What Everyone with Diabetes Should Know: The Truth-by Harold Gunatillake
Diabetes is a lifelong chronic metabolic disease. Type 2 diabetes is classified as a metabolic disorder because it disrupts the way the body converts food into energy and stores fuel.
Although it cannot be cured, it can be managed through a sound understanding of the condition and consistent self-discipline.
This article will help you understand diabetes and the steps you can take to manage it and potentially achieve remission.
As noted, diabetes cannot be cured.
More specifically, it explains how improving insulin sensitivity can help bring type 2 diabetes under control.
In Sri Lanka, the usual approach after a doctor diagnoses diabetes—often following a high fasting blood glucose result—is to prescribe medication.
For mild or early-stage diabetes, sometimes called spring diabetes, a doctor may initially provide advice and delay prescribing medication.
In most developed countries, patients are also referred to an experienced dietitian for personalised dietary advice.
They are also given an instruction booklet and encouraged to follow its guidance carefully.
In Sri Lanka, many people assume that consulting a doctor and taking medication are all that is required, without understanding the importance of proper ongoing care.
If blood glucose remains uncontrolled, the doctor will usually increase the dose or prescribe an additional medication.
Patients often accept this approach instead of adopting non-medical measures to lower blood glucose and improve insulin sensitivity.
In people without diabetes, blood glucose returns to its fasting level after a meal. In people with diabetes, it remains elevated for longer, increasing the risk of complications over time.
Blood sugar returns to basic levels in a nondiabetic through the following mechanisms.
After a meal, carbohydrates are broken down into glucose, which enters the bloodstream. The resulting rise in blood glucose prompts the pancreas to release insulin, allowing cells to use glucose for energy or store it as glycogen or fat. Blood glucose usually returns to baseline within two to three hours.
In people with diabetes, the body may produce too little insulin after meals, or the cells may not respond to it effectively, leaving blood glucose elevated.
Persistently high blood glucose, or hyperglycaemia, gradually damages blood vessels, nerves, and vital organs throughout the body.
How High Blood Sugar Harms the Body
Excess sugar molecules in the bloodstream attach to proteins and fats (a process called glycation), triggering inflammation, oxidative stress, and structural breakdown in delicate tissues.
Cardiovascular Damage: High glucose stiffens and narrows arteries (atherosclerosis), raising blood pressure and drastically increasing the risk of heart attacks, strokes, and poor circulation in the limbs.
Nerve Damage (Neuropathy): Deprived of proper blood flow and oxygen, nerve fibers deteriorate, leading to tingling, numbness, burning pain, or a total loss of sensation—most commonly starting in the feet and hands.
This explains why poorly controlled diabetes can lead to serious complications.
Many complications are irreversible and can substantially reduce a person’s health and quality of life.
Reducing this risk requires better insulin sensitivity and effective blood glucose management.
Does medication prescribed to control blood glucose also improve insulin sensitivity? In most cases, medication alone is unlikely to do so.
Relying only on additional diabetes medication may fail to address the underlying insulin resistance, especially if it reduces motivation to make lifestyle changes.
In other words, diabetes control depends primarily on lifestyle changes, whether medication is also required.
Because these lifestyle changes require sustained self-discipline, some people choose the easier option of relying on prescribed diabetes medication.
Even when medication keeps diabetes under control, complications may still develop, though often later than in people with poorly controlled diabetes.
Some people eventually require intensive care in Sri Lanka’s major public or private hospitals.
Consistent, disciplined lifestyle changes are essential for reducing the risk of severe complications and intensive care admission.
Learn about the glycemic Index of all carbs you enjoy.
The Glycaemic Index (GI) does not indicate a food’s total sugar or carbohydrate content. Instead, it compares how quickly carbohydrate-containing foods raise blood glucose against a reference food, usually pure glucose or white bread.
Choose more low-GI foods with a GI of 55 or below. Because they are digested slowly, they produce a gradual rise in blood glucose. Examples include dhal, beans, nuts, oats, and apples.
As rice and curry are staples in Sri Lanka, limit rice to five tablespoons or less and fill more of your plate with vegetables.
Choose long-grain rice varieties, such as basmati or Australia’s Doongara. Their higher amylose content slows digestion by pancreatic amylase, resulting in a more gradual release of glucose.
People with diabetes may benefit from eating rice that has been cooked and cooled overnight because cooling triggers a molecular change called starch retrogradation.
Intermittent walking for up to two hours each day, indoors or outdoors, can naturally lower blood glucose by improving insulin sensitivity.
With this approach, some people may be able to reduce or stop antidiabetic medication under medical supervision as their blood glucose levels fall and insulin sensitivity improves.
As noted earlier, relying on medication alone may not address insulin resistance; lasting improvement also requires appropriate lifestyle changes.
This article explains diabetes in simple terms and outlines practical ways to manage it and potentially achieve remission. Consider these recommendations and discuss any changes with your healthcare professional.
Thank you for taking the time to understand this information.
Insight for the Global Sri Lankan
Harold Pulse is an independent editorial platform offering clear, thoughtful analysis on Sri Lanka’s political direction, governance reforms, diaspora concerns, and the evolving health landscape of Sri Lankans living abroad. Built for global Sri Lankans who value informed perspectives, it clarifies the issues shaping the nation’s future—from domestic policy shifts to the well-being of expatriate communities navigating new health systems, lifestyles, and challenges worldwide.
Harold Pulse speaks to Sri Lankans everywhere: those shaping change at home, and those building lives overseas while staying deeply connected to the island’s progress. It is a space where political clarity, community insight, and diaspora health awareness come together to support a stronger, more informed global Sri Lankan identity.
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