Living well with diabetes: You can do it!

November 14, 2011

Healthy meal for good health

If you have diabetes, you're not alone. Almost 26 million people in the United States are living with the disease. That's more than 8 percent of the population. Another 79 million are at high risk for developing it. Diabetes is a serious condition. It can lead to big health problems when it isn't well managed. But when you take charge, you can help yourself live a much healthier life.

November is American Diabetes Month. It's a great time to take a look at what you can do to live well with diabetes.

What is diabetes?

When you eat, your body breaks down the sugars and starches in food into blood sugar, or glucose. It is the basic fuel for the body's cells. Normally, a hormone called insulin carries glucose from the blood into the cells. But in people with diabetes, this system doesn't work the way it should. Without careful management, glucose can build up in the blood and not reach the cells.

The types of diabetes

As the American Diabetes Association, or ADA, explains, there are three types of diabetes.

  • Type 1 is most often found in children and young adults. In type 1 diabetes, the body does not make insulin. People with type 1 diabetes need insulin therapy or other treatments. Only 5 percent of people with diabetes have this type.
  • Type 2 diabetes is the most common form of the disease. Either the body does not make enough insulin, or the cells ignore the insulin. It may be treated by a combination of medications, diet, and exercise.
  • Gestational diabetes occurs in some women during pregnancy. It raises the woman's future risk of getting diabetes. It may also raise her child's risk of being overweight and developing type 2 diabetes. If a woman develops this, it is important for her to follow her doctor's advice.

Diabetes can cause complications

When glucose builds up in the blood, it can lead to long-term health problems. Among them are:

  • Eye problems that can put your sight at risk
  • Foot problems such as nerve damage and slow wound healing
  • Skin infections and disorders
  • Heart disease
  • Stroke
  • High blood pressure
  • Hearing loss
  • Kidney disease

With correct care and lifestyle changes, many people with diabetes are able to prevent complications.

These four steps can help you control your diabetes – for life

The National Diabetes Education Program, NDEP, recommends these four steps. They can help you manage your diabetes. And that can help you stay healthy.

Step 1: Learn about diabetes

  • Make sure you understand what type of diabetes you have. Learn all you can about it. Talk with your doctor and ask questions. Talk with a dietitian or certified diabetes educator for help with your diet. Ask your treatment team for help when you need it.
  • Ask about the things nearly everyone with diabetes needs to do: Make healthy food choices. Stay at a healthy weight. Exercise every day.

Step 2: Know your diabetes ABCs

  • A is for A1C. This is a test that shows what your blood glucose has been over the last three months. The A1C goal for many people is below seven. But your healthcare provider can tell you what A1C target is right for you. As you've read, high blood glucose can harm your heart, blood vessels, kidneys, feet, and eyes.
  • B is for blood pressure. The goal for most people with diabetes is a measure below 130/80. High blood pressure makes your heart work too hard. It can lead to heart attack, stroke, and kidney disease.
  • C is for cholesterol. Cholesterol is a waxy material that is found in foods and made by your body. LDL, or bad cholesterol, can build up and clog blood vessels. That can cause a heart attack or a stroke. HDL, or good cholesterol, helps remove cholesterol from your blood vessels. The LDL goal for most people with diabetes is below 100. The HDL goal for most men with diabetes is above 40. The HDL goal for most women with diabetes is about 50.

Step 3: Manage your diabetes

  • Work with your healthcare team to reach your ABC targets.
  • Follow your diabetes meal plan. It will guide you in deciding how many meals and snacks to eat each day.
    • Choose healthy foods. They include fruits and vegetables, fish, lean meats, chicken or turkey without the skin, dry peas or beans, whole grains, and low-fat or skim milk and cheese.
    • Keep fish and lean meat and poultry portions to about three ounces. That's about the size of a deck of cards. Bake, broil or grill it.
    • Eat foods that have less fat and salt.
    • Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice, or pasta.

The ADA reminds people with diabetes that they can eat the same foods their families enjoy. Everyone benefits from healthy eating, so the whole family can take part. You can fit your favorite foods into your meal plan and still manage your diabetes.

What you eat and when you eat affect how your diabetes medicines work. Talk with your doctor about when to take your diabetes medicine. It may help to make a chart with the following: names of your medicines; when to take them; and how much to take.

