Over 422 million people have diabetes, and the statistics are rising, with the vast majority suffering from type 2 diabetes mellitus (T2DM). The need to watch what you eat and be conscious of your diet has never been more pressing. However, when faced with the vast array of delicious foods in Thailand, finding the right balance to lower blood-sugar levels is essential.

The distinctive sweet-salty-spicy-sour taste of Thai cuisine is world-renowned. There’s no denying that the incredible flavor of fresh Thai dishes made with an exotic range of herbs, spices and vegetables. Certainly far healthier than the stodgy baked goods and processed foods associated with the West. However, all is not what it seems, and to say a diet of Thai food is healthier than any Western counterparts is far from accurate, and in many respects is downright misleading.

Diabetics Beware

Plenty of classic Thai dishes incorporate a healthy balance of ingredients, with dark leafy greens, raw vegetables and steamed seabass, for example. Meanwhile, juices are often laden with sugar, snacks are deep fried in palm oil, and generous helpings of white sugar added to the most savory of dishes. That’s not including a good pinch of MSG thrown into the mix.

Added to this is the round-the-clock advertising and availability of sugary drinks and fatty snacks. There’s also a voracious appetite for junk food in Thailand, with the quest to upsell snack food as equivalent to a nutritious meal well underway. Fizzy drinks, tempting in a hot country, contain phosphorous which can increase calcium loss via the kidneys. Evidence suggests there may be a link between low calcium levels and T2DM.

The reality of diets in Thailand is nothing new, with a Food Safety News article back in 2010 reporting a statistic that the percentage of Thais living with diabetes was higher than in the US.

Portion Control

A major issue is portion control, especially when it comes to rice, which should account for only a quarter of any plate, with the other quarter made up of protein and half a plateful of vegetables. Brown rice, including popular riceberry rice, is a good alternative too because of its lower Glycemic Index (GI) score which measures the impact of carbohydrates on raising blood glucose levels.

Tackling Insulin Resistance

Lifestyle and diet factors, such as excess weight and lack of exercise, can lead to insulin resistance which in turn leads to a high blood-sugar level. Amino acids such as isoleucine in aloe vera, which is great drank as a juice, helps the body absorb sugar in the right way. This works by repairing the beta cells in the pancreas to stimulate the insulin function. This cell-signaling reduces the inflammatory C-reactive protein (CRP) marker as well as prostaglandin E (PGE) which also inhibits glucose-induced insulin secretion.

Ginger, found in lots of Thai dishes, is an effective anti-inflammatory as is the daikon white radish often served in soups. Bitter melon is considered something of a diabetic’s superfood as it contains a substance called charantin, along with vicine and polypeptide-p which together help reduce blood glucose and also suppress appetite. One small fruit a day will suffice, however, it must be stressed that anyone taking diabetic medicines does need to consult a doctor before including bitter melon into their diet.
 
Thai basil is believed to be beneficial to diabetics, which is found in one of Thailand’s most popular everyday dishes ‘gaprow’, although there’s no direct evidence. A teaspoon of cinnamon is also a way to lower blood-sugar levels.
 
Meanwhile, a high fiber diet helps the body’s sugar-control mechanism and beta glucan fiber in brewer’s yeast can improve glucose tolerance.

Thai Foods to Enjoy

Asking for dishes that are ‘waan noi’ lets a chef know you want your food cooked with less sugar. Or, if you don’t want any added sugar you can simple request, ‘mai sai nam tan’. Fresh and tasty foods include a spicy and sour yam hot noodle salad, som tam papaya salad pounded in giant pestle and mortars and yam ma-muang green mango salad. Stir-friend morning glory is a great side, as long as the sauce is kept to a minimum, and a healthy low-sugar starter is rice-paper spring rolls with salad served Vietnamese style with fresh herbs and a spicy dip.

A classic tom yum goong, a popular hot and sour soup with shrimp, is perhaps healthier than coconut-cream curries. However, a 2009 paper published in the ‘Diabetes Metabolism Research Review’ reported that coconut oil is rich in medium chain triglycerides which can help diabetics manager blood sugar. Keep in mind that coconut oil is rich in saturated fat, therefore moderate use is recommended.
 
There’s a great choice of vegetable dishes in Thailand and a growing interest in plant-based foods as well as a clean-food trend with classic favorites cooked using less oil and sugar. Asking for ‘man noi’ when ordering a stir-fry reduces the amount of oil which even for non-diabetics can be unappetizingly too much at times.

Thai Foods to Avoid

Pad Thai and other noodle dishes are high on carbs and a lot of sugar is usually added too, not to mention oil. Fried rice is a no-no as is sticky rice which is possibly worse than white steamed rice for those with T2DM.
 
A big sugar boost comes from drinks such as Thai tea and iced coffees. An eye-watering amount of sugar added along with condensed milk which increases fat and calorie count too. Deep-fried snacks are part of the culinary culture of Thailand but with plenty of grilled goodies too these are easily avoided. Thai desserts are overly-sweet for many palates to be tempting anyway and many are simply an unadulterated sugar-rush.
 
Dealing with T2DM is all about nutrition and getting the best support can really turn around quality of life, reducing many of the unpleasant and life-changing consequences of unchecked diabetes. The Nutrition Support Team at Bumrungrad Hospital provides the latest, most effective personalized advice, diet plans and treatment path for diabetics on an outpatient, consultation basis.