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14diabetesWhy Is Folic AcidSo Important?Recommends National Institutefor Health and Care Excellence, UK,“High‐dose folic acid supplements(5 mg/day) should be prescribedfor women with diabetes who areplanning a pregnancy from atleast 3 months before conceptionuntil 12 weeks of gestation. Arecommendation supported by theAmerican Diabetes Association,that appears in ‘Diabetes Care’ in2008, advices women with preexistingdiabetes to consume 400micrograms of folic acid daily if theyare capable of becoming pregnant,and to increase their consumption to600 micrograms of folic acid dailyif they are pregnant or are planningto become pregnant. The Center forDisease Control and Prevention, USA,seconds the use of folic acid to reducethe number of cases of spina bifidaand other neural tube defects inbabies born to diabetic mothers. Saysa 2018 study published in ‘Annalsof Epidemiology’, homocysteineis associated with higher risk ofdiabetes. Folate, which reduceshomocysteine, is promising for theprevention and treatment of diabetes.The study concluded, “Our studysuggests a potential benefit of folateon insulin resistance and glycaemiccontrol.”Folate in foodsFolate can be found in leafygreen vegetables, asparagus, brusselsprouts, avocados, oranges, papayasand bananas. Writing in the journal‘Diabetes Research and ClinicalPractice’, University of Phayao,Thailand, researchers observe thatfolic acid supplementation (FAS) cansignificantly reduce homocysteinelevels and may therefore offer anapproach for lowering cardiovascular(CV) risk among patients with Type 2diabetes.According to the Diabetes Council(www.thediabetescouncil.com),Dr. MaheshPadsalgeMD (Medicine) ,DFID(CMC, Vellore),Navi Mumbai“At least some studies haveshown a positive relationship indiabetes between folate/folic acidsupplementation and reducing therates of heart disease, blood vesseldisease and stroke in patientswith diabetes.” It adds, “We knowthat in at least some studies, highhomocysteine and low folatelevels was associated with diabeticneuropathy and retinopathy.” Thestudy concludes, “Overall, folatesupplementation may benefitand may help prevent diabeticneuropathy and diabetic retinopathy,particularly if started early in thecourse of your diabetes.”diabetesmatters - express
15Diabetic Peripheral Neuropathy:Yays & NaysOut-of-control blood glucoselevels are the main cause of diabeticneuropathy. Keeping your bloodglucose in an acceptable range canhelp you avoid nerve damage orprevent it from getting worse. Here area few dos and don’ts of DPN:1Do: Eat healthy and atregular intervalsKeeping your blood sugar level asclose to normal as possible is the bestway to prevent diabetic neuropathy.Get diet plan for diabetes control fromyour nutritionist. Cut down foodsheavy in saturated fats and transfats, processed meats, organ meats,such as liver, processed snacks, saltyand fried foods, sugary drinks, andhigh-fat dairy products, etc. Countyour carbs, and eat plenty of fruitsand vegetables. Make sure to havemore frequent and smaller mealsthroughout the day.Don't: Skip mealsIf your sugar drops, your bodymanifests a series of reactionsintended to raise its blood glucoselevel. Hormones are producedthat cause the release of storedglucose from the liver. Thesehormones also produce some of thesymptoms typically associated withhypoglycaemia, like trembling andsweating. If you don’t recognise thesymptoms of low blood glucose anddon’t have some foods that can givecarbohydrates immediately, the bloodglucose level will drop further. If itgoes too low enough, a person maybecome confused or even pass out.If you have diabetic neuropathy, youmay not get these warning signs. Thebest way to prevent hypoglycaemia isto enjoy smaller meals more frequentlyand not skip meals.2Do: Eat whole grainsThe bran and fibre in wholegrains slow the digestion of the starchinto blood glucose, causing less of aglycaemic impact and hence leadingto smaller blood sugar spikes thanrefined grains. Plus, they’re abundantin phytonutrients, vitamins andminerals, making them a better forpeople with type 2 diabetes. Goodchoices are brown rice, dalia, wholewheat breads, rolled and steel-cut oats,and whole wheat flour. They havebeen shown to increase the metabolicrate, thereby burns more calories,and because of their lower glycaemicimpact, they tend to be more filling,making you eat less.Don't: Eat refined grainsRefined grains are ‘white’ products,like white rice, white bread, and whitepasta. Refining whole grains removestheir outer shell and, along with it,important B vitamins and fibre thatis essentials for your diet. Refinedgrains make it harder for you toregulate your blood sugar, which isbad for diabetic neuropathy. Sugarydrinks, white bread, white rice, maidaand sugar-based desserts can lead toinsulin resistance, high triglycerides,and weight gain, especially around themiddle.3Do: Get your vitamin B12 level checkedVitamin B 12 deficiency can leadto, or worsen, peripheral neuropathy.You can get B 12 in your diet from redmeat, dairy, fish, eggs and poultry, butmany people need supplements. Askyour doctor if you should have yourB 12 level checked. Having diabetescan increase your risk of having aB-12 deficiency because it may be aside effect of metformin, a commondiabetesmatters - express
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