For people taking certain diabetes medicines, following a schedule for meals, snacks, and physical activity is best. However, some diabetes medicines allow for more flexibility. You can work with your healthcare team to make the diabetes and meal plans that are best for you.

  • Get 30 to 60 minutes of physical activity on most days. Physical activity is an important part of staying healthy and controlling your blood glucose. Here are some important things to keep in mind:
    • Ask your doctor what exercises are safe for you. Brisk walking is one great way to move more.
    • Make sure your shoes fit well and your socks stay clean and dry. Check your feet for redness or sores after exercising. Call your doctor if you have sores that do not heal.
    • Warm up and stretch for 5 to 10 minutes before you exercise. Then cool down for several minutes after.
    • Always wear your medical identification or other ID.
    • Find an exercise buddy. Many people are more likely to do something active if a friend joins them.
    • Ask your doctor whether you should exercise if your blood glucose level is high.
    • Ask your doctor whether you should have a snack before you exercise.
    • Know the signs of low blood glucose, shown below. Always carry food or glucose tablets to treat it.
  • Exercise affects what you eat and when you need to eat. So be aware of your blood glucose when you exercise. The National Institute of Diabetes and Digestive and Kidney Diseases, NIDDK, tells us that low blood glucose can make you feel shaky, or weak. You may be confused, irritable, hungry, or tired. You may sweat a lot or get a headache. If you have any of these symptoms, check your blood glucose. If it is below 70, have one of the following right away:
    • 3 or 4 glucose tablets;
    • 1 serving of glucose gel;
    • ½ cup, or four ounces, of any fruit juice;
    • ½ cup of a regular - not diet - soft drink;
    • cup of milk;
    • 5 or 6 pieces of hard candy;
    • 1 tablespoon of sugar or honey.
  • After 15 minutes, check your blood glucose again. If it's still too low, have another serving. Repeat these steps until your blood glucose level is 70 or higher. If it will be an hour or more before your next meal, have a snack as well.

  • Stay at a healthy weight by using your meal plan and by exercising more. The experts at the Mayo Clinic stress the importance of a healthy weight. If you're overweight, losing just 5 to 10 percent of your body weight can make a big difference. It can help you control your blood glucose better.
  • Ask for help if you feel down. Talk with a mental health counselor, support group, member of the clergy, friend or family member.
  • Learn to cope with stress. Stress can raise blood glucose. While it is hard to get rid of stress, you can learn to handle it. One source for help is Diabetes HealthSense. It offers online access to resources that can help you make healthy changes. Visit Your Diabetes Info: Health Sense
  • Stop smoking. Smoking increases your risk of many diabetes complications. For help in quitting, call 1-800-QUITNOW.
  • Take your medicine even when you feel good. Ask your doctor if you need aspirin to help prevent a heart attack or stroke. Tell your doctor if you cannot afford your medicine or if you have side effects.
  • Check your feet every day for cuts, blisters, red spots, and swelling. Call your doctor right away about sores that don't heal.
  • Brush your teeth and floss every day. This can help you avoid problems with your mouth, teeth, and gums.
  • Check your blood glucose. Talk with your doctor about how and when to do your testing. Show your results to your healthcare team. Ask how you can use your test results to help you manage your diabetes.
  • Check your blood pressure if your doctor tells you to. Do it as often as advised.
  • Report any changes in your eyesight to your healthcare team. Treating problems early can help protect your vision.

Step 4: Get routine care

  • The NDEP says to see your healthcare team at least twice a year. They can help find and treat any problems early. At each visit, you should have a blood pressure check, foot check, and weight check. Your doctor should also review your self-care plan.
  • At least twice a year, you should have an A1C test. You may need testing more often if your A1 is more than seven.
    • Once a year, you should have the following:
    • cholesterol test;
    • test to check for fat in the blood;
    • complete foot exam;
    • eye exam;
    • flu shot;
    • urine and blood test to check for kidney problems;
    • dental exam. Be sure to tell your dentist that you have diabetes.
  • At least once, you should have a pneumonia shot. Ask your doctor when to get it.

Keeping a close eye on your diabetes and your health takes effort. But it is worth it. After all, it can help you live a longer, healthier, and more active life.

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