Life sweet life: Managing diabetes

The key to living with diabetes is to understand how it affects your life

old couple enjoying a picnicIt is natural for people with diabetes to experience anxiety and fear because they have to maintain their blood sugar levels at all times. Therefore, a few changes in lifestyle and food habits along with proper medication and monitoring can help a diabetic lead a normal and healthy life.

Advancements in treatment options are helping diabetics stay well and live a healthy life without complications. Diet, exercise, medication and monitoring are four pillars for maintaining glucose and insulin levels in the blood at all times.

The four pillars

Diet/nutrition

Diabetes diet is not about totally abstaining from food you love, but about making simple modifications. Choose foods like whole grains, pulses and nuts, vegetables, fruits and fat-free/low-fat milk products.

Eating at regular intervals helps control blood glucose levels. Diabetics should have six small meals rather than 2 – 3 large meals in a day. They should also limit fried foods, sugars, sweets, desserts, candies, honey and refined foods.

Physical activity

Regular exercise is important for everyone, especially diabetics. Around 30 minutes of exercise on most days of the week is necessary to control blood sugar levels. It also burns excess calories and fat.

However, exercise doesn’t mean spending hours at the gym or running for miles. It can even be activities like dancing, skipping, cycling, playing badminton and swimming. It is important to choose an activity that you enjoy and do it regularly.

Medicine

People with type-2 diabetes are either on oral hypoglycaemic drugs [tablets] or insulin. Oral medications act only till some of the insulin producing beta cells are alive. Recent studies have shown that early and appropriate use of insulin not only prevents short-term complications but also reduces long-term effects of poorly controlled diabetes and slow down the natural progression of the disease.

Diabetics should take medications as directed and should not drop or change drugs without consulting their doctor.

Monitoring

Check your blood sugar as often as your doctor suggests. Regular monitoring of blood sugar levels helps doctors to analyse the effect of food, exercise and insulin or medicine on you. Along with self-monitoring of blood glucose level, get a HbA1c [glycosylated haemoglobin] test done every three months without fail.

The HbA1C level shows how well the blood sugar has been controlled during the previous 2 – 3 months. Also, get blood pressure, lipid profile, urine microalbuminuria and serum creatinine checked regularly to prevent further complications.

Lifestyle modifications

There are various day-to day situations that can alter your daily routine and hence the best way to cope with diabetes is to take an active part in the treatment plan.

Acute illness: Illnesses like viral colds or flu, infections, dental problems, injuries, fever, vomiting and diarrhoea can disrupt your blood glucose control. In case of illness, glucose monitoring should be increased along with treating the illness. Also keep a check on the fluid intake during this period.

It is better to visit your doctor if your blood sugar is too high or low. Emotional stress also affects blood glucose levels. Hence, it is better to stay at home when ill and take adequate rest.

Travelling and vacation: Diabetes shouldn’t stop you from travelling, but it is important to control your diabetes and take necessary precautions before you travel. Before you leave, ensure that you carry your diabetes medication.

Carry some extra food and check your blood sugar levels more frequently as the new routine and different foods can affect your sugar levels. Also carry your doctor’s prescription along with you. Finally, wear comfortable shoes.

Party time and festivals: People with diabetes can enjoy foods served at parties and festivals—but in moderation. Don’t stop your medicines and monitoring on any occasion and practise portion control. Follow a regular exercise routine. Eating more during a party can be compensated by moderate exercise.

Avoid smoking and alcohol. If you want to drink, then don’t drink on an empty stomach—preferable drink along with your meal. [But no more than one drink for women and two drinks for men]. It is better to avoid fasting. But if you want to, it is essential to consult doctor your before you fast.

Sports and activity: People with diabetes can participate in almost all sports and other play activities. Sports and exercise are beneficial but ensure that you do not exercise on an empty stomach.

It is also essential to check your blood sugar before any strenuous exercise. Always consult your doctor before starting any new exercise or sports routine.

Marriage and family: People with controlled diabetes can marry, enjoy their married life and have children like normal people. Uncontrolled diabetes can however cause sexual dysfunction.

In a nutshell

  • Stick to your schedule of eating, activity, and medicine regime.
  • Set goals with your doctor for weight, activity, blood sugar level, HbA1C level and try to achieve them.
  • Carry an identification about your diabetes. This helps in case of an emergency such as hypoglycaemia [low blood sugar].
  • Always carry a carbohydrate [such as hard candy] to handle a low blood sugar level at anytime.

Understanding diabetes and keeping balance between all four pillars remains the key to good health for people with diabetes. It is a disorder—you can manage it and live a happy life.

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Dr Ananthakrishna Sanjay, MBBS, DNB [Internal medicine], has a post graduate diploma in Diabetology and runs his own clinic Oxybliss Cardio and Diabetic Research Centre in Bengaluru

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