Culture gap can make diabetes diet harder

13 Aug, 2016 10:26 am

OHIO – Patients with diabetes must work hard every day to count the carbs they consume, to avoid dangerous spikes or dips in blood sugar.

Learning how to do it can be close to impossible, though, when language and cultural barriers make it difficult for doctors to understand what patients typically eat, a case report in Lancet Diabetes and Endocrinology suggests.

“Carbohydrate counting is critical for accurate management of diabetes,” said co-author Dr Sumana Narasimhan, a pediatric endocrinologist at Cleveland Clinic Children’s in Ohio.

“If we don’t fix this problem, families of children with diabetes from non-western cultures may continue to guess the carbohydrate count of their ethnic foods, resulting in inaccurate insulin dosing and poorly controlled diabetes,” Narasimhan added by email. “The risk of diabetes complications is higher when diabetes is not managed properly.”

The case report involved a child recently diagnosed with type 1 diabetes, a chronic condition usually diagnosed in children or young adults. With this condition, the pancreas produces little or no insulin, a hormone needed to allow blood sugar, or glucose, to enter cells and produce energy.

People with type 1 diabetes typically have to test their own blood sugar levels throughout the day and inject insulin to manage them. Getting the insulin dose right requires patients to count carbs correctly.

In this case, the child’s mother asked doctors how to count carbs for the traditional Middle Eastern foods she prepared at home.

Doctors found some pamphlets and online resources for following a diabetes diet that were translated into Arabic. But the information was still mostly based on a typical Western or European diet, not on traditional foods like tabbouleh, hareeseh and chicken shawarma that are more common in a typical Middle Eastern diet.

While doctors did eventually find some resources in Arabic based on nutrients common in Middle Eastern diets, it was still difficult to calculate the carbohydrates in an entire meal.


While this is just one case, the patient’s experience suggests a need for culturally appropriate food lists and nutrition information in multiple languages, Narasimhan and co-author Dr. Hamza Nasir of Dow University of Health Sciences in Karachi, Pakistan, conclude.




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