prescribed by your treating diabetologist.
2. Monitor your Blood Sugar Religiously; Diabetics should check their blood sugar at-least 3 times a day or whenever they feel symptoms of hypoglycaemia. Signs of hypoglycaemia include feeling weak and giddy, having palpitations. If they find that the blood sugar is below 80 you need to break your fast and have something to eat ASAP! Like a fresh fruit juice!

Managing Diet when fasting if you are diabetic:

The critical challenge for diabetics when fasting is to make sure they don’t go into hypoglycaemia nor should they suffer from hyperglycaemia. For example, Some fasting foods like sabudana (Tapioca) which has a higher glycaemic index if taken in excess can trigger hyperglycaemia While not eating anything for more than 2-3 hours can cause hypoglycaemia. Hence, as suggested earlier its critical to check your blood sugars actively when fasting.

So What should a typical fasting diet include during Navratri;

Diabetics cannot do the fasting where no food or water is allowed during day, please don’t. Fortunately fasting in Navratri allows most of us to have fruits and some sattvic foods during the course of the day. it is important to select foods which have a lower glycaemic index for the reason stated above. Nonetheless you can have other foods with higher glycaemic index in moderation aswell so lets dig in

1. Foreword: Diabetics must make sure that they have something every 2 hours to keep their sugar level maintained. Having Mid-meals like Fresh fruit, Milkshake, Chaas, Shikanji, kheer, Shakarkandi ki chaat or Sabudana wada with dahi can be a good option. Keep the portions balanced depending on your physical activity.
   Stay Hydrated: Diabetics should have atleast 3 litres of water in a day.
   Avoid Caffeine – Tea Cofee – Tea can often cause acidity leading to vomiting and other complications.

2. Just after waking up– Early morning are critical as the blood sugars in general are low so diabetics need to make up for it else can go into hypoglycaemia. Start the day by having either of these.
   1. Any Fresh fruit that you like or may have
   2. Handful of nuts
   3. Overnight soaked almonds with kesar

3. Breakfast– This meal should ideally help your regain your blood sugar levels and also keep you going for the day hence something like
   1. Singhare ke pakode
   2. Sabudana khichdi
   3. Sweet potato with dahi
   4. Alu Ki kheer
   5. Chana poori and halwa (Yes but on last day! With some moderation)

4. Lunch – For lunch you can have.
   1. Rajgira or kuttu or singhare atta ki roti with Alu or arbi sabzi
   2. Makhane ki sabzi
   3. Kuttu ki kadhi with samo chawal
   4. upasacha thalipeeth

5. Dinner – For fasting diabetics, skipping dinner is not an option. Dinner needs to keep your sugars up all night so you the diabetic can stills stand in the morning. A proper fasting meal would be ideal or you could try
   1. Samo chawal with dahi
   2. Jhangora kheer
   3. Paneer ki sabzi with kuttu or singhare or rajgira or banana flour ki roti

So have a happy & safe fasting! and remember If you are unsure of how to go about this you can contact your treating diabetologist or contact us 9167444888 on and our inhouse diabetologist & Diet consultant will guide you.

This Articel has been written by our Diabetologist Dr. Vinod Methil & Diet Consultant Prateeksha Kadam.

Does Type 1 Diabetes Increases Risk of Autoimmune Diseases?

There’s no doubt that the primary concern of people dealing with type 1 diabetes is “how to control the blood sugar levels”? Perhaps, the only way they can prevent the kidney, eye, and vascular problems is by maintaining their blood sugar level. However, the recent studies suggest type 1 diabetes patient is more prone to autoimmune diseases. The study further revealed that 1 out of every 5 children suffering from type 1 diabetes tends to develop another autoimmune ailment. Type 1 Diabetes has a major impact on aged people (65+ years). In fact, half of the aged individuals struggling with Type 1 Diabetes are likely to experience other autoimmune diseases. Now the question is “what autoimmune diseases are the Type 1 Diabetes patients are prone to?”

What Autoimmune Diseases are Common in Type 1 Diabetes Patients?

