Written by: Ms. Poh Kai Ling, Clinical Dietitian, University Malaya Medical Centre

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Having high blood sugar for long term will increase the risk of getting health problems such as heart disease, poor vision, nerve damage and kidney disease. Diabetes is a complicated disease, however it can be controlled and treated. Lifestyle modification and diet management play crucial roles in diabetes management.

People with diabetes often get overloaded with information from the internet as well as many other sources. Yes, some of them might be true, but some can be myths. It is very important to understand the facts about diabetes. Let’s check out the myths and facts below.

Diabetes is a complicated disease that happens when the body is unable to produce enough insulin or when the insulin that is produced doesn’t work properly. When this happens, the person will suffer from high blood sugar and leads to other health issues. Diabetes is caused by a combination of genetic and lifestyle factors, not solely because of eating too much sugar.

People with diabetes should consume healthy balanced diet consists of adequate carbohydrate, protein, fat and fiber. They do not have to give up on their favourite food or stop taking sugar. However, it is very important that the simple sugar intake should be reduced and controlled well in order to prevent high blood sugar.

One can always modify the food during meal preparation by reducing the amount of sugar needed. Reducing additional toppings and sauces can also help to reduce the sugar intake in order to maintain a better blood sugar profile.

Both vegetables and fruits provide good source of fiber, vitamins and minerals. It is crucial to take adequate fiber as it helps to protect against heart disease, cancer and diabetes. Fiber also helps to improve blood glucose, lower total and LDL cholesterol, prevent constipation, and the most important thing is to control appetite by providing fullness and satiety.

Fiber is not only important for diabetic, but also important to non-diabetics in order to maintain general health. Malaysian Dietary Guideline recommends to take at least 2 servings of fruits and 3 servings of vegetables per day.

However, people with diabetes should watch out on the fruits intake as fruits contain 15g of natural sugar (fructose) in each serving size. People with diabetes are recommended to take 2 servings of fruits per day, either taking it during main meals or in between meals. It is also advised not to make it into juices or adding sugar into it in order to prevent overconsumption of sugar intake. Prevent taking too much of fruits can help to maintain better blood sugar level.

Three servings of vegetables are recommended for daily intake. Each serving size is about 1 cup of raw vegetable or ½ cup of cooked vegetables. Starchy vegetables should not be included in this category as they contain carbohydrate.

Bitter gourd is low in calorie and high in fiber, it also contains various vitamin, minerals and antioxidants. Apart from that, bitter gourd contains active substances with anti-diabetic properties. Some studies suggest it can help in diabetes treatment. However, most of the researches are not conclusive and more research is needed to determine the function and effectiveness in diabetes control.

Bitter gourd can be eaten as part of a healthy and varied diet. Healthy cooking method is important to ensure that the bitter gourd can be enjoyed in a healthier way. In Malaysia, bitter gourd is sometime deep-fried to ensure crispiness and this will significantly increase the fat content in it. This excessive fat intake will lead to weight gain issue in long term and increase the risk for many other health issues.

Even though bitter gourd is nutritious, it should not be over consumed and results in poor variety of food choices. The key of healthy eating should be well balanced diet with healthy cooking preparation. Consult with health professional before supplementing with bitter gourd, as there isn’t enough research to know how much is safe to take.

All the stated food above is in the food group of carbohydrate. Yes, carbohydrate intake will increase the blood sugar level. However, these starchy vegetables are highly nutritious and consist of various vitamins, minerals, antioxidants and fiber which are essential to our body. One should never avoid taking these, but to control the portion size.

One small potato has the same amount of carbohydrate as in 1 scoop of rice or 1 piece of bread. Control the portion size accordingly will help you to enjoy these starchy vegetables well in your daily meal intake.

There is no ONE diabetes diet that suits everyone. Recommendations for diabetic diet should be individualized according to nutritional needs, cultural practices and willingness to change. Different individuals have different body requirement based on their age, gender and activity level. It is important that people with diabetes should consume healthy balanced diet consists of adequate carbohydrate, protein, fat and fiber to support their daily needs and maintain good blood sugar profile.

For people with diabetes who suffers from other diseases such as high blood pressure, heart disease and kidney disease, always consult with dietitians to understand what works the best for them.

Malaysian Healthy Food Plate provides general guideline on how to properly portion the food in single meal intake, by ensuring balanced diet filled up with carbohydrate, protein, vegetables and fruits. It’s recommended to fill up ¼ of the plate with carbohydrate such as rice, noodle, cereal, another ¼ of the plate with protein such as chicken, fish, meat, legume and lastly ½ plate of fruits and vegetables. Portion out the carbohydrate as such helps to control the starch intake and maintain good diabetes control.

