Monday 28 February 2011

Living With A Diabetic Hubby

Last week was a week of major upheaval of lifestyle for us, for on Monday, hubby was confirmed as a Type 2 diabetic, with a reading of 14 mmoL/L. Which means, to a layman, a very high level of plasma glucose.


For the rest of the week, we were kept busy trying to figure out what he should eat and should not eat. A dietary plan has to be worked out, with the intake of carbohydrates, sugar, fat, protein, and even sodium calculated. Everything I put into the pot or wok, had to have its calories calculated, and broken down into the carbo/fat/protein/sodium/sugar levels. 


Eating out is worse. We were suddenly stumped for ideas on where to go or what to eat, as most food outside are not healthy. Of course, healthy foods are sashimi (not sushi as it contains white rice and sake, alcohol), or Korean grilled stuff or steamboat. But then, we had to take into consideration the sodium levels in the Korean grilled stuff and the soup in the steamboat. 


So, that left us only sashimi, which we already had a week earlier. So we decided on Chinese food on Sunday evening. Imagine our order to the cook of a Chinese restaurant: "Spinach soup with no salt, and no century eggs, please....fried beehoon with no salt, or soy sauce please." And on Saturday, we had to turn down an invitation to pancakes cooked by a "top English chef", in his own words. What a bummer! 


When I mentioned this, some friends of mum said, "Oh, I have diabetes, too. There's no upheaval. Just take less sugary food, and if possible, don't take any white sugar." 


Well, I'm sorry, it's not as simple as that. And this is the reason why I have chosen to write this post, to hopefully educate those who hold to the myth that if you have diabetes, you only need to stop taking white sugar and take less sugary food.


My father-in-law died within two years of injecting insulin. No, not from insulin injection, but from the complications caused by diabetes, which I think some people are not aware of.


First, the complications caused by diabetes:

  • Vascular disease - The large blood vessels are narrowed, resulting in nutrients not being carried to your body's organs which might result in heart failure or stroke.
  • Small blood vessel disease - Blood vessels in the eyes and kidney may be damaged, which might result in vision loss and kidney failure.
  • Nerve damage - The nerves in the feet and hands might be damaged, and cuts or blisters might be infected, which might result in having to amputate the limb.
  • Skin disorder - Skin disorder such as bacterial infections, fungal infections, itching, Diabetic Dermopathy, Necrobiosis Lipiodica Diabeticorum, Atherosclerosis, Eruptive Xanthomatosis and Acanthosis Nigricans (see: http://tiny.cc/41z01 and  http://tiny.cc/wzeeq)

Two in three diabetic patient will suffer from the complications above. A good diet management will only manage to delay the complications, but if the patient lives long enough, the complications will come as surely as it will rain after a long dry spell.


Second, the list of food to avoid:

  • Refined and simple carbohydrates - Sucrose, glucose or fructose (sugar derived from fruits), white rice, white bread, white flour, table sugar (whether white or brown does not matter), sweets, honey and corn-syrup are to be avoided as they convert to glucose very quickly. 
  • High fat food - The list is endless and self-explanatory, too, I think, so I'll leave it as it is.
  • High sodium food - Canned food, preserved food, processed food, snacks like potato crisps, sauces and gravy are to be avoided as those food contain salt. 
  • Alcohol - this can cause liver damage and heart failure in a diabetic patient.
List of recommended food that hubby should take to prevent rapid peaks in the blood glucose levels:
  • Complex high-fiber carbohydrates - Oats, cereals, legumes, wholegrain products, dried beans, peas, lentils, fruits like oranges, strawberries, and dark green vegetables, or yellow peppers.
  • Omega 3 - Salmon, tuna, mackerel (but NOT king mackerel) and herring. These fish contain omega 3 and protect against the hardening of arteries.
  • Omega 6 fatty acid - Blackcurrant oil, primrose oil, borage oil. These protect against nerve damage.
Have I considered the Atkins Diet? Well, I have researched that as well, and found that the Atkins Diet is an over-hyped commercial diet, which might in the long term do more harm than good. Why? Because the Atkins Diet opt for a high protein and low-carbohydrate program, which causes a person to lose the water in their body rather than the fat cells. That is why anyone on Atkins Diet loses weight rapidly. (see the claims and reality of the Atkins Diet - http://tiny.cc/5dbya )

So, I had to resort to planning our own menu. After calculating hubby's calorie needs, I have to calculate each and every ingredient I use. For those who may not know how to work out your own calorie needs, below is the Harris-Benedict formula I used:

Men: BMR = 66 + (13.7 x W) + (5 x H) - (6.8 x Age) = Daily calories required
Women: BMR = 665 + (9.6 x W) + (1.8 x H) - (4.7 x Age) = Daily calories needs
W = weight in kg   
H = height in cm
Age = years

After I got the daily calories need for BMR, I multiply it by an activity factor for our lifestyle. 
Activity factor guideline table:
  • Sedentary - none or very little exercise = BMR X 1.2
  • Light activity for average of 2 days/week = BMR X 1.375
  • Moderate activity level exercising  4 days/week = BMR X 1.5
  • High activity levels exercise & sports more than 6 days/week = BMR X 1.7
  • Higher activity levels = up to 2 x BMR

And now, I have to go cook. I do believe I will become an expert dietitian by the end of two months!!