Diabetes mellitus is a nutritional disorder, characterised by an abnormally elevated level of blood glucose and by the excretion of the excess glucose in the urine. It results from an absolute or relative lack of insulin which leads to abnormalities in carbohydrate metabolism as well as in the metabolism of protein and fat.

Diabetes is a disease known to the medical world since time immemorial. Its incidence is, however, much higher at present than ever in the past. This is especially true in case of more advanced countries of the world due to widespread affluence and more generous food supply.

The most commonly used screening tests are the determination of the fasting blood glucose level and the two-hour post-prandial, that is after a meal. The normal fasting blood sugar content is 80 to 120 mg. per 100 ml. of blood and this can go up to a level of 180 mg. per 100 ml. of blood two hours after meals. Anything above these norms can be termed diabetic levels.

Diabetes occurs in all age groups, from your infants to the elderly. The greatest incidence occurs in middle or older aged persons. It is estimated that 80 to 85 per cent of all individuals with diabetes mellitus are 45 years of age or older.

Symptoms

The word diabetes is derived from the Greek word meaning "to siphon ; to pass through," and mellitus comes from the Latin word "honey". Thus two characteristic symptoms , namely, copious urination and glucose in the urine give the name to the disease. The normal volume of urine passed daily is about three pints, but in the diabetic condition it can vary from eight to forty pints. The urine is of a pale colour, has an acidic reaction and sweetish odour. The quantity of sugar present in it varies from two to forty grams per ounce, the total per day in many cases reaching as much as two lbs. in 30 pints of urine.

A diabetic feels hungry and thirsty most of the time, does not put on weight, though he eats every now and then, and gets tired easily, both physically and mentally. He looks pale, may suffer from anaemia, constipation, intense itching around the genital organs, palpitations and general weakness. He feels drowsy and has a lower sex urge than a normal person.

Causes

Diabetes has been described by most biological doctors as a "prosperity: disease, primary caused by systematic overeating and consequent obesity. Not only is the overeating of sugar and refined carbohydrates harmful but also of proteins and fats, which are transformed into sugar if taken in excess and may result in diabetes. Too much food taxes the pancreas and eventually paralyses its normal activity. It has been estimated that the incidence of diabetes is four times higher in persons of moderate obesity and 30 times higher in persons of severe obesity.

Grief, worry and anxiety also have a deep influence on the metabolism and may cause sugar to appear in the urine. The disease may be associated with some other grave organic disorders like cancer, tuberculosis and cerebral; disease. Heredity is also a major factor in the development of the disease. It has been rightly said, "Heredity is like a cannon and obesity pulls the trigger. "

Dietary Treatment

Any successful method of diabetes treatment should aim at removing the actual cause of the disease and building up the entire health-level of the patient. Diet therapy is the basis of such a treatment. The primary dietary consideration for a diabetic patient is that he should be strict lacto-vegetarian and take a low-caloric, low-fast, alkaline diet of high quality, natural foods. Fruits, nuts and vegetables, whole meal bread and dairy products form a good diet for the diabetic. These foods are best eaten in as dry a condition as possible to ensure thorough ensalvation during the first part of the process of digestion.

Cooked starchy foods should be avoided as in the process of cooking the cellulose envelops of the starch granules burst and consequently the starch is far too easily absorbed in the system. The excess absorbed has to be got rid of by the kidneys and appears as sugar in the urine. With raw starchy foods, however, the saliva and digestive juices in the small intestine regulate the quantities required to be changed into sugar for the body’s needs. The unused and undigested portion of raw starchy foods does not become injurious to the system, as it does not readily ferment.

The diabetic should not be afraid to eat fresh fruits and vegetables which contain sugar and starch. Fresh fruits contain sugar (fructose) which does not need insulin for its metabolism and is well tolerated by diabetics. Fats and oils should be taken sparingly, for they are apt to lower the tolerance for proteins and starches. Emphasis should be on raw foods as they stimulate and increase insulin production. For protein, home-made cottage cheese, various forms of soured milk and nuts are best. The patients should avoid overeating and take four or five small meals a day rather than three large ones.

The following diet should serve as a guideline .

Upon arising : A glass of lukewarm water with freshly squeezed lemon juice.

Breakfast : Any fresh fruit with the exception of bananas, soaked prunes, a small quantity of whole meal bread with butter and fresh milk.

Lunch : Steamed or lightly cooked green vegetables such as cauliflower, cabbage, tomatoes, spinach, turnip, asparagus and mushrooms, two or three whole wheat chappatis according to appetite and a glass of butter-milk or curd.

Mid-afternoon : A glass of fresh fruit or vegetable juice.

Dinner : A large bowl of salad made up of all the raw vegetables in season. The salad may be followed by a hot course, if desired, and fresh home-made cottage cheese.

Bedtime snack : A glass of fresh milk.

Flesh foods find no place in this regime, for they increase the toxaemic condition underlying the diabetic state and reduce the sugar tolerance. On the other hand, a non-stimulating vegetarian diet, especially one made up of raw foods, promotes and increases sugar tolerance. Celery, cucumbers, string beans, onion and garlic are especially beneficial. Cucumbers contain a hormone needed by the cells of the pancreas for producing insulin. Garlic has proved beneficial in reducing blood sugar in diabetes.

Recent scientific investigations have established that bitter gourd (karela) is highly beneficial in the treatment of diabetes : It contains an insulin -like principle, known as plant-insulin which has been found effective in lowering the blood and urine sugar levels. The diabetic patient should take the juice of three or four bitter gourds daily in between meals for positive results.

The patients should avoid tea, coffee and cocoa because of their adverse influence on the digestive tract. Other foods which should be avoided are white bread, white flour products, sugar, tinned fruits, sweets, chocolates, pastries, pies, puddings, refined cereals and alcoholic drinks.

The most important nutrient in the treatment of diabetes is manganese which is vital in the production of natural insulin. It is found in citrus fruits, in the outer covering of nuts, grains and in the green leaves of edible plants. Other nutrients of special value are zinc, B-complex vitamins and poly-unsaturated fatty acids.