What is Glycemic index and why you should know about it

Blood sugar levels in our body is determined by what we eat,when we eat and how much we eat and is regulated by a hormone called Insulin. In a normal person,insulin hormone regulates the post prandial blood sugar that is roughly 1-2 hours after a meal and keeps it under control.

If you have Diabetes, high blood sugars can be a wake-up call, telling you that it is the time to start making healthier food choices.

In simple language,the carbohydrate component of the food breaks down in the stomach and contributes towards the blood sugar levels.Excess protein and fats too convert to blood glucose eventually by various pathways.

Complex carbohydrates which contains fibers and starches made of complex structures gets broken down and absorbed slowly in the stomach and the blood sugar levels rise steadily. These foods are better choices for people with Diabetes, because they do not cause spikes in blood glucose levels which cause damage to your organs in the long run. Simple sugars like sucrose,fructose are broken down easily and increase blood sugar quickly causing harm.

What is Glycemic Index?

Glycemic Index or GI, measures how a carbohydrate-containing food raises blood glucose.

GI can be classified into-

  • Low GI-Foods which do not increase the blood sugar levels too much post meal.
  • Higher GI-Foods which increases blood sugar levels considerably post meal.

Why is Glycemic Index important?

In diabetes patients,the regulation of blood sugar levels are impaired and there is a unregulated sugar levels.These blood sugar levels have a direct association with which food is consumed.As mentioned earlier,carbohydrates after consumption contribute towards the blood sugar levels and hence  glycemic index of a carbohydrate is an important factor in determining the post prandial blood sugar levels.

Hence for diabetics it is advised to include lower glycemic index foods to the diet on the contrary high glycemic index foods are told to be avoided as they increase blood sugar levels quickly.


What affects the glycemic index of food?

As a general rule fiber lowers the GI and simple sugars have higher GI.

  • Ripeness and storage time — the more ripe a fruit or vegetable is, the higher the GI and increase in storage time increases GI
  • Processing — juice has a higher GI than whole fruit; mashed potato has a higher GI than a whole baked potato,  whole wheat bread has a lower GI than white bread.Processed potato chips,snacks made of rice and potato have higher GI.
  • Cooking method — Food cooked for longer duration tends to break into simple sugars and have lower GI.
  • Variety —  Brown rice has lower GI than white rice.

The Glycemic Index of a food is different when eaten alone than it is, when combined with other foods. Include Higher GI food with lower GI food items to balance out the meal.

Example of foods according to Glycemic index

Low Glycemic Index Foods

  • Oatmeal, oat bran, muesli
  • Barley,ragi,millets,bajra
  • Sweet potato, corn, yam, beans, peas, legumes and lentils,chickpeas
  • Most fruits, non-starchy vegetables and carrots
  • Whole wheat, rye and pita bread
  • Brown, wild or basmati rice

High GI

  • White bread,maida
  • Corn-flakes,puffed rice snacks,bran flakes,instant oat
  • Short grain white rice, rice pasta, macaroni,pizza,cheese
  • Potato, pumpkin
  • Rice cakes, popcorn,  crackers,cookies,candies,donuts and cakes
  • pineapple,mango

There is no best meal plan best for diabetics.So it is important to follow a meal plan that is tailored according to the requirements. Better food choices and lifestyle changes keep the blood sugar levels steady.

Research indicates Glycemic Index is a tool that helps with Diabetes management. Combined with carbohydrate counting, it may provide an additional benefit for achieving blood glucose goals for diabetics and pre diabetics.

Discuss with your doctor/nutritionist about the various glycemic indices in the food of your choice and tailor it to your diet by using this important tool.

-Dr Prerna Gaur







Self monitoring of blood glucose or SMBG refers to home blood glucose testing for people with diabetes.

-Self-monitoring of blood glucose provides information regarding an individual’s dynamic blood glucose profile. This information can help with the appropriate scheduling of food, activity, and medication. It is also required for understanding of the timing of blood glucose variations

There are a number of benefits of home blood glucose testing:

  • Helps to determine which foods or diet are best for one’s blood sugar control.
  • Helps in informing the patient and doctor about how well the medication regime is working.
  • Reduces anxiety about, and increases understanding of, hypoglycaemia.
  • It is important for undertaking serious tasks which could be influenced by high or low blood sugar such as driving.

There are several necessary steps to assure accurate data from Self-monitoring of blood glucose.

using the glucometer for Self-Monitoring of Blood Glucose- The instructions must be read and followed thoroughly as missing out on them may affect the results. Proper use of the strips and general procedures for meter handling must be understood appropriately in order to obtain useful data.

