Watching our blood sugar level is an essential component of a healthy diet and lifestyle – whether we are in good health or diagnosed with diabetes. According to the National Health and Morbidity Survey 2019, it is estimated that 18.3% (3.9 million or 1 out of 5 people) of the adult population in Malaysia is currently living with diabetes. In this article, a doctor and a dietitian share their suggestions on keeping our blood sugar under control to prevent diabetes or manage the disease better.
Healthy eating
A healthy diet does not mean you need to only consume salad and give up everything else. You can still enjoy your favourite foods, but you need to watch your food intake. “When it comes to watching our blood sugar levels, the goal is to practise healthy, balanced meals consisting of various foods while incorporating portion control. You can follow the Malaysian Healthy Plate guideline, which advocates a healthy portion of carbohydrates (quarter plate), proteins (quarter plate), fruits and vegetables (half plate),” advises Ms Poh Kai Ling, Clinical Dietitian from the University of Malaya Medical Centre (UMMC), Kuala Lumpur.
Choose your carbs wisely
In a typical Malaysian diet, carbohydrates such as rice, bread, tosai or noodles are all similar and can be interchangeable. While carbs can cause blood sugar spikes, we need to incorporate sufficient and healthier carbohydrates into our daily diet to avoid hypoglycaemia.
Sources of preferred carbohydrates would be whole grain products, fruits, low-fat dairy products and legumes. This said, we should limit carbohydrates from sugar-sweetened drinks and food such as white sugar, brown sugar, honey, gula Melaka, condensed milk and jam. Ultimately, portion size is crucial, no matter what type of carbohydrates are being consumed.
“You can eat any carbs but in moderation and correct portions. Adding more fibres and taking low Glycemic Index food is also helpful for controlling our blood glucose levels. This is especially beneficial for diabetes patients. For example, if possible, choose brown rice over white rice that is higher in fibre content. This can help slow down sugar absorption, improving blood sugar levels,” shares Ms Poh.
Do not skip your meals
Many people have the misconception that skipping meals can help them manage their blood sugar levels. Dietitians say this is not true. In fact, skipping meals can negatively impact blood glucose levels and sometimes cause hypoglycaemia or low blood sugar levels, which in combination with certain diabetes medications or insulin, would result in severe outcomes.
Get enough sleep
Sleep plays an important role in maintaining healthy blood sugar levels. A good rule of thumb is not to eat a heavy meal right before bedtime. In addition, alcohol or caffeine late at night is a big no-no.
80-year-old Type 2 diabetes patient, Mr Subramaniam A/L Kalimuthu, shares that when he first discovered he had diabetes 30 years ago, one of the challenging lifestyle changes besides diet was to alter his sleeping patterns. “I am used to sleeping late, and I realised that it is important to keep to a regular sleeping schedule.”
Check your blood sugar regularly
It’s a good idea to monitor your blood sugar levels daily. One of the simplest ways is to test your blood sugar at home with a portable electronic device called a blood sugar meter, which uses a small drop of your blood. This device is readily available from your local pharmacies. However, if you have not been feeling well or have been experiencing symptoms suggesting glucose level problems, consult a doctor immediately.
Associate Prof. Dr Jeyakantha Ratnasingam, Consultant Endocrinologist & Head of Endocrinology, University of Malaya Medical Centre, Kuala Lumpur, recommends Malaysians to get screened regularly for diabetes, particularly if they are at risk of diabetes. “Individuals at risk include people who are overweight or obese, with hypertension and high cholesterol, history of gestational diabetes, abdominal obesity (increased waist circumference), strong family history of diabetes, polycystic ovarian syndrome (PCOS) and those on steroids. Looking at the list, particularly those who are overweight or have a family history of diabetes, it basically means almost all Malaysians should be screened,” Dr Jeya says, adding that most Malaysians who have diabetes or pre-diabetes think they are healthy because diabetes is often asymptomatic. Therefore, screening is the best way to prevent diabetes and its complications.
Mr Ghazali Baharum, a Type 2 diabetes patient, shares one of his best practices. He would check his blood sugar level two hours after his meal, so he is consistently aware of his condition. Mr Ghazali also brings his test kit and insulin with him everywhere he goes, especially when travelling.
Be active every day
According to Dr Jeya, increasing physical activity and weight reduction are crucial for ensuring healthy blood sugar levels. Doing regular workouts is also a necessity for people with diabetes. “A total of at least 150 minutes per week, or at least 30 minutes each day for most days in a week, is recommended. However, the type and duration of exercise should be individualised so that the workouts can be incorporated into our daily lives as much as possible,” he advises.
There are many good examples of ensuring consistent physical exercise. For instance, Mr Subramaniam helps with household chores and parks his car further to incorporate more physical activity into his daily routine. Mr Ghazali, on the other hand, takes morning walks within his house compound.
Reduce your weight
For people who are overweight, significant weight loss helps improve glucose control. If they have diabetes, losing weight can also lead to reduction or discontinuation of medications. “A significant weight loss of more than 15% of initial body weight, at the initial few years of the onset of diabetes can, in fact, help a diabetes patient go into remission. For overweight non-diabetic individuals, reducing weight can help in the prevention of diabetes altogether,” adds Dr Jeya.
