Diabetes is a complex and chronic disease affecting millions of Pakistanis. The most effective means to attain successful health outcomes and improved quality of life for people living with diabetes is Diabetes Self-Management (DSM).

DSM is an ongoing process for individuals with diabetes to actively participate in managing their condition and control blood glucose levels and prevent complications.

Diabetes self-management (DSM) primarily takes place at home. It encompasses a range of activities, including blood glucose monitoring, maintaining a balanced diet with appropriate portions, regular exercise, proper hydration, and adhering to prescribed medications.

In Pakistan, there is a pressing need to enhance Diabetes Self-Management Education (DSME), as it is an effective, side-effect-free approach to managing the condition.

DSME empowers patients to understand how various factors like insulin use, meal planning, physical activity and stress management impact their health.

By mastering these components, individuals with diabetes can effectively control their blood sugar levels and, in some cases, even reverse the disease.

However, it is crucial to access proper nutritional support while developing your DSM practices, as wrong information is very commonly shared, which promotes overly restrictive diets for diabetes management. These unnecessary dietary restrictions make compliance difficult.

Poor diet compliance may increase need for additional medication, with further side effects. Be aware that cutting out key nutrients can have negative impact on health outcomes.

A common misinformation is the belief that if you take medication to manage diabetes, you can eat whatever you want!

Medication cannot do all the work alone and must be used in combination with diet and lifestyle change which can preserve the body’s insulin producing function.

Similarly, there is the wrong belief that diabetic folk need to eat three meals and two to three snacks per day.

The reality is that meal frequency and timing can be individualised, and what is right for one person is not necessarily true for another.

Carbohydrates do not affect blood glucose levels equally for everyone, and your genetics and unique body determine how they are absorbed.

Diabetes self-management requires you to develop a skill for continuous glucose monitoring.

You should also keep a food journal (records) of everything you eat and in what amounts. List the symptoms — if any — you experience after eating certain foods.

This will help you to notice which meals result in blood glucose levels higher than the target.

By remaining vigilant, you will learn to have symptom causing foods less often, change some of the ingredients, or change the amount of food.

For better glucose control, choose high-quality carbs, include healthy fats in diet, eat a bigger breakfast, move calories earlier in the day and eat during the most active daytime hours.

Timing and size of meals are critical in lowering blood sugar. Accurate carbohydrate counting and making a habit of reading nutrition labels can significantly contribute to better food choices and overall diabetes management.

Dietitian nutritionists are invaluable resources in educating patients about lifestyle modifications and diabetes management.

In Pakistan, there are currently many qualified dietitian nutritionists available to provide expert guidance to people living with diabetes.

The writer is a diabetic specialist and nutritionist

Published in Dawn, November 14th, 2024