Coffee is a popular drink which provides many health benefits to the body. It has zero calorie and high in antioxidants. Research showed that regular coffee consumption may be linked to a lower risk of developing type 2 diabetes over the long term, however, there are limited studies and more research needs to be done on the effects of caffeine and diabetes.

Coffee with sugar, syrups, condensed milk and sweetened milk are temping choices for all, but it could be problematic for people with or at risk of diabetes. Addition of sugar, syrups and milk will increase the sugar content and carbohydrate content, which will cause high blood sugar level. Black coffee is the best choice among those. Those with diabetes or at risk of diabetes should watch out and reduce on the sugar intake in order to maintain better blood sugar level while enjoying the drinks.

Alcohol intake may cause the blood sugar level to either rise or fall. When soda, syrups and fruit juices are added into alcohol, this will provide additional sugar intake which will cause high blood sugar. Apart from that, alcohol is high in calories, making it difficult to control the body weight.

Alcohol can also interfere with the oral diabetes medication or insulin which will lead to low blood sugar level (hypoglycemia). Liver removes the alcohol from the blood instead of managing blood sugar levels and this will lead to low blood sugar. Low blood sugar will result in drowsiness, confusion and instability which can be mistaken as being drunk. This is extremely dangerous as untreated low blood sugar can lead to seizure, coma and death.

It is advisable not to start taking alcohol. If you would like to drink alcohol, remember to control the intake and to take only when the diabetes and blood sugar level are well controlled.

Always watch out for the nutrition claims such as “sugar-free”, “no sugar added” in the food packaging. Sugar-free products do not mean they are carbohydrate-free. Many foods come with natural sugar, complex carbohydrate and starch which will contribute to blood sugar. Read the food labels can help to understand the nutrition content better. Check out the ingredient list and look at the carbohydrate content to prevent misunderstanding.

Yes, smoking is harmful to the body and it also increases the risk of getting diabetes. Smokers are 30 to 40 percent more likely to develop type 2 diabetes than nonsmokers. Cigarettes contain a lot of chemicals which bring harm to the cell in the body.

High levels of nicotine can lessen the effectiveness of insulin, causing them not responding to the insulin which will then leads to high blood sugar. It is advisable to reduce or stop smoking in order to improve the general health and prevent diabetes. It is never too late to make changes in life and live differently.

Intermittent fasting is an eating pattern that involves periods of eating little to no food, followed by regular meals. The most famous among all is 16:8 intermittent fasting, where people fast for 16 hours and allowed to eat within 8 hours in a day. Intermittent fasting helps people to reduce the calorie intake by restricting the hours of eating of the day.

Many people using this method in order to control their food consumption and body weight. However, this should be combined with healthy balanced diet in order to prevent fluctuation of blood sugar. One should always control their carbohydrate intake during meal time to prevent surge of blood sugar level. The combination of portion control and time restricted intake can significantly improve on a person’s blood sugar level if intermittent feeding is well managed.

Eating less or skipping breakfast helps to reduce the calorie or energy intake of the day. However, if someone skips the breakfast and feels hungry later on, there is a high tendency that the person will crave and overeat at later meals. This will then increase the calorie intake for the subsequent meals later on. Inconsistent of meal intake will leads to dangerous blood sugar swings especially for people with diabetes. Blood sugar tends to fluctuate and making diabetes hard to control.

People with diabetes should eat proper meals with adequate carbohydrate, protein and fiber in order to prolong the satiety and prevent frequent snacking. It is advisable to follow the hunger cues, eat when the body needs. Ignoring hunger cues tends to create craving issues and making it hard for the person to control food intake in the subsequent meals.

There are no rules for diabetes diet, just stick to the basic principle which is suitable to everyone, with or without diabetes.

Diabetes is a treatable when diet intake is well managed and patients are complying to the medication. People with diabetes can follow healthy and balanced meals with food variety in order to help them control their diabetes better.

Healthy diet should consist of a variety of foods from all food groups with suitable portions and healthier food preparation according to the diabetes treatment. Healthy diet should be low in unhealthy fats (saturated and trans-fat), moderate in salt and sugar intake, high in fiber (whole grains products) and preferably prepare in healthy cooking method.

If there are any further doubts on diabetes management, always consult with health professionals such as doctors, dietitians and diabetes educators in order to work out individualized treatment plan based on a person’s needs.