This article is in conjunction with World Diabetes Day which falls on Nov 14 every year.
KUALA LUMPUR – Consider this fact: many people with diabetes in Malaysia are actually struggling to keep their glucose levels under control.
As reported in the National Health and Morbidity Survey 2019 report by the Ministry of Health, the prevalence rate of diabetes in adults in Malaysia has increased from 13.4 percent in 2015 to 18.3 percent in 2019.
In a recent survey among people with diabetes by paediatric and adult nutritional products manufacturer Abbott Nutrition Malaysia, respondents agreed that managing diabetes was taking up too much of their time and energy. The survey also revealed that caregivers were feeling stressed from managing diet plans suitable for diabetics.
A caregiver, Mohd Nor Azmi Nasir, told Bernama he had to quit his job as a senior IT executive at a company two years ago to pay full attention to his eight-year-old daughter Dhia Amani who was diagnosed with Type 1 diabetes when she was six.
He admitted that it is really strenuous to prepare nutritious meals daily for his daughter and also ensure that she did not overeat sugary food as she has a craving for ice cream, sweets and chocolate cake.
For diabetics and caregivers, the power of innovation in nutrition can help them to control their blood glucose levels better and prevent distress due to diabetes management.
Abbott Nutrition Malaysia medical director Dr Nina Mazera Mohd Said said it is crucial for diabetics to consume diabetes-specific products that can support glycaemic control (the typical levels of glucose in a person with diabetes) in two ways – by reducing total carbohydrate levels and by introducing carbohydrates with different digestion and absorption profiles.
She said diabetes-specific formulas are different from standard nutritional beverages as the former have a defined nutrient composition to enable better glycaemic control and have clinically demonstrated efficacy in people with diabetes. The latter may compromise glycaemic control in patients with diabetes and have limited demonstrated efficacy.
“For over 30 years, Abbott has studied and developed nutrition formulas specifically for people with diabetes. This is where Abbott’s new Glucerna formula comes into the picture as it offers a new and improved low glycaemic carbohydrate system to help manage blood sugar,” she said, adding that the beverage can be incorporated into a well-balanced diet as part of a diabetes management plan.
According to Dr Nina Mazera, with regular consumption of Glucerna, significant reductions in daily glucose fluctuations can be seen within four weeks as its slow-release carbohydrate system helps to minimise blood sugar spikes and maintain blood sugar levels within the recommended range.
Personalised meal plan
Meanwhile, Hospital Canselor Tuanku Muhriz UKM consultant physician and endocrinologist Dr Norlaila Mustafa said there is no one-size-fits-all diet that works for all diabetes patients. Instead, a personalised meal plan is the best, she said, as this would take into account dietary preferences, as well as daily activity and metabolic targets.
Diabetics are advised to eat a low carbohydrate diet (30 to 90 grammes per day), lots of vegetables (preferably two portions) and a good serving of protein. Combining the meals with other nutritional products that serve as meal replacements would help to maintain blood glucose levels within the targeted range.
“In people with diabetes, reducing calorie intake will definitely lower the blood glucose. Replacing one or two of the main meals with nutritional products is encouraged to maintain a decent calorie intake for diabetes,” she said.
For women who develop diabetes during pregnancy (known as gestational diabetes), maintaining blood glucose levels within the target can be achieved with a healthy lifestyle, including a good diet and antidiabetic agent that is approved for pregnant women.
“Women develop diabetes during pregnancy partly because of hormonal changes, as well as due to risk factors such as being overweight, family history, age factor, previous history of a big baby or existing diabetes even before pregnancy,” Dr Norlaila added.
Professor of Nutrition and Dietetics at the International Medical University Prof Winnie Chee said the latest findings from recent research have shown the benefit of total or partial meal replacements in lowering calorie intake within a structured lifestyle programme or plan.
“Short-term (three to six months) interventions that use partial meal replacements can achieve significant weight loss and good control of blood glucose levels. And this good control can be maintained for longer periods with the right motivation and healthy diet plans,” she said.
Chee said total meal replacements, where all three daily meals are replaced with a nutritious beverage, can lead to a very low-calorie intake of less than 800 kcal per day.
And, when closely supervised medically, such a diet can bring about diabetes remission that can be maintained with proper guidance on weight maintenance, she explained.
She, however, said this would require a multidisciplinary team with the physician and dietician monitoring the weight loss and providing a proper eating plan.
In terms of nutrition, at the individual level, it is important for diabetics to acquire knowledge and skills such as understanding the basics about food and blood sugar levels, and knowing how to plan healthy meals and choosing the right dishes when eating out, she added.
Diabetes mellitus is a chronic disease that occurs when the pancreas is no longer able to produce insulin, or when the body cannot make good use of the insulin it produces.
Insulin allows the glucose from the food to pass from the blood system into the cells in the body to produce energy.
There are three main types of diabetes, namely Type 1, Type 2 and gestational diabetes.
People with diabetes have an increased risk of developing a number of serious health problems that can lead to serious diseases affecting the heart and blood vessels, eyes, kidneys, nerves and teeth.