-Some practical tips to make the self-monitoring of blood glucose easy and effective

  1. Make sure that the area to be pricked is cleaned with soap and water thoroughly.
  2. Use a new lancet for each blood glucose check.
  3. Store the testing strips as advised (in moisture and heat free environment)
  4. Alternate the fingers instead of repeatedly using the same finger.
  5. To minimize pain from forceful squeezing of the fingertip to get a sufficient blood sample, start squeezing the palm and push the blood progressively into the fingertip.

6.Make sure to note down all the readings in a systematic way-with date, time, relationship with meal, exercise etc. and take the log to the doctor, so that necessary steps can be taken by your doctor to help you to control your blood sugar levels after going through the reading.





-Dr. Afroze

Differences between type I and II diabetes

If you have ever wondered what your doctor means when he writes down Type I or Type II diabetes in the diagnosis section or when you generally hear both the terms and wonder what they mean, here is an article that would help you.

Basic understanding of what Diabetes is,



What happens to the key (Insulin) in type I and Type II?


People with type 2 diabetes don’t respond to insulin as well as they should and later in the disease don’t make enough insulin. You can think of this as having a broken key or defect in the lock.

Risk Factors in Type I and Type II-

Type I-Different factors, including genetics, Family history and body’s immune system is responsible. The immune system attacks and destroys the insulin-producing beta cells in the pancreas. After these beta cells are destroyed, the body is unable to produce insulin.

Type II –Multiple factors like Genetic , being overweight, Inactivity. , Family history, history of Polycystic ovary syndrome or diabetes during pregnancy, High blood pressure, Abnormal cholesterol and triglyceride levels

Age Groups most commonly effected by-

Type I DM – Often diagnosed in childhood

Type II DM- Usually diagnosed in over 30 year olds


Type I DM- unfortunately can not be prevented.

Type II DM- It may be possible to lower your risk of developing type 2 diabetes through lifestyle changes like staying active, maintaining healthy weight, regular exercise and eating balanced diet, and reduce your intake of sugary or overly processed foods.

Symptoms- The inability to control blood sugar causes the symptoms and the complications of both types of diabetes.

Type I-The first symptoms of type 1 diabetes appear when blood sugar gets too high. Symptoms include thirst, hunger, fatigue, frequent urination, weight loss, tingling or numbness in the feet, and blurred vision. Very high blood sugar can cause rapid breathing, dry skin, fruity breath, and nausea( an emergency situation called DKA=Diabetic ketoacidosis)

Type II-the first symptoms of type 2 diabetes may not show up for many years Early symptoms include frequent infections, fatigue, frequent urination, thirst, hunger, blurred vision, erectile dysfunction in men, and pain or numbness in the hands or feet.

Diagnosis / tests-

Blood tests used to diagnose type 1 and type 2 diabetes include fasting blood sugar, a hemoglobin A1C test, and a glucose tolerance test.






-Dr. Afroze


A blood glucose test measures the amount of glucose in your blood.Your doctor may order this test to help diagnose diabetes. And people with diabetes can use this test to manage their condition.

It is very important that you know and understand the method, precautions necessary for the tests so that the results are more accurate. Here are a few tips that you would want to know about particular tests( fasting and random)

  1. RANDOM BLOOD SUGAR TEST– If you are going for a random glucose test, you may eat and drink normally as you do but don’t overdo on high sugary drink.
  2. FASTING BLOOD SUGAR TESTING– If you will be taking a fasting blood glucose test, you must not eat or drink anything other than water for 8-10 hours before the test.
  3. It is much better if you can schedule your fasting glucose test early in the morning so you can have overnight fasting and will not have to fast during the day.
  4. 2-hour Postprandial (post lunch) blood sugar- For a 2-hour postprandial test, you need to have your blood collected exactly 2 hours after a regular meal, ideally breakfast or Lunch.


            A few general tips to keep in mind –

  • High stress is another reason for high blood glucose levels temporarily. It is very important that you tell your doctor when your doctor is reviewing the lab results,  if you had any health issue recently such as any infection or any stressful event recently.
  • Take a snack with you if you will not be going directly back home or to work. That way you can eat it directly after the blood draw.
  • You should never stop taking prescribed medication on the day of the test, unless you’re advised to do so by your doctor.




– Dr. Afroze


Prediabetes means that your blood sugar level is higher than normal but not yet high enough to be type 2 diabetes. Without lifestyle changes, people with prediabetes are very likely to progress to type 2 diabetes. If you have prediabetes, the long-term damage of diabetes especially to your heart, blood vessels and kidneys may already be starting.

There’s good news, however. Progression from pre diabetes to type 2 diabetes isn’t inevitable. Eating healthy foods, incorporating physical activity in your daily routine and maintaining a healthy weight can help bring your blood sugar level back to normal.



Prediabetes generally has no signs or symptoms.



