Our life revolves around numbers—phone numbers, birth dates and bank account numbers. In diabetes management too, numbers are key. Call it numerology of diabetes management if you will, but if you follow these numbers, diabetes will never come in the way of living a happy, fulfilled life.
Four pillars for leading a healthy life with diabetes are: a healthy diet, regular exercise, appropriate medication and diligent monitoring.
Eat six small meals instead of three large ones as eating smaller, frequent meals reduces the burden on the pancreas. It also helps keep the metabolism up to speed. For diabetics, both fasting and feasting are best avoided.
Aim for BMI [Body Mass Index] of less than 25. BMI is a crucial factor for diabetics. Lose weight if your BMI is more than 25. For non-diabetics or the insulin resistant too, BMI of less than 25 is ideal. However, if it is more than that, even if you lose up to 5 per cent – 10 per cent of your body weight, it will cut back your risk of developing type-2 diabetes by up to 50 per cent.
Zero tobacco. For a diabetic, smoking is an invitation to all sorts of health problems. It damages blood vessels, doubles your risk for heart disease and reduces your body’s ability to use insulin by 15 per cent.
One annual check-up. Since diabetes brings along a whole array of health complications, a total health check-up helps keep important parameters such as blood pressure and cholesterol in check, avoiding problems. It’s the best way to keep a tab on the status of your diabetes. Get tests once a year [at least]:
- Fasting lipid profile
- Dilated eye exam [where the doctor places drops in the eyes] to examine the retina [the inside of the eyes].
- A urine test for protein [called the microablumin test].
- Foot examination for altered sensation and decreased circulation.
Less than 120 mg/dl of fasting or pre-meal blood sugar levels. If you manage to maintain this level, you won’t have a worry.
You must eat at least five servings of vegetables and fruits every day.
Your postprandial capillary glucose levels should be less than 180 mg/dL. This is the sugar that is found in your blood two hours after the start of a meal.
Three-month average blood glucose levels, which can be monitored with the help of the HbA1c test. This test measures the amount of glycosylated haemoglobin [HbA1c] molecules in the blood. These molecules are formed when glucose sticks to haemoglobin. Hence, if you have more glucose in the blood, you will also have more HbA1c. This test is not the same as your regular test for blood glucose and experts find that it is more accurate in predicting the prognosis of the condition.
Less than seven per cent of HbA1c should be your aim. If your HbA1c is higher, it increases your risk for developing complications. If your HbA1c is more than 9 per cent at the time of diagnosis or over 7.5 per cent after being on oral anti-diabetic, ask your doctor about insulin.
Remember, less than 200mg/dL of total cholesterol should be your goal.
Two dental check-ups in a year. Visit your dentist once in six months for a thorough dental cleaning and exam. Oral problems are closely linked with diabetes and, in fact, those with diabetes are 3 – 4 times more likely to develop gum disease.
Aim for more than 40mg/dL of HDL if you are a man. HDL is the good, healthy cholesterol that protects you from heart disease, so the higher it is, the better. About 67 per cent of diabetic adults [type-2] suffer from at least one lipid abnormality. Low HDL levels, and high total cholesterol, LDL and triglycerides levels means a greater risk of heart disease.
Women should aim for more than 50mg/dL of HDL.
Less than 100 mg/dL of LDL or bad cholesterol. This is the cholesterol that your heart hates. Keep the levels down.
Aim to keep your triglyceride levels below 150 mg/dL.
Less than 80 mmHg of diastolic blood pressure [the bottom number in your reading]. About 70 per cent individuals with diabetes also suffer from high blood pressure. Having both conditions considerably increases your risk of developing micro- and macro-vascular complications associated with diabetes mellitus.
Get 30 minutes of exercise in a day. Physical activity moves sugar from blood into cells thus helping in lowering blood sugar levels. For the best health benefits, aim for 10,000 steps a day of a physical activity of moderate intensity. This is equivalent to 30 minutes of brisk walk per day.
Less than 130 mmHg of systolic blood pressure. When hypertension coexists with diabetes, the risk of heart diseases and stroke goes up by 75 per cent.
Less than 20 mg microalbuminuria. This is an indicator of presence of protein in the urine. Over 20 mg microalbuminuria in the urine is an early indicator of kidney trouble as a result of diabetes.
Either you control diabetes or it controls you. It is not a disorder that you can forget about and needs to be managed 24×7. These numbers will help do so with ease.