Some of the most common autoimmune diseases associated with Type 1 Diabetes are celiac disease, Addison’s disease, and hypothyroidism. As most of the Type 1 Diabetes patients are likely to develop celiac disease and hypothyroidism, doctors often suggest these patients a routine screening. It is essential to note that autoimmune diseases can either develop before or after the diagnosis of Type 1 Diabetes.

Specialists should check the diabetic patients for celiac disease and thyroid. There are no critical symptoms associated with celiac disease or thyroid, but the Type 1 Diabetes patients are advised to consult with their doctor if they witness unusual symptoms such as changes in glycemic control or weight, improper digestion, and other digestive problems. Our immune system is one of the most vital parts of a human body, as it keeps the body from hazardous organisms including bacteria, viruses, and other microbes. But what’s surprising is the immune system that is designed to preserve our body from the attack of foreign matter can sometimes turn awry and attack the vital organs of our body. When the immune system doesn’t work properly and negatively affect the other tissues and organs of a human body, the autoimmune diseases are likely to happen.

What Causes Autoimmune Diseases in Type 1 Diabetes Patients?

Though the exact reason behind this issue isn’t confirmed yet, research suggests that environmental and genetic factors are the leading causes behind autoimmune ailments. As per the clinical research, it is not diabetes that causes autoimmune problems in teens and kids. There isn’t any proven cause of autoimmune diseases in Type 1 Diabetes patients discovered but genetics are most likely the cause of these ailments.

Studies based on Type 1 Diabetes associated autoimmune diseases discovered that the genetic risk factors had a major influence on celiac disease, thyroid, and other autoimmune ailments. As DNA of an individual passes through several generations, the occurrence of autoimmune diseases in Type 1 Diabetes patients isn’t uncommon. The main reason why it is hard to discover the exact cause behind autoimmune disorders is the complex structure of the human immune system. That’s why the treatment of thyroid, celiac disease, and other immune disorders is challenging. A proper diet, hormone replacement, and anti-inflammatory drugs may relieve the symptoms to some extent but they can’t cure the issue.

I have diabetes… I have no symptoms… Am I really Healthy?

We Human’s have a peculiar attitude when it comes to our health. We often tend to ignore a minor pain, fever or scratches. We often believe that our body will heal itself… In most cases that just what our body does. However, the same is not the case when it comes to Diabetes. Diabetes is quite rightly called the Silent Killer and for good reason. Diabetes does not allow body to heal in a normal manner. Hence, diabetic patient cannot & should not take even a minor injury lightly.

Generally, Diabetic patient only check their sugar test (fasting & post lunch sugar). If their sugar parameters are in the normal range, they believe they are doing fine and go about their routine, without a care in the world. It gives them a false sense of security, that their diabetes is in control and consequently they will not suffer from any other diabetic complication. Unfortunately, that is not the case and such diabetics should still go for a complete diabetes check-up atleast once a year while keeping a regular follow-up with their Diabetologist.

Take the case of one our regular patients, who had her blood sugar in check had just done her annual Heart Rate Variability (HRV) test at Sweet clinic. The test highlighted that she has a coronary condition. Following which our Diabetologist further analysed her for diabetes related coronary symptoms and eventually suggested to undergo an angiography. Unlike a normal person who would have got chest pain & unexplained sweating, a diabetic patient with a heart condition only has some breathlessness and a feeling of heaviness. Which is the symptoms she showed. Her angiogram showed a heart block and she had to undergo an angioplasty. This patient’s adherence to her diabetologist follow-up and annual testing protocol helped save her life. Similarly, many diabetics can save themselves from life-threating conditions by simply showing up for their diabetologist consultation and regular tests.

One must understand that diabetes can affect heart, eyes, kidneys, blood vessels, feet, brain or any other organ without any clear symptoms. It is still a mystery why in some diabetics, it affects the heart while in others affecting a different organ, some studies suggest it related to a person’s genetics.

Nonetheless, what we know for sure is that a diabetic patient generally has a higher blood sugar level than what is ideal for the human body. This increase in blood sugar first starts affecting the minute blood vessels called capillaries by making them thinner. These are present in all organs of the body by making them thinner. The first change occurs at the minute level of these capillaries.

