One common misconception is that people with diabetes should avoid fruits altogether because they contain sugar
The debate surrounding the food habits of Delhi Chief Minister Arvind Kejriwal took a controversial turn recently, following revelations about his high glycemic index (GI) diet. This has brought the focus back on diabetes, a chronic lifestyle disease that affects millions globally. Diabetes, which is influenced by a combination of genetic and lifestyle factors, remains a complex condition. Proper diet and regular exercise are crucial in managing the disease effectively.
Uncontrolled diabetes can lead to severe complications affecting almost every organ system in the body. These include kidney failure, blindness, amputation, heart attacks, strokes, nerve problems, dementia, and even gangrene. Diabetes can also adversely affect sexual health, potentially leading to infertility. Hence, the importance of managing the disease through diet and exercise cannot be overstated.
What is Diabetes?
Diabetes is defined by the World Health Organization (WHO) as a chronic disease that occurs when the pancreas fails to produce enough insulin, or the body cannot properly use the insulin it produces. Insulin is a hormone that helps regulate blood glucose (sugar) levels. Diabetes can cause two main issues: hyperglycemia (elevated blood glucose) and hypoglycemia (low blood glucose), both of which can lead to significant damage, particularly to nerves and blood vessels.
Globally, over 500 million people suffer from diabetes, with projections indicating that this number will more than double to 1.3 billion by 2050, according to a study published in The Lancet. In India alone, an estimated 101 million people are affected by diabetes, while another 136 million are pre-diabetic, as reported by the Indian Council of Medical Research (ICMR).
Dr. V. Mohan, a top diabetologist and chairman of Dr. Mohan’s Diabetes Specialities Centre, explained that a combination of diet, high-calorie intake, rising obesity rates, and increasing consumption of junk food are major contributors to the growing diabetes epidemic in India. Factors such as lack of exercise, disturbed sleep patterns, rising pollution levels, and food contamination with pesticides are also linked to the rise in diabetes cases.
Diet Management in Diabetes
Managing diet is crucial for people with diabetes. While eating a healthy, balanced diet rich in fruits and vegetables is essential, controlling portion sizes and monitoring carbohydrate intake are key factors in maintaining stable blood glucose levels. A key concept in managing diabetes through diet is the glycemic index (GI), which ranks foods based on how quickly they increase blood sugar levels.
High-GI foods, which cause rapid spikes in blood glucose levels followed by a sharp decline, increase the demand for insulin, leading to worsening of diabetes or even the development of Type 2 diabetes. In contrast, low-GI foods help prevent diabetes and its associated complications, including heart disease, obesity, and even cancer.
Recent research from the Harvard T.H. Chan School of Public Health shows that consuming a low-carbohydrate, plant-based diet can significantly reduce the risk of premature death among people with diabetes. Dr. Sudhir Kumar, a neurologist at Indraprastha Apollo Hospitals, emphasized the importance of “carbohydrate restriction” in managing the disease. He recommends avoiding or limiting sugar, jaggery, honey, and sugar-sweetened beverages like soft drinks and packed fruit juices.
Can Diabetic Patients Eat Fruits and Drink Tea or Coffee?
One common misconception is that people with diabetes should avoid fruits altogether because they contain sugar. However, most fruits have a low to medium GI compared to carbohydrate-rich foods like white or wholemeal bread. Nutritionist Rujuta Diwekar advises against fearing local, seasonal fruits, saying, “The truth lies beyond the fear of calories, sugar, and weight gain.”
For example, mangoes—rich in antioxidants, fiber, and Vitamin C—are often mistakenly believed to be harmful to people with diabetes. Diwekar clarifies that mangoes are not only safe for diabetics but are also recommended due to their nutrient-rich profile. However, portion size is crucial, as eating too many mangoes or any other fruit can increase carbohydrate intake, thus affecting blood sugar levels.
Mayo Clinic’s Dr. M. Regina Castro points out that the quantity of carbohydrates in a fruit has a greater impact on blood sugar levels than the type of carbohydrate it contains. According to Diwekar, “One serving of fruit should contain no more than 15 grams of carbohydrates.” Thus, managing portion size is essential to avoid spikes in blood glucose.
Furthermore, sugary beverages like cola and fruit juices can cause significant spikes in blood sugar levels. In contrast, studies from the Harvard T.H. Chan School of Public Health suggest that drinking more coffee, tea, or plain water may lower the risk of premature death among Type 2 diabetes patients by around 25%. This indicates that diabetic patients can enjoy these beverages in moderation, but should avoid sugary, carbonated drinks.
The Role of Exercise in Diabetes Management
Diet alone is not enough to manage diabetes; regular physical activity is crucial. Aerobic exercises such as walking, swimming, and cycling, combined with strength training, are effective in improving insulin sensitivity, which is essential for managing Type 2 diabetes. A recent study published in the American Journal of Medicine Open found that resistance exercises, such as using dumbbells or resistance bands, alongside aerobic exercises, help improve insulin sensitivity, leading to better blood glucose control.
Additionally, research from the University of Alberta in Canada suggests that a combination of diet and exercise not only slows the progression of diabetes but may even lead to remission. This underlines the importance of incorporating both lifestyle changes into diabetes management plans.
The growing global diabetes epidemic requires a concerted effort in managing the disease through diet and exercise. While managing carbohydrate intake, particularly through a low-GI diet, is crucial for controlling blood sugar, regular physical activity further enhances insulin sensitivity and helps keep the disease in check. By adopting a balanced diet and incorporating consistent exercise into daily routines, individuals can significantly reduce the risk of complications and improve their quality of life. With diabetes cases expected to rise exponentially in the coming decades, understanding the vital roles of diet and exercise is essential in managing and mitigating the disease’s impact on global health.
