Edwin*, a 29-year-old man from Chemba district was referred to Benjamin Mkapa Hospital. He was a known diabetic on insulin treatment irregularly for past three years whose blood glucose was swinging/unstable.
Doctors diagnose diabetes mellitus using the World Health Organisation’s criteria, which include symptoms of high blood glucose such as polyuria - excessive urination, polydipsia - excessive drinking/thirst, unexplained weight loss, visual blurring, genital thrush and lethargy.
A diabetic meal plan
Edwin’s main problem was poor choices of food he made that wasn’t compatible with his condition. He represents one among the many diabetes patients in Tanzania who don’t have the right information on how to plan their meals.
Thus, in today’s article, I will grossly focus on diabetic meal planning.
Edwin, as I mentioned earlier had swinging glucose levels, yet he found himself eating rice and at times bread frequently since he said that he felt hungry often.
Thus I advised him to focus on food from all groups with fewer calories about the same amount of carbohydrate at each meal/snacks and eating healthy fats.
I sketched out for him a diabetic meal plan using Plate Method. This method advices the following:
Half a plate to be portion of non-starchy vegetables with quarter a plate moderate portion of proteins and quarter a plate of starch (low carbohydrate foods).
I had to allude to some groups of the aforementioned foods.
1. Vegetables
Go for fresh or frozen vegetables without added fats/salts. Non-starchy vegetables include dark green and deep-yellow vegetables such as spinach, broccoli, lettuce and cabbage.
2. Fruits
Choose fresh or frozen without added sugar or dried fruits. Try apples, grapes, water melon, pawpaw and drink juices that are 100 per cent fruit with no added sweeteners or syrup.
3. Grains
Whole grains or refined grains? Here I insisted to Edwin that “Dona ni nzuri kuliko Sembe” (maize whole grains are better than maize refined grains). Whole grains are unprocessed and have entire grain kernel and have lots of fibres; fibers in diet keep your blood sugar from rising too fast.
So whole grains are preferred to refined grains.
4. Proteins
Protein food includes meat, poultry, seafood, eggs, beans, peas, nuts, seeds, and processed soy beans.
Eat fish and poultry more often, but remove the skin from chicken and turkey. It’s wise to trim all the visible fats from the meat (what an arduous task !).
Do note that the meat should be baked, roasted, broiled, grilled or boiled instead of frying. Select lean cuts of beef, pork.
5. Dairy
Choose low fat or non-fatty dairy products. Beware that milk, yogurt and other dairy foods have natural sugars even when they do not contain sugars.
6. Oil and Fats
Avoid or limit bad fats/saturated fats such as hamburgers, beef-fried food, bacon, and butter. Instead choose foods that are high in unsaturated fats such as fish, nuts and vegetable oil.
It’s important to know that oil can raise sugar but not as fast as starch.
7. Alcohol
Most diabetic patients do ask this question whether they should stop alcohol or not.
If you choose to drink alcohol, limit the amount and have it with a meal instead of empty stomach.
*Not his real name
The author is a Medical Doctor and a public health activist now based in Dar es Salaam.