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India Diabetes Educatorj Issue No. 8, November 2015 In this issue: • World Diabetes Day • Sugar Consumption and Diabetes To keep the members of diabetes care team abreast with Diabetes Self-Management Education (DSME) concepts To download PDF of current and previous issues, please scan the code Indian Diabetes JOURNAL Preface USV as your reliable healthcare partner believes in supporting your endeavour to make India a Diabetes Care Capital of the World. Indian Diabetes Educator Journal is a first-of-its-kind initiative in India developed to strengthen the concepts of Diabetes Self-Management Education (DSME) and Diabetes Self-Management Support (DSMS) among the members of diabetes care team, especially the diabetes educators. Traditionally, any occasion in India is celebrated with intake of sweets. Also, it is customary to "sweeten the mouth" post every meal and any celebration. There is an undesirable link between sugar and diabetes which are well documented. Also, evidences support the association between consumption of sugar sweetened beverages and type 2 diabetes mellitus. On occasion of World Diabetes Day – 2015, this issue of IDEJ gives more insights on the link between sugar intake and diabetes. We dedicate this journal to all the healthcare professionals who are working relentlessly towards making “India a Diabetes Care Capital of the World”. Sincere Regards, Disclaimer: This Journal provides news, opinions, information and tips for effective counselling of diabetes patients. This Journal intends to empower your clinic support staffs for basic counselling of diabetes patients. This journal has been made in good faith with the literature available on this subject. The views and opinions expressed in this journal of selected sections are solely those of the original contributors. Every effort is made to ensure the accuracy of information but USV Limited will not be held responsible for any inadvertent error(s). Professional are requested to use and apply their own professional judgement, experience and training and should not rely solely on the information contained in this publication before prescribing any diet, exercise and medication. USV Limited assumes no responsibility or liability for personal or the injury, loss or damage that may result from suggestions or information in this book. You can contribute your articles, opinion, cases, recipes & experiences by sending an email to: [email protected] or [email protected] Indian World Diabetes Day World Diabetes Day (WDD) is held on the 14th of November every year since this day marks the birthday of the person who co-discovered insulin, Sir Frederick Banting. WDD is the world’s largest Diabetes diabetes awareness campaign reaching a global audience of over 1 billion people in more than 160 countries. JOURNAL TABLE OF CONTENT The WDD campaign is represented by a blue circle logo as a symbol for diabetes awareness. It signifies the unity SR. NO. TOPIC PAGE NO. of the global diabetes community in response to the diabetes epidemic.1 1. World Diabetes Day 1 Need for such awareness campaigns 2. Expert Opinion 4 Diabetes is a huge and growing burden with 387 million adults having diabetes according to 3. KOL Speak – Link Between Sugar Intake and Diabetes 8 available data in 2014.This number is soon expected to increase to up to 600 millions by 2015 worldwide. Most of the patients with diabetes suffer from at least one complication by the time 4. Sugar Sweetened Beverages and Rising Tide of Diabetes 12 they are diagnosed with diabetes. Therefore, to raise the awareness of diabetes, its prevention and complications becomes the need of the hour. 5. World Diabetes Day Celebration 14 Governments and private organisations are encouraged to increase awareness of the 4. Indian Sugar Consumption Pattern 15 disease, particularly among the high risk general population. 5. Indian Sugar Guide 17 Looking back – WDD campaigns 6. Various Apps for Measuring Sugar Intake in Diabetes 18 Thematic flow of World Diabetes Day from origin till date 7. Counselling Tips 21 WDD is a campaign that features a new theme chosen by IDF each year to address the issues 8. Busting the Myth 22 faced by the global diabetes community. 9. Patient Voice 23 The major areas covered since year 2000 are: 10. Case of the Month 24 2000: Diabetes and lifestyle in the new millennium 11. Frequently Asked Questions on Sugar Consumption 25 2001: Reducing the burden: Diabetes and cardiovascular WDD is centred on a theme disease related to diabetes and covers 12. Diabetes Self Management Education (DSME) discussion on diabetes and 2002: Your eyes and diabetes: Don't lose sight of the risks Approach To Tailoring Indian Scenario 27 human rights, diabetes and 2003: Diabetes could cost you your kidneys: Act Now! lifestyle, diabetes and obesity, diabetes in the disadvantaged 13. Superfood 30 2004: Fight obesity, prevent diabetes and the vulnerable, and also 14. Recipe 31 2005: Diabetes and foot care diabetes in children and adolescents 15. References 32 2006: Diabetes in the disadvantaged and the vulnerable 1 2007–2008: Diabetes in children and adolescents2 Key messages