Once a person comes to know that he has become diabetic, the first fear that pops up in his mind is about dietary restrictions. Diabetes is considered a disorder of sugar and so patients start enquiring about foods, which contain sugar. Often doctors, dieticians, diabetes educators also forbid the patients from taking rice, potato, fruits, fruit juices, sugar, etc. Thus, with the diagnosis of diabetes, everyone in the family becomes concerned about what NOT to give to the patients as they believe these restrictions can only curb or help in the treatment diabetes.

In countries like India, there are many myths about diet in Diabetes and as a result any rise in glucose is believed to have occurred solely due to dietary reasons. This leads to inadequate medical treatment and thus glucose levels remain high leading to higher diabetes complications.

No book and none of the International organizations on diabetes have prohibited any food in Diabetes, says Dr. Sunil M Jain, CEO of diabeteshormone.com. Diabetics can consume all food items but in moderation and as per Calorie requirement, he adds.

There is a need of awareness among healthcare providers about diet in Diabetes. The food we eat contains carbohydrates, proteins and fats. A healthy diet implies that at least 50 – 60% of calories should come from carbohydrates, 20% calories from fats and 20% calories from proteins. If a meal of a diabetic patient has a healthy diet calorie distribution, it can be permitted.

What is required is an understanding of the composition of food items and then planning of a meal pattern. Doctors and nutritionists should consider this concept and try to remove food related myths rather than reinforcing them. It is crucial to understand that if glucose levels are high, there may be other causes like inadequate medications, missing medications, need of insulin, etc and not small amounts of rice or fruits. Blaming to just diet is one of the cause for inadequate treatment and thus high glucose levels. Patients need to think more in terms of Insulin deficiency and this will automatically lead to process of improvement in medical treatment and better glucose control.

Diabetic diet actually comprises a healthy and proportionate diet. Due to misconceptions, people fail to understand the basic and important concept. Diet modification is an adjustment to decreasing Insulin supply. If glucose is high in spite of a healthy diet, then it more advisable to revise treatment so as to improve Insulin supply.

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1. The action of both short and long-acting insulin is unpredictable. In clinical studies, the amount of insulin that reaches a person’s blood varies by 15% to 50 % from one day to the next with injections.
2. Multiple injections are often inconvenient.
3. To achieve normal glucose levels, a very rigid and consistent meal plan is a must. At the same time Carbohydrate every day is needed.
4. Long acting like NPH or analogs like Glargine and Detemir can provide basal Insulin but this may not necessarily match the variable background needs of an individual like Dawn Phenomenon in morning, or a different basal need in late evening.

These all problems can be better dealt with help of Insulin pumps. According to Dr. Sunil M Jain, CEO, diabeteshormone.com, Insulin pump can be considered as artificial pancreas. It provides Insulin constantly mimicking basal Insulin delivery by human pancreas as well as instantly to take care meal related Glucose rise. It is considered as gods standard for Insulin replacement.

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In order to understand the relation between Sugar (glucose) and hormone (insulin), it is essential to know the working of the body at cellular level.

Body Work at cellular level:

Our body is composed of millions and millions of cells. Our muscles are made of muscle cells, our livers of liver cells, and there are even very specialized types of cells that make the enamel for our teeth or the clear lenses in our eyes. Each cell is a complete unit in itself. A number of complex metabolic processes are taking place in these cells for which the required energy is produced by glucose. Anything we eat (carbohydrate) is transformed to glucose after absorption in the intestine. This glucose enters the blood and through the blood vessels is circulated all over the body. When we are in a fasting state, glucose comes from liver (Hepatic Glucose Output).

It means that even in a fasting state glucose is continuously reaching the blood through liver. As liver is known as the store house of glucose and in urgent situation when no food is available it helps in maintaining all the body functions by releasing glucose into the blood. Glucose then acts as a fuel for carrying out the various metabolic processes of the body. So it can be said that glucose is to our body what gas is to a car. Hence, whether we eat or are in a fasting state, glucose level in blood is maintained at all times.

Now the next step is that this glucose should enter the cells where it will be used as a source of energy by the cells to carry out the various metabolic processes.
GL UT4 acts as a door of body cell. In basal state this door GLUT4 is closed. For glucose to enter the cells this door (GLUT 4) must be open. When this door opens, glucose enters the cells of the body and provides energy to the cells. The process of entry of glucose from blood into the cells is complex and is carried out by a hormone called insulin. Insulin opens the door on body cells and makes glucose entry in body cells possible which then provides energy to the cells. So in brief we can say that relationship between glucose and insulin lies in the fact that insulin opens the lock allowing glucose to enter inside the cells.

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