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Understanding Diabetes

Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body’s cells do not respond properly to insulin, or both. The 14th of November is World Diabetes Day and Mopani Pharmacy has decided to follow a unique approach in highlighting not only the general information related to Diabetes Mellitus, but also the healthiest and most successful way to regulate blood glucose levels. There are mainly three different types of Diabetes:

Type 1 Diabetes – This is a case where the body does not produce insulin at all.

Type 2 Diabetes – The body doesn’t produce enough insulin to function properly.

Gestational Diabetes – This type affects women during pregnancy.

What is Glycemic Index?

The Glycemic Index (GI) is a relative ranking of carbohydrates in foods according to how they affect blood glucose levels. Carbohydrates with a low GI value (55 or less) are digested slower, absorbed and metabolised, causing a lower and steadier rise in blood glucose. As a result, insulin levels are elevated which has been proven to have numerous health benefits.

There are three classifications for GI:

Low: 55 or less

Moderate:  56 – 69

High: 70+

 

The Benefits of a Low GI Diet

  • Improved glycemic control: A healthy low GI diet will improve glycemic control compared to a high GI diet or a measured carbohydrate exchange diet.
  • Improved insulin sensitivity and reduced insulin resistance: Low GI diets increase insulin sensitivity in type 2 diabetes and have the added benefit of reducing hyperinsulinemia, thereby preserving beta-cell function. In contrast, high GI and GL (Glycemic Load) diets are associated with an increased risk of insulin resistance and the metabolic syndrome.
  • Reduced risk of vascular disease: Randomised controlled trials show that a low GI diet is associated with improved lipid profiles, specifically higher serum HDL-C and reduced LDL-C5. Low GI diets also significantly reduce concentrations of the inflammatory marker, C-reactive protein (CRP).
  • Weight loss: Low GI diets also lead to greater weight loss compared to other healthy diets. In a weight loss study where patients with type 2 diabetes were randomised to a low fat, high carbohydrate vegan diet, or a conventional diet following American Dietetic Association recommendations, the dietary GI was associated with weight loss. GI, which was lowest in the vegan group, predicted changes in weight, where every percentage point decrease in GI lead to a 0.2kg weight reduction.

What is the Role of GI in Type 1 Diabetes?

Low-GI diets improve glycemic control in children and adults with type 1 diabetes and are now recommended as part of type 1 diabetes education. By using a continuous glucose monitoring system to measure the blood glucose profiles in people with type 1 diabetes eating macronutrient-matched low-GI and high-GI meals, researchers observed significantly lower daytime blood glucose levels when low-GI meals were consumed. Lower blood glucose excursions expected with a low-GI diet has led researchers to explore the optimal pattern of insulin delivery for low-GI meals. A dual wave bolus (whereby the insulin dose for the meal is delivered in 2 parts over 2 hours) via insulin pump was found to achieve a greater reduction in postprandial glucose over a standard bolus.

What is the Role of GI in Type 2 Diabetes?

Epidemiological studies and clinical trials have shown that low-GI and low-GL diets protect against type 2 diabetes. Of note however, is that while low-GI and low-GL are associated with prevention, a low carbohydrate intake is not. In their prospective analysis of a cohort of 36,000 adults followed for 4 years, Hodge et al. 21 found that higher carbohydrate diets were associated with a lower risk of development of type 2 diabetes. However, the type of carbohydrate was extremely important: low-GI carbohydrates reduced the risk, while high-GI carbohydrates increased the risk.

It is important to understand that diabetes is a chronic condition and so, when managed correctly and effectively, it is more than possible to live a healthy, wholesome lifestyle.

Be sure to contact Mopani Pharmacy for assistance from our healthcare professionals to enlighten you further on the topic of diabetes and inform you about the different treatments we offer at our dispensary.

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