Indian diabetes diet: How to use glycemic load to decide what to eat, what not to eat

Just like the body develops resistance to substances like caffeine, alcohol, and nicotine with increased exposure, it can also grow desensitized to insulin. Therefore, the remedy lies in enhancing the body’s insulin responsiveness rather than external supplementation for patients with type 2 diabetes. (Photo by Nataliya Vaitkevich via Pexels)

Over 100 million people in India live with diabetes - the number is expected to rise to 134 million by 2045. When the body cannot manufacture healthy insulin levels, the subsequent condition is identified as Type 1 diabetes, and insulin injections become the mainstay of treatment. Until the 1920s, scientists hadn't established a correlation between the disease and insulin, a hormone responsible for managing our blood sugar levels. In the past, diabetes diagnosis relied heavily on conspicuous symptoms such as frequent urination, unexplained weight loss, intensified thirst, and presence of sugar in the urine. Forty years later, by the 1960s, two renowned physiologists, Berson’s and Yalow’s innovative technology, for the first-time, allowed for the quantification of insulin levels in the blood. Ironically, they discovered that many individuals with diabetes exhibited elevated, not decreased, insulin levels. Patients with this type of diabetes produced more than the required insulin levels to reduce the blood sugar to normal levels because their bodies had become resistant to the sugar-lowering effect of insulin. This ‘insulin resistance’ phenomenon was later recognized as Type 2 diabetes, which won Yalow the Nobel Prize in Medicine in 1977. Type 2 diabetes is often associated with obesity due to insulin overproduction, contributing to 95 percent of current diabetes cases.

Regrettably, the conventional treatment for both types of diabetes frequently involves insulin administration. This strategy addresses the symptom (elevated blood sugar levels) but overlooks the core issue of insulin resistance. Just like the body develops resistance to substances like caffeine, alcohol, and nicotine with increased exposure, it can also grow desensitized to insulin. Therefore, the remedy lies in enhancing the body’s insulin responsiveness rather than external supplementation for patients with type 2 diabetes.

Understanding glycemic index and load: A crucial dietary aspect

Most of us seeking to maintain stable blood sugar levels refer to a food’s glycemic index (GI). GI is a numerical scale reflecting the rate and extent to which a particular food can increase our blood sugar levels. However, consuming these foods in larger quantities escalates our blood sugar more, but the GI number remains static, demonstrating the GI’s limitations for evaluating our meal’s healthfulness.

Therefore, a superior metric to use is a food’s glycemic load (GL), which combines the quality (GI) and quantity (carbs per serving) of carbohydrates in a particular food. It provides a more comprehensive picture, considering the amount of carbohydrates consumed and its subsequent impact on our blood sugar. High GL foods prompt a quicker and higher blood glucose increase, while low GL foods result in a more moderate and measured increase. Hence, the aim should be to keep our meal’s glycemic load as low as possible, ideally below 20 (see above table).

Also read: How strength-training in your 30s and 40s can keep diabetes at bay

Busting food myths in the Indian diet

The Indian culinary landscape, renowned for its robust flavours and diverse offerings, unfortunately harbours many misconceptions about diabetes-friendly foods. Some foods labelled “diabetic-friendly” could actually amplify our blood sugar and insulin levels, exacerbating insulin resistance. To combat diabetes, the focus should be on foods with a low glycemic index and ensuring minimal glycemic load per meal. Let’s dispel some common myths:

White Rice: A staple in Indian diets, white rice has a high glycemic index, causing a swift rise in blood sugar. Substituting it with brown or wild rice, with a lower glycemic index, is a smarter option.

Refined flour: Refined flour found in packed foods such as instant noodles and soup, with its high glycemic index, leads to swift blood sugar surges, aggravating insulin resistance.

Fruit juices: While fruits are beneficial, their juices, even unsweetened ones, can cause significant sugar spikes. Whole fruits, containing all their dietary fibre, are preferable.

Low-fat dairy products: While they appear to be a healthier choice, these products often contain added sugars to compensate for the lost taste from fat removal, leading to higher blood sugar levels.

Jaggery: While often viewed as a healthy sugar substitute, jaggery can still spike blood sugar levels and should be consumed in moderation.

Exotic vegetables: Imported, pricey vegetables aren’t necessarily superior. Local produce like bitter gourd (karela) and fenugreek (methi) are traditionally recognized for their anti-diabetic properties.

“Diabetes-friendly” drink mix: India’s burgeoning health market has seen the rise of “diabetes-friendly” drink mixes, but not all are as they seem. Despite being touted as high-protein, popular brands contain a more than double carbohydrate-to-protein ratio. Alarmingly, their primary carbohydrate sources, namely maltodextrin, corn flour, and maize starch, are high-glycemic. These ingredients can rapidly spike blood sugar and insulin levels, potentially aggravating insulin resistance—a significant concern for people with diabetes. Always read labels carefully and consult healthcare professionals before incorporating such products into a diabetic-friendly diet.

To effectively manage diabetes, foods rich in dietary fibre, protein, and complex carbohydrates should be incorporated into the diet. Their slow-digesting nature ensures steady blood sugar levels post meals, thus gradually releasing insulin and potentially reversing insulin resistance. Foods that neither cause a dramatic blood sugar spike nor require significant insulin should be prioritized.

Complementing diet with physical activity

Alongside dietary modifications, consistent physical activity, such as maintaining daily step counts and participating in strength training, can significantly ameliorate Type 1 and Type 2 diabetes. Numerous studies have validated the potential of exercise to enhance insulin sensitivity.

While modern medicine has significantly advanced from historical diagnostic methods, a holistic understanding of diabetes necessitates debunking food myths. It’s apparent that our approach to control and perhaps reverse diabetes should focus on managing symptoms and tackling the disease’s root cause.

Despite India’s rich culinary heritage, it’s crucial to differentiate myths from facts in our diet, particularly concerning a condition as pervasive as diabetes. As we navigate this health crisis, let’s base our choices on scientific evidence. By understanding the mechanisms behind insulin resistance and making informed dietary choices, we can make substantial progress in the fight against diabetes, paving the way towards a healthier future.

Finally, it’s always important to consult a healthcare professional or registered dietician before starting or changing to a new diet plan.