of WDD – 2015 campaign 2009–2013: Diabetes education and prevention • Act to change your life today – Healthy eating is an important part of managing all types of 2014–2016: Healthy living and diabetes3 diabetes • Act to change the world tomorrow – Access to affordable healthy food is essential for Current year theme of WDD – 2015) reducing the global burden of diabetes and ensuring globally sustainable development What diabetes educators can do this WDD? • Identify patients at high risk of developing diabetes through a simple questionnaire to assess risk factors such as age, waist circumference, family history, cardiovascular history and gestational history • Promote measures to reduce risk factors of type 2 diabetes • Encourage healthy eating practices among paediatric population to halt the rise in diabetes epidemic Benefits of healthy eating • Help people understand the risks and set realistic goals to improve health • It helps to prevent the onset of type 2 diabetes • Raise awareness of the warning symptoms of diabetes and encouraging early diagnosis • It is an important part for the effective management of all types of among people diabetes to help avoid complications • Highlight the importance of evidence-based education in the prevention and treatment of • WDD – 2015 campaign shall address the importance of healthy eating diabetes and its complications pattern in diabetics as well access to healthy foods. It also stresses • Promote measures to prevent or hold back complications of diabetes3 upon the foods which help to prevent onset or effectively manage type 2 diabetes • Educate people about health risks associated with excess sugar intake based on current year theme Meats and sweets: Less often Poultry, eggs, cheese and Wine: In moderation yoghurt: Moderate portions, daily to weekly Fish and seafood: Often, at least 2 times Drink water per week Fruits, vegetables and grains: (mostly whole) Olive oil, beans, nuts, legumes and seeds, herbs and spices Base every meal on these foods Daily physical activity 2 3 Expert Opinion the importance of sugar not only as a food item, but it is also intrinsic to the Indian way of life. Nutritionally, sugar provides only “empty” calories (1 g of sugar gives 4 kcal and lacks the natural minerals). Sugar consumption and diabetes Consumption of Indian sweets varies from region to Contributed by: region depending on the climate, agriculture and tradition. For example, sweets commonly consumed in Dr. V. Mohan North India are different from those consumed in South MD, FRCP (London, Edinburgh, Glasgow, Ireland), PhD., DSc. FNASc, DSc (Hon. Causa), FNA, India. Other local practices also increase sugar FACP, FACE, FTWAS, Chairman & Chief Diabetologist, Dr. Mohan’s Diabetes Specialities Centre & consumption in meals, for example in the state of Gujarat Madras Diabetes Research Foundation, Who Collaborating Centre for Non-Communicable Diseases (mid-west India), there is a practice of adding sugar to all Prevention And Control & IDF Centre Of Education. gravies, breads, curd, aamras (mango pulp), etc. There is a strong relationship between calorie intake and Ms. S. S. Jaishree obesity. In India, the prevalence of obesity is increasing at a MSc., PGCDE rapid pace due to an increase in energy intake owing to increased purchasing power and Assistant Manager in N&D Dr. Mohan's Diabetes Specialities Centre & Gopalapuram, Chennai. availability of high fat, energy-dense foods, along with reduction in the energy expenditure consequent to urbanisation and mechanisation.4,5 Common sweets during festive season in India Sugar and sweet consumption have been popular and In India, during different festivals, there is a wide range of Though sugar is of considerable intrinsic to Indian culture, traditions and religions since sweets available. The amount of sugar present in different cultural and hedonic relevance in India, nutritionally it provides ancient times. Indian festivals portray a rich cultural types of Indian sweets varies considerable across the only “empty” calories heritage and significance of our country. Food is an nation, for example, gulab jamun (medium size) contains integral part of Indian festivals. Indian sweets contain 224 calories whereas kajukatli (medium size) has 101 6 high amount of sugar as well high saturated and trans fats calories per piece approximately. Similarly juices are also (prepared using partially hydrogenated vegetable oils). as bad as sweetened drinks and beverages like Coca-Cola and Pepsi as they have Decreasing physical activity and increasing trend of per added sugar. capita sugar consumption assumes significance in view of the high tendency for Indians to develop insulin resistance, abdominal adiposity and hepatic Table 1: Common sweet items with their calorie values7 steatosis, along with increasing “epidemic” of type 2 diabetes mellitus and cardiovascular Sr .no Sweet (100 g) Energy (kcal) Fat (g) Carbohydrate (g) Protein (g) diseases. 1 Adhirasam 498 15 86 4 Sugar consumption during festive seasons in India 2 Badhusha 436 25 50 4 The most popular sweetener in the world, sugar, was discovered in India.
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