Classic signs and symptoms that suggest you’ve moved from prediabetes to type 2 diabetes include:

  • you’re hungrier than normal
  • you’re losing weight, despite eating more
  • you’re thirstier than normal
  • you have to go to the bathroom more frequently
  • you’re more tired than usual
  • blurred vision

Risk factors:

Research indicates that prediabetes is often associated with unrecognized heart attacks and can damage your kidneys, even if you haven’t progressed to type 2 diabetes.

The same factors that increase the risk of developing type 2 diabetes increase the risk of developing prediabetes. These factors include:

  • Weight. Being overweight is a primary risk factor for prediabetes. The more fatty tissue you have especially inside and between the muscle and skin around your abdomen the more resistant your cells become to insulin.
  • Age. Although diabetes can develop at any age, the risk of prediabetes increases after age 45. This may be because people tend to exercise less, lose muscle mass and gain weight as they age.
  • Family history. Your risk of prediabetes increases if you have a parent or sibling with type 2 diabetes.
  • Polycystic ovary syndrome. This common condition characterized by irregular menstrual periods, excess hair growth and obesity increases women’s risk of prediabetes.
  • Sleep. People with a certain sleep disorder have an increased risk of insulin resistance. People who work changing shifts or night shifts, possibly causing sleep problems, also may have an increased risk of prediabetes or type 2 diabetes.

Diagnosis of Diabetes:

There are several blood tests for diagnosis of prediabetes.

  • Glycated hemoglobin (A1C) test
  • Fasting blood sugar test
  • Oral glucose tolerance test

Prevention of progression of Prediabetes to Diabetes



  • Lose excess weight. If you’re overweight, losing just 5 to 10 percent of your body weight, i.e only 10 to 20 pounds (4.5 to 9 kilograms) if you weigh 200 pounds (91 kilograms) can reduce the risk of developing type 2 diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.
  • Stop smoking.

Children and prediabetes treatment


  • Losing weight
  • Eating fewer refined carbohydrates and fats, and more fiber
  • Spending at least one hour every day in physical activity









Management of type 2 diabetes includes: It is a choice that a doctor makes based on the blood sugar levels and the status of the patient. The first line treatment includes Life style modifications Below are a few recommendations-

  1. Eat healthy :

-This is crucial when you have diabetes, because what you eat affects your blood sugar


  1. Exercise :

-An active lifestyle helps you control your diabetes by bringing down your blood sugar.

-Your goal should be 30 minutes of activity 4-5 days a week, that makes you sweat and breathe a little harder

  1. Manage stress:

-When you’re stressed, your blood sugar levels go up.

-Find ways to relieve stress — through deep breathing, yoga, or hobbies that relax you.

  1. Stop smoking:

Diabetes puts one at a higher risk of getting heart diseases, eye diseases, kidney, vessel and nerve damage and smoking multiplies the risk.

-talking to one’s doctor for help to quit smoking is highly advisable.

  1. Watch your alcohol

– Alcohol can make your blood sugar go too high or too low.

-It may be easier to control your blood sugar if you don’t get too much beer, wine, and liquor.

-If in spite of following the above lifestyle modification, the blood sugar levels do not come under control, your doctor may have to start medicine for diabetes. A few tips that will help you to achieve good control over blood sugars when you are put on medicine for diabetes-

  1. Stick to your medication plan – Take the medicines as and when advised by your doctor.
  2. Eat on schedule – Plan on your meal timings in coordination with the medicine.
  3. Test your blood sugar – Testing with a glucometer is the only way to know how your body responds to the medicine.
  4. Stay consistent- Taking your prescribed medicine consistently can help with more stable blood sugar readings.
  5. Use a pill box- using a pill box is one of the best ways to take your medications correctly. Not only does it help you remember to take your meds, but it can help tell you when you’re missing your medications and prevent re-dosing

TYPE I DIABETES MELLITUS – People with type 1 diabetes don’t produce insulin due to damage of insulin producing cells by the body’s own immune system therefore, treatment for type 1 diabetes involves taking insulin. Along with Insulin injections, people with Type 1 Diabetes Mellitus also need to follow all the lifestyle changes mentioned above, ust as people with Type 2 Diabetes need to follow.

Insulin needs to be injected through the skin into the fatty tissue below.

The methods of injecting insulin include:

  • Syringes








– Dr. Afroze

Diet in Diabetes



Meal plan


  • 40% to 60% of calories from carbohydrates.
  • 20% calories from protein.
  • 30% or fewer calories from fat.



Foods to include-











Dietary Do’s-


Dietary don’ts


  • Skip meals.
  • Eat heavy and fatty meals.
  • Eat high salt foods..
  • Choose sugar-sweetened beverages like sodas and fruit juices.
  • Add sugar to your foods.


-Dr Prerna Gaur