Here's everything you need to know.
Diabetes – a Non-Communicable Disease* typically associated with golden agers – has been infiltrating down the ranks into the younger generations, most specifically in Sri Lanka. If we get down to numbers, from the approximately 21 million people populating the island, nearly 4 million are diabetics. The number of young people – those in their late teens and early 20s – within this sub-demographic has been rising at an alarming rate. A diabetes diagnosis is definitely not something to be taken lightly, but that doesn’t mean you have to let go of your joie de vivre. We sat down for a conversation with Dr. Chamari Warnapura, MBChB (Sheffield), Deputy Medical Director of the Diabetes Association of Sri Lanka, to talk on how diabetes should not be limiting you from living life to the fullest.
What is diabetes?
“Broadly speaking, there are two main types,” says Dr. Warnapura. “Type 1 diabetes usually occurs in those below 20 years of age, and is when the body itself destroys the cells that generate insulin; Type 2 is when the body begins resisting the naturally produced insulin and requires additional boosts of the hormone to remain healthy.”
What causes diabetes?
“For Type 1, the causative factor is yet to be found,” says Dr. Warnapura. “Type 2 can be caused through certain genetic links, changes in fetal nutrition and rapid urbanization, among others. But the main cause is often due to unhealthy lifestyles, lack of exercise and a large fast food intake.” The takeaway? We have zero control over whether or not we’ll be diagnosed with Type 1 diabetes; but we do have some control over the Type 2 variety.
I’m diabetic. Can I still eat the fun stuff?
There’s no need to be constantly on edge about what you can and cannot eat. Eating can be one of life’s greatest pleasures, and being a diabetic doesn’t mean you have to feel totally deprived. Dr. Warnapura says the typical Lankan diet is high in fibers and carbohydrates—but, we eat typically tend to eat more rice than veggies during each meal. Instead of cutting out rice and curries entirely, she emphasizes simply reducing the carbs. This isn’t as arduous as it sounds; you just have to improve on your rice to veggies ratio. (Using mallung as a substitute to rice is also super easy, and just as delish.) According to Dr. Warnapura, diabetics should be wary of white rice and breads, which are sure to result in sugar spikes. Instead, she advises on incorporating red rice (which has a slow sugar absorption rate) as a healthy substitute.
Additionally, indulging in a piece of cake may not seem like the best of ideas when you know your sugar levels are kinda loco, but it’s all a matter of moderation, according to Dr. Warnapura. Depriving yourself too strictly of desserts will only instigate cravings, potentially causing you to rebel and binge eat, or contribute to underlying feelings of depression. Stick to fruit for the most part, but a controlled bit of fudge probably won’t hurt!
Allowing yourself small doses of foods you enjoy ensures you feel satiated in a healthy, safe manner. For instance, Dr. Warnapura says that if you have an upcoming party, it’s better to reduce the quantity of your meals before and after, to facilitate the amounts you know you’re going to consume during the shindig.
She also stated that diabetics should keep a close eye not just on what they eat, but what goes into what they eat—a huge advantage of home cooked meals, compared to those procured at restaurants. Still, treating yourself to a delicious snack once in a while is not taboo, as long as you control the rest of your daily diet.
Does that mean no more wine for me?
Being a diabetic won’t restrict you from having that glass of red at the end of a long day or a few shots when you’re out on the town with the girls. “The main thing we tell our patients is to do everything in moderation. It’s very important for a sustainable diabetes plan that patients stay happy and content,” explains Dr. Warnapura. Instead of thinking Okay I’m not allowed to do this, think along the lines of I should stick within these limits if I want to be healthy.
The alcohol consumption guidelines available to the public states that only 14 units of alcohol must be consumed per week to keep general health risks to a minimum. For diabetics, Dr. Warnapura says the number of units should be halved at the very least due, to the high quantity of sugar present in each drink.
Diabetics can maintain glucose levels sensibly by not having both desserts and drinks on the same night. Or by adding an extra couple of minutes to their workout, if a night of higher-than-usual sugar intake seems imminent.
Can diabetes put a damper on my sex life?
Some women are concerned that diabetes affects natural lubrication and diminishes the sexual experience due to nerve damage that can occur with the disease. Not so fast, says Dr. Warnapura, as it is a very rare occurrence. The said nerve damage is known as neuropathy and occurs due to damage caused to the walls of the small blood vessels that supply oxygen (and hence, pleasure) to the body’s extremities. But, this usually takes about 10 years to develop and is often due to extremely poor control of diabetes.
Instead, Dr. Warnapura states that what’s more likely to cause a drop in sexual desire and satisfaction is the indirect effects of spin-off conditions, like depression. In such cases, talking to your GP or even consulting a sexpert is an effective first step in the return to the sexcapades.
I’m prone to yeast infections. Is it because I’m diabetic?
Maybe. Bacteria is more prone to grow in dark, moist places, like in your vagina and mouth, and on your feet. Additionally, according to Dr. Warnapura, diabetics are more prone to infections, because the high concentration of sugar in the blood stream provides nutrition to bacteria and slows down the body’s ability to fight infections…all of which means diabetes could be contributing to your rise in yeast struggles. But fear not, most yeast infections are controllable through early detection and effective medication. In addition, tighter controls on the amount of glucose entering your system could reduce the number of infections over time.
I heard I have to give up wearing heels. What?! (And why?)
With diabetics, foot care is of paramount importance, says Dr. Warnapura. This is due to the fact that, with poor attention, diabetes can cause nerve damage and circulation problems, resulting in reduced sensation on your feet. So, any cuts, pricks or bruises are likely to go unnoticed, leading to an increase in infections that are hard to treat because of the same poor circulation problem. “We usually advise wearing comfortable shoes,” says Dr. Warnapura. Still, donning your favorite pair of stilettos is not a problem as long as you keep your feet safe from the smallest of injuries. “Carry out a daily foot check for any infections, cuts or wounds that may have occurred as you go about your day. And maintain your nails short, precise and dirt-free!”
Here’s the thing…
“Diabetes is a controllable disease, but diabetics have to get the right kind of lifestyle advice, because it’s not just about going to the doctor and taking medication,” explains Dr. Warnapura. Instead, it’s a delicate balance of the two. And, according to her, the best way of coping with this condition is through acceptance. “I’ve seen people who are in denial and people who have accepted it. The thing with patients in denial is that they almost always have poor control, not realizing how severely the disease might affect them. Then, I see patients who’ve accepted the diagnosis and so have amazing control and willpower.” How you approach the diagnosis is up to you, but it can make all the difference.
TIPS TO SIP
Guidelines for alcohol consumption from The American Diabetes Association state that diabetic women should not have more than one drink per day. According to its measurements, one drink is equal to a 12oz beer, 5oz glass of wine or a 1 ½oz tumbler of distilled spirits.
YOU CAN EAT FAST FOOD
It’s okay to dig in…once in a blue moon. But, the American Diabetes Association advises on staying away from foods that have the words “jumbo,” “deluxe,” “giant” or “super” in their titles, which indicate they have even more carbs and saturated fats than your average double-cheeseburger.
BE DESSERT SAVVY
Instead of the usual ice cream, opt for sugar-free, fat-free options. Fruits are almost always easy on the glucose content and on your wallet, allowing your body the sugar it needs without overdoing it on the whipped cream!
*NCDs are often chronic by nature, progressing slowly and lasting for long periods of time. They cannot be transferred by touch or through shared spaces.
This article was originally published as ‘How To Cope With Diabetes When You’re Young’ in the May 2017 issue of Cosmopolitan Sri Lanka. For more health news, grab a copy of our latest magazine.
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