Patients are advised to take low-fat, low-calorie, sugar free / restricted and high-fibre diet. A low-fat diet is especially required when one has higher levels of blood cholesterol. In general also, a low-fat diet is recommended for preventing the complications of diabetes, especially coronary artery disease / stroke. It may be mentioned that diabetes is a disease of the blood vessels.



In addition to a low-fat diet, the patient should avoid sugar, sweets and very sweet fruits. A high-fibre diet, which diabetics are advised to take, consists of green vegetables-cooked/ salad, whole wheat, cereals, unpolished rice, etc. It is the outer covering of grain i.e. bran, which helps in the control of diabetes. Green vegetables, besides being a high-fibre diet, also contain very low calories, and hence can be used, by diabetics in larger quantity so as to satisfy their appetite.

As regards exercise for the control of diabetes, diabetics are advised to take exercise according to the recommendation of the physician. If a diabetic is suffering from anyone or more complications of the disease, especially coronary artery disease, he/she should take only limited exercise for its control. In uncomplicated cases, especially in young age, even vigorous exercise can be taken. Ideally, light exercise, especially walking after meals, is very useful for most diabetics, as blood sugar is raised after taking food, and walking will control its higher levels, reducing or completely eliminating the use of antidiabetic drugs. However, walking should be taken in a pleasant atmosphere, say in the evening/night after food, and should not be taken after lunch, especially in summer.

In case diabetes is not, controlled by diet and exercise, only then drugs i.e. insulin (administered by injection) or oral drugs should be started in minimal dosages, and the patient should be again detailed about the diet and exercise, as it will reduce the dose of antidiabetic drugs. It is important to point out that the dose of antidiabetic drugs should be properly adjusted to avoid low blood sugar, causing unconsciousness. However, a diabetic may also become unconscious when the level of blood sugar is markedly elevated, say above 400 mg/ dl.

It is worth mentioning that even if the glucose tolerance test (GTT) is impaired (i.e. the level of the test does not indicate a case of diabetes), particularly if the range of the level of the test is close to the diabetic level, the patient must be advised regarding the value of diet and exercise so as to correct the impaired glucose tolerance (IGT). Small dosages of oral antidiabetic drugs may have to be advocated in cases where the diet and exercise regimen fail. If this step is not carefully followed, cases of IGT are likely to become regular diabetics sooner or later. Even if the level is on the lower side of the range, as in the above situation, the patient must be advised to strictly follow the regimen of diet and exercise. Early intervention is necessary to check the progress and complications of the disease.