Treating Diabetes: Lifestyle Changes
The best thing a known diabetic can immediately do is to switch to a healthier lifestyle. It is important to keep in mind that treatment of diabetes must include not only blood sugar control, but associated complications as well.
1. Exercise. A steady and dedicated regiment of daily exercise is an effective way to help the fight against diabetes. Aside from the obvious benefits of exercise in reducing obesity, the risk of developing other complications of diabetes is greatly reduced. Making the habit of exercising regularly is a lifestyle change. It has been proven that steady exercise promotes health by: improving muscle strength (more usage), increasing bone density, decreasing blood pressure, decreasing low-density lipoproteins (LDL), increasing high-density lipoproteins (HDL) and reducing stress levels (control cortisol). These changes directly affect risk factors for complications associated with diabetes.
The lowering of overall body fat is highly recommended for two key reasons. First, decreased body fat improves overall circulation, risk of heart disease and it is widely believed that people with lower total body fat have an increased life expectancy. Second, shedding body fat improves your body’s efficient use of insulin by sensitizing target cells for insulin use (insulin resistance).
- Moderate exercise helps to lower blood sugar levels because active muscles need glucose as fuel. Be sure to have a steady exercise program from the start. Inform your physician about your exercise program. Make sure you mention what exercise you are doing, for how long, and how fast you are doing it. Your physician may need to take action to adjust your medications accordingly. Too much exercise, too fast is also not recommend as this can release stress hormones that actually increase blood glucose levels. A good strategy is to incrementally increase the level of strenuous exercise over a period of time to acclimate your body to the stress.
- Exercising need not be especially intense or time consuming. In fact, if you already have associated complications of diabetes such as blindness, nerve damage or even foot damage, your ability to exercise may be hampered. Consult your health professional to start an appropriate exercise program tailored to your needs.
- Any amount of exercise is better than none.
2. Diet. Many diabetics are unaware that the foods they are used to eating may not be the best for them. While in general there is not a “diabetic diet”, careful control of blood sugar levels sometime necessitates restructuring what you eat on a regular basis. Particular emphasis should be placed on monitoring the total amount of carbohydrates consumed as carbohydrates have the largest effect on blood sugar levels.
- A well-balanced meal that is low in fat (no more than 25-35% of total daily calories), low in sugar and high in fiber is ideal (20-30 grams/day). Decreasing fat intake has been proven to decrease the risk of suffering heart attacks, strokes and vascular accidents. Limiting saturated fats while exercising has been shown to change LDL and HDL levels for the better. Lowering LDL levels while increasing HDL levels has a clear protective effect on the body.
- Protein intake in diabetics should also be monitored. Reducing fat and carbohydrates from the diet does not mean you should increase you protein intake to make up for it.
- Portions (amount of food) you eat needs to be carefully monitored. When changing a diet, it is often easy to overeat or not eat enough. A consistent caloric intake is best.
- Ask your health care professional about a nutritionist or dietician to help you along. A dietician can individualize a plan right for you, including guidelines as to what percentage of carbohydrates, fats and proteins are appropriate for your condition and daily lifestyle.
- Sugar: most experts agree that small amounts of sugar are allowable as long as they are part of an overall balanced diet plan. Sugar is just another type of carbohydrate and have the same affect on blood sugar levels. Be sure to carefully read food labels and understand how much sugar/carbs you are consuming. The key is to control the total amount of carbs consumed. Keeping your sugar down is easy these days given the variety of Sugar Free Products and non-caloric artificial sweeteners available. Artifical sweeteners such as Aspartame (Equal), saccharine (Sweet ‘N Low), sucralose (Splenda) will help you control total carb intake and do not raise blood sugar levels. Pregnant / breast feeding women are advised to avoid saccharine however.
3. Smoking. Any and all forms of smoking raises virtually every risk you have for developing complications due to diabetes. Hardest hit is your vasculature since smoking can damage your blood vessels. Consider quitting altogether. If you need help, consult your health care professional.
4. Alcohol. Excessive drinking is a known risk factor for diabetes. Though there seems to be varying literature on the amount of alcohol consumption that is acceptable, it is generally wise to either eliminate or limit your drinking to low levels. Many experts think that consuming more than 2 drinks in an evening is excessive for a known diabetic.
5. Self-Testing. Get into the habit of keeping accurate records of your blood glucose levels. Some physicians recommend keeping a daily journal. Diabetes is not something that can be cured over-night, it must be tracked and dealt with everyday. It is also important to know that diabetes and associated complications can and do vary from person to person. Since all of these complications must be treated in conjunction with desired blood sugar control, it is not enough just to monitor blood sugar levels alone. It is not uncommon that a health care provider takes each case and devises an individualized plan for each patient. Because diabetic complications are often system-wide, there is often a group or team of physicians who are called upon to treat one patient. A typical diabetic team can include nutritionists, podiatrists, neurologists, nephrologists, ophthalmologists, etc.