It is through the capillaries that each organ gets their oxygen & nutrients and also send their waste products to the blood to be excreted out of the body later.

Hence, during the initial stages of any diabetic, complications are symptom less. For example if kidney is getting affected by diabetes, at the onset, the person will have no complains whatsoever. Even the blood marker test results (Kidney Function Test -Blood Urea & Creatinine) will be within acceptable limits. This happens because kidney, like a good soldier, will try it’s best to maintain normal functionality. Its only when the kidney cannot sustain its normal functioning that the blood markers show a spike. This is when most diabetics will start witnessing some uneasiness or pain. Nonetheless, these changes take place at a very slow rate and warning signs can be identified before any major change in the organ takes place. For example, keeping a check on the urine protein test (micro-albumin test) can help a diabetologist know that the kidney is getting stressed (even before the patient experiences any symptoms) and take necessary corrective steps to save the organ from further damage. Hence, It is important for any diabetic to go for a complete diabetes check-up.

Similarly, diabetic retinopathy which is known to cause irreversible damage to the eye, even blindness in some patients can be prevented by a simply going for an annual diabetes specific eye test …

Hence, a diabetic patient can never be too complacent and should only consider normal blood sugar levels with a pinch of salt. They should visit their diabetologists regularly and get those specific tests done to be extremely sure that diabetes is not affecting any of their other organs adversely.

Based on our experience of treating more than 3000 diabetes patients, we at Sweet Clinics have introduced the Sweet Secure and Sweet Shield, complete diabetes care programs that make sure each and every early marker for diabetic complication is measured. Our diabetologist and super specialist doctor team are always available to help our patients live a healthy & happy life.

Diabetes & Diwali

Diwali and Diabetes

Diwali the festival of lights is here. It’s also the time when food is in abundance especially sweets and offered to all. So with the wealth of rich food available it can be very taxing time for a diabetic to keep his blood sugar in control. A maximum number of diabetics come with haywire blood sugars post Diwali.

So for those of us whom will power does not come easily here are some tips for enjoying sensible eating at Diwali.

Commit yourself to a food plan. It is very easy to get carried away by what is on the table .To reduce this from happening plan how much you intend to eat and what to eat and make a point sticking to the meal plan. Keep to your routine meals as much as possible as it will prevent unnecessary snacking. Avoid feeling hungry for long. When you are hungry you tend to over eat. One way to avoid being ravenous is to break the delay. Protein and non starchy vegetables based premeal snacks are a good choice as they are filling and slowly broken down.

Have a glass of water before eating, it’s a very effective way of reducing your food intake and reduces appetite.
Have food in a small plate. It gives a fuller look with less amount of food. Again base your meals with non starchy vegetables .Make sure vegetables account for a good portion of your plate.

Eat gradually and slowly. Eating with family is a nice occasion but if you are a fast eater it can make you tempted for additional helpings and adding to your overall calorie intake.

Don’t feel guilty or shy about turning offers down. Any food you eat is going to end in your blood and so don’t feel shy about turning food down especially the sweet ones.
Go very easy on the sweets. One can be forgiven for indulging every once in a while. So if you cannot resist the sweet, keep the serving small and sensible. Once again apply the rule about eating gradually.
If temptation is too much to have a sweet dish, try fresh fruits. Fresh fruit mixed with yoghurt and frozen can be a good replacement for the Rabidi or Jalebi or ice cream. Try using sugar free sweeteners in a limited amount in your sweets but remember every thing has calories and just because you have used artificial sweeteners does not give you the liberty to have unlimited amounts.

After and between meals put food under cover. Food that is exposed grabs the eye tempting to small unwanted indulgency .Apply the rule out of sight is out of mind.

Try to increase your physical activity as this is a good way of utilizing those extra calories that you may have indulged in.
Remember to take your medications .With family and friends around and the excitement of festival should not make you miss your insulin shot or regular medications.

Continue regular checking of your blood sugars to make you aware of your indulgences,
.
Finally Diwali is not just about sweets, it’s about family and friends. Enjoy your time with family doing things that you love the best.

Have a happy and safe Diwali…………….Dr Vinood Methil.