By Radhika Ganesan

Diabetes has become a major health threat to the whole world; indeed, the greatest increase will be contributed by India, which has already been declared by the World Health Organization (WHO) as the country with the largest number of diabetics in the world. Diabetes is frequently not diagnosed until complications appear, and approximately one third of all people with diabetes may be undiagnosed, though diagnosed many people are not aware of their condition.

Late detection of diabetes often means that at the time of diagnosis complications have already damaging the eyes, kidneys and nerves. These complications are costly in the physical, financial and psychosocial sense. Early detection and treatment of diabetes may not only improve glycemic control, but also improves blood pressure and lipids.
Who should be screened? In general all adults should be screened at regular intervals
o Family history of diabetes (i.e., parents or siblings with diabetes)
o Overweight (Body Mass Index >25 kg/m2)
o Age >45 years
o Previously identified impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)
o Hypertension (>140/90 mmHg)
o Hyperlipidemia (HDL - 250 mg/dL or both)
o History of gestational diabetes or delivery of a baby over 9 lb (4.1 kg) (ADA -Diabetes Care 2004)

What are the Screening test for Diabetes

Fasting Plasma Glucose: The fasting plasma glucose (FPG) test is the standard test for diabetes. It is a simple blood test taken after eight hours of fasting. The FPG test is not always reliable, so a repeat test is recommended if the initial test suggests the presence of diabetes.

Oral Glucose Tolerance Test: The glucose tolerance test may be more accurate than the FPG in certain groups (e.g., women with a history of gestational diabetes). The test uses the following procedures: I) after an overnight fast Fasting Plasma Glucose test is performed. ii) After this test a person receives 75 g of glucose (100 g for pregnant women) blood samples are taken every half an hour {(fasting-30mts-60mts-90mts-120mts-(five times)} to measure the blood glucose. It not only helps in detecting diabetes but also help to detect the pre-diabetic status, Impaired Fasting Glucose (IFG) & Impaired Glucose
Tolerance (IGT))

Is it important to detect pre-diabetic stage? Yes! Because it is "preventable"
Criteria for the diagnosis of diabetes mellitus

Normal DIABETES

Symptoms of diabetes + Random plasma glucose o Blood pressure check up, regular at every visit for Hypertension (High blood pressure) - should be 40
o An electrocardiogram (ECG), that provides information about the status of heart
o Chest X ray, information about the lungs and shape of the heart and vascular system (aorta and blood vessels)
o Carotid Intima-media Thickness (IMT), marker of early atherosclerosis

Diabetic Nephropathy (Kidney Damage): Person with diabetes are several times more prone to kidney disease than the general population. The earliest manifestation of kidney damage is microalbuminuria, (tiny amounts of protein called albumin are found in the urine). Symptoms include Protein in the urine, High blood pressure, burning during urination, frequent urination, puffiness and swelling around the eyes, hand & feet, excessive itching, nausea, vomiting & weakness.

About 20% of type 2 patients show evidence of microalbuminuria upon diagnosis of diabetes, however, only a small percentage of type-2 diabetics eventually develops kidney disease. Microalbuminuria typically shows up in type 2 diabetics who have high blood pressure. Normal: 15yrs will develop diabetic retinopathy in their lifetime.
Who are more prone to Diabetic retinopathy? : Uncontrolled blood sugar, longstanding diabetes, Hypertension with diabetes & Genetic predisposition.

What are the stages of retinopathy? : Mild non proliferative diabetic retinopathy (NPDR), Moderate-non proliferative diabetic retinopathy, severe retinopathy, Maculopathy and Proliferative diabetic retinopathy. Treatment: Retinopathy can be treated through laser photocoagulation. Screening test: Patients with diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist right from the day of diagnosis of diabetes and every year thereafter. Early detection, timely treatment, appropriate screening and care reduce the risk of vision loss & 90% of diabetes related blindness.

All patients should be regularly screened for risk factors and encouraged at each health care visit to pursue a healthy lifestyle that includes a healthy diet, adequate exercise, weight control and stress reduction. 'Try for good control to be sure, but don't try for perfection. Perfection lasts for a moment, and diabetes lasts a lifetime'. The main theme is to be focus on to 'live a Healthy Life Despite Diabetes'.

