Weight Loss improves Diabetic State
• Moderate & sustained weight-loss (5 % to 10 % of body weight) can improve insulin action. It can decrease fasting glucose concentrations. It can also reduce the need for some diabetes medications.
A program of diet, exercise & behavior modification can successfully treat obesity, but pharmacotherapy & /or surgery may be warranted.
• Unfortunately, the results are not always permanent. People with longstanding diabetes have been on insulin for more than 10 years. They seem to be at risk for recurrence of their diabetes after RNYGB. Those with poorly controlled diabetes before bariatric surgery are also at risk.
•BPD/DS is generally accepted to have the most durable effect on resolution of diabetes in people affected by the disease.
Dietary Recommendations for Diabetes
| Diabetes/ Insulin Resistance/ Hyperinsulinemia | |
| Diet Approach | High Fiber, High Magnesium, Low Glycemic Index, Low Glycemic Load and Low Fat Diet |
| Allowed Liberally | • Low GI Vegetables – Broccoli, cabbage, lettuce, mushrooms, onions & red peppers, green leafy vegetables, tomatoes, cucumber, radish, lemon, carrot, karela (bitter gourd), green beans, cauliflower & eggplant. • Low GI Fruits – Cherries, grapefruits, plums, peaches, apple, guava, strawberries & prunes. • Magnesium Rich Foods – Beans, barley, dark leafy greens, nuts, seeds, fish, whole grains, avocados, low fat yogurt & dried fruit. • Whole Grains – Whole wheat products, roasted channas, quinoa, in whole grains form or sprouted grains (steamed – one whistle) & brown rice, jowar, bajra, ragi, barley. • Beverages – Clear soups, herbal tea, low fat soya – milk, buttermilk, lemonade. • Plant based protein intake is recommended especially from – Soya, quinoa, beans, nuts & seeds. • Beneficial Herbs & Spices – Cinnamon, garlic, flax seeds (ground), curry leaves, onion, turmeric, amla & cumin. |
| Allowed in Limited Amount | • Medium GI Vegetables – Potatoes, yam, arbi, sweet potatoes & corns. • Medium GI Fruits – Mangoes, grapes, bananas, chiku. • Fat- free or low-fat milk & yogurt • Lean meat, fish, poultry, low-fat cottage cheese & tofu • Reduce sodium intake – salt should be limited to 3-5g/day i.e. 1tsp • Add Herbs as taste enhancers e.g. oregano, basil, thyme & rosemary. |
| To be Avoided | • Sugar, honey, jaggery, sweets, candies, chocolates, fruit juices & candies. • Refined grains sources such as white bread, pasta, bagels, white rice or sugared cereals. • Sweetened juice, canned fruit in heavy syrup, or sweetened applesauce. • Saturated, hydrogenated and trans fats are all fats that should be avoided. • Trans fat in biscuits, cakes, breads, pastries, muffins, pies, & doughnuts. • Saturated fat sources like ghee, butter, red meat, organ meats, full cream milk & its products etc. • Salt Preserved Foods – Pickles, canned foods, frozen foods. • Highly salted Foods – such as potato chips, ketchups, sauces, peanut butter, salted butter, namkeens, papad, chutneys. • Monosodium Glutamate (Ajinomoto), baking powder, sodium bicarbonate & sodium benzoate containing processed food items – chips, soya sauce, fast & restaurant foods, and bakery items. • Avoid fasting and feasting. • Avoid smoking & alcohol intake. |
Exercise Recommendations for Diabetes
Be physically Active
Cardio/ Aerobic Exercise at mild to moderate intensity (like walking, dancing, cycling, cross-strainer, treadmill, rowing etc.) for 45 mins to one hour, may be done in 2-3 sessions during the day + toning and strengthening exercises for 15 mins every day + 15 mins day to day activity.
• Follow De-Stressing Techniques especially meditation, yoga & breathing exercise.
• Exercise only when feeling well. It is advisable to postpone exercise for 2 days. Do this after signs and symptoms of a cold or flu, including fever, have been absent.
• Generally, it is best to exercise with a friend who is aware of your diabetes.
•Know the symptoms of too much and too little glucose in your blood.
• Low blood glucose- light headedness, rapid heart beat, sweating.
• High blood glucose- frequent urination, vision difficulty, increase appetite and thirst, weight loss.
Before Exercise
- Estimate intensity, duration, and energy expenditure of exercise
- 30 to 45 minutes of exercise is safe when diabetes is under good control
- Good control is defined as blood sugar between 90 to 140 mg/dl.
- Eat a meal 1 to 3 hours before exercise.
- Monitor blood glucose:
-If blood glucose <100 mg/dl, take supplemental pre-exercise snack
-If blood glucose >250 mg/dl or urine ketones positive, delay exercise
During Exercise
- Supplemental calories with carbohydrate feeding (whole grain bars, sand witches smoothies or juice) every 30 minutes during extended, strenuous exercise.
- Drink plenty of fluid.
• Monitor blood glucose intermittently when engaging in prolonged exercise
After Exercise
- Monitor blood glucose, especially if exercise is not consistent.
- Increase caloric intake for 12 to 24 hours after exercise.
- Be aware of post-exercise symptoms of too much/little blood glucose
- You are advised to wear shoes and socks at all times to avoid trauma to the feet. Inspect your feet on a regular basis for blister, corns bunions or any other abnormalities.
- If you have diabetic retinopathy, avoid activities such as contact sports, heavy weight training or inverted hanging to minimize the risk of eye complications
- Consult your physician if any symptoms develop during/after exercise. Notify your physician when changing your exercise routine.
