Diabetes Mellitus is a chronic metabolic disorder that doesn’t spare anyone, be it a child, adult or old person. It is a condition characterised by raised blood glucose concentration. This is due to failure in the formation of insulin or the body doesn’t use the insulin. 
There are three types of diabetes mellitus: 
Prediabetes– Prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes.
Type 1 Diabetes – Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition. In this condition, the pancreas makes little or no insulin. Insulin is a hormone the body uses to allow sugar (glucose) to enter cells to produce energy.
Type II Diabetes – Type 2 diabetes or non-insulin-dependent diabetes is an impairment in the way the body regulates and uses sugar (glucose) as fuel. This long-term (chronic) condition results in too much sugar circulating in the bloodstream. Eventually, high blood sugar levels can lead to disorders of the circulatory, nervous and immune systems.
A person with diabetes mellitus complains of excessive thirst, frequent hunger, weight loss and increased frequency and amount of urine, so look out for these symptoms. Here are some tips which help to control blood glucose levels:
Low-carb diet: Carbs in food, if not eaten along with protein and fats, make your blood glucose level go higher. A recent national study conducted by the Indian Council of Medical Research (ICMR) based on 18,090 adults has shown that a low-carb diet reduces the risk of diabetes. Counting carbs in foods and drinks is an important tool to manage blood glucose levels. Your diet should contain complex carbs such as oats, brown rice, millets, Dalia, quinoa and whole wheat grains.
Dietary fibre: Fiber in complex carbs and green leafy vegetables promotes weight loss and lowers the risk of diabetes mellitus. It increases satiety, reduces cravings and keeps you fuller for a longer time. Eat a variety of healthy fibre-rich foods such as spinach, mustard leaves, watercress, ferns, pumpkin stems, and legumes like beans, chickpeas and lentils.
Fenugreek seeds: Fenugreek seeds contain mucilaginous fibre which improves insulin sensitivity and improves blood sugar levels. The seed can be taken as such after overnight soaking in water or powder form, 15 minutes before a meal. The fenugreek seeds can be incorporated into preparations such as chapatti, rice, dal and vegetables.
Bitter gourd: Most people don’t like bitter gourd but the compound, polypeptide-P (insulin-P), present in bitter gourd aids in the regulation of insulin levels which in turn manages blood glucose levels. It can be taken as juice, boiled, sautéed, streamed or stir-fried. 
Gurjo/giloy: Gurjo is said to be useful in managing type II diabetes mellitus. In Sanskrit, it means ‘destroyer of sugar.’ It has anti-inflammatory, anti-arthritic, anti-allergic, anti-malarial and anti-diabetic properties. It helps in the production of insulin. Take the stems and leaves of gurjo, crush them and boil them in water. Drink it first thing in the morning.
Fruits with low glycemic load: Fruits have a whole lot of nutrients and fibre but mainly carbohydrates that can spike your blood glucose level if you eat more than what is required. Pick fruits that have a low glycemic load such as apples, berries, avocados, peaches, pears and plums.
Saying no to sugar: Sugar in any form, be it brown sugar, white sugar, caster sugar, honey, jaggery or sugar in beverages, should be avoided. As sugar contains empty calories and contributes to more calories than your body needs. Too much sugar leads to weight gain which increases the risk of getting type II diabetes, heart disease and stroke. Sugar is naturally found in fruit and vegetables so it is better to eat whole fruits and vegetables rather than having juices, sweets or chocolates containing sugar. 
Physical activity: Good physical activity or exercise helps in the good control of diabetes mellitus. Exercise helps to maintain weight, and heart function, and control blood lipids and glucose levels. In addition, it is also known to reduce stress which enhances the quality of life. At least 30-45 minutes of exercise should be done in a day. Walking, bicycling, swimming, jumping rope, yoga and strength exercises should be encouraged. 
Gestational diabetes occurs in women during pregnancy but the blood glucose level returns to normal after delivery. Many women develop diabetes mellitus in later years due to poor food choices and a sedentary lifestyle.
Take diabetes seriously and learn how to manage it. People often make bad choices in food options, lead a sedentary lifestyle and are not active at all. It is important to keep your blood glucose level in control to prevent or delay long-term serious health problems, such as heart disease, vision loss, kidney disease and many other conditions. Poorly controlled diabetes mellitus can cause damage to nerves and blood vessels in the feet leading to poor blood circulation and ultimately diabetic foot. If you feel numbness, tingling sensation, pain in the legs or no pain at all, it’s a warning sign for you to visit your respective doctor. 
Pheelina Bhujel is a Dietitian at the Diet Clinic, Dept. of Medicine, Central Referral Hospital, Sikkim Manipal University.
At Central Referral Hospital, dietitians support people to improve their health by providing expert nutrition and dietary advice. A dietitian can help you manage health conditions, such as diabetes, hypertension, heart disease, renal disease, dialysis and cancer. Diet Clinic at Central Referral Hospital also offers customised meal plan and food charts. Visit: Diet Clinic, Level 3, Central Referral Hospital, Tadong, Gangtok.
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