Diabetes is a disease that affects millions of people in the U.S. alone. A simplified definition of diabetes is when your body does not produce enough insulin to properly use the right kind of sugar into your bloodstream. This can have devastating effects on the body, as the cells do not get all of the fuel they need for energy and growth. While all of the causes of diabetes are not fully understood, eating raw foods helps to reduce some of the currently known risk factors. Therefore, it makes sense to choose a diet of raw foods whether you have been diagnosed or not.

Dietary needs of diabetics
Diabetics still require the same levels of nutrition as everyone else, maybe even more so. Nutrition is one of the most important elements for controlling diabetes properly. As you will see, following a raw food menu will fit in with diabetic nutritional recommendations. Here are some basic tips on eating right.

Choose a wide variety of fruits and vegetables. (Diabetics may need to limit starchy vegetables)

• Avoid processed grains such as white flour, and white rice.
• Opt for whole grains instead.
• Add lentils and beans (like pinto, garbanzo, or kidney beans) to your diet.
• Eat fish a few times a week.
• Consume non-fat dairy products.
• Reduce high-calorie snacks and like cake, cookies, chips, and ice cream.

Raw foods for diabetes
Most of these recommendations fit in well with the raw food lifestyle. The main difference is that the food would not be cooked, as raw foodists eat raw, uncooked, unprocessed and organic food. Fish and dairy products may or may not be a part of your raw foods diet. People that eat raw foods are already reducing their risk for disease, including diabetes.

If you have diabetes and are thinking about a raw foods program, you can see how it is an ideal choice. A raw food diet helps those with diabetes by sticking to the current dietary guidelines. The reason raw foodists do eat uncooked food is because all of the naturally occurring enzymes. These enzymes promote optimum health and digestion. Diabetes is a serious disease, so be sure to check with doctor before switching to raw foods. Take some time to explain what the raw foods diet is all about. Be sure to continue monitoring your blood sugar level according to your doctor’s instructions. Some diabetics eating raw foods have seen remarkable improvements in their condition.

Eat to Beat Diabetes
When it comes to maintaining good blood sugar levels, a healthy diet is vital. People with diabetes have to take extra care to ensure their diet is properly balanced with their insulin and oral medications.

The right meal plan will help any diabetic improve blood glucose levels, blood pressure and cholesterol numbers.
All diabetics must control their refined carbohydrate intake. These types of carbohydrates increase blood glucose levels. While some promote health, others when eaten often and in large quantities, may increase the risk for diabetes.

Carbohydrates come from a wide array of foods including fruit, vegetables, beans, milk, popcorn, potatoes, cookies, spaghetti and corn. The most common and abundant ones refined in are sugars, fibers and starches. It is advised diabetics avoid white bread, rice and pasta, along with foods containing unnaturally added sugars.

The body will convert all types of refined carbohydrates into glucose. Eating extra servings of rice, pasta and bread will make blood sugar rise.

Diabetics should consume carbohydrate-rich foods close to their natural form. These items have greater vital nutrient density. Whenever possible, replace highly processed grains, cereals and sugars with natural whole-grain products.

Eating complex carbohydrates rich in fiber significantly lower blood sugar levels. It is capable of slowing down the digestion and absorption of carbohydrates and increasing the sensitivity of tissues to insulin, thereby preventing rises in blood sugar.

It is recommended diabetics eat 13 fiber-rich servings of fruits, veggies, beans and grains daily. Soluble-fiber rich foods include orange and grapefruit segments, prunes, cantaloupes, papayas, raisins, lima beans, zucchini, oatmeal, oat bran and granola. Other foods high in soluble fiber include barley, peas and strawberries.

The glycemic index system, or GI, is a good guideline for diabetics to follow.
Invented in the early 1980s by University of Toronto researchers, the glycemic index ranks carbohydrate foods by their effects on blood sugar levels.

The GI assigns carbohydrate-containing foods a number based on how they affect blood sugars. The longer the body has to break an item down into glucose, the slower the rise in blood-sugar levels, and the lower the GI. Adding a half a teaspoon of cinnamon to any meal can stabilize blood sugar swings.

Many diabetics also supplement with vitamins, herbs and medicinal teas. Incorporating natural ginseng into a diet can produce positive affects. This herb, which is recognized throughout China to have healing properties, has been known to help improve fasting blood glucose levels and increase insulin secretion.

The easiest method to control diabetes is through proper diet. An eating plan high in fiber and low in refined carbohydrates will ensure the best strategy to beat the disease.