Coping with Type 2 Diabetes
A few warnings
You will see claims being bandied about by people who say they have the secret to curing diabetes.�¯�¿�½ These are scams.�¯�¿�½ Diabetes is not just incurable at present, it is irreversible.�¯�¿�½ Anyone who offers a cure is only after your money.�¯�¿�½ Listening to them will place you at extreme risk for blindness, neuropathy, circulatory failure, kidney failure, stroke, and heart disease.�¯�¿�½ You are the one who will suffer, not the snake-oil peddler.
Many alternative treatments and dietary supplements are being promoted as treatments for diabetes.�¯�¿�½ The supplements include chromium picolinate, alpha lipoic acid, cinnamon, garlic, and magnesium.�¯�¿�½ Be aware that the claims that these substances help control blood sugar have not been proven in clinical trials.�¯�¿�½ Also, the large amounts of these supplements that are recommended can sometimes be harmful in and of themselves.�¯�¿�½ Be sure to discuss any alternative treatments you are considering with your primary care doctor.
Finally, do not ignore your diabetes.�¯�¿�½ Being diagnosed is shocking, sometimes overwhelming.�¯�¿�½ Denial is easy; compliance is hard.�¯�¿�½ You must realize that diabetes is a progressive disease.�¯�¿�½ The earlier you can arrest it and control it, the better your chances of avoiding complications altogether.�¯�¿�½ Every day you let your blood sugar soar takes time off your life.�¯�¿�½ Please listen to your medical team and make these lifestyle changes.�¯�¿�½ A longer, happier life will be your reward.
Monitoring your health
As a diabetic, it is up to you to put together a medical team, determine your treatment plan, and monitor your health.�¯�¿�½ Because diabetics are prone to health problems and are slow to recover from injuries and disease, you must watch carefully in order to catch problems either before they occur or before they become severe.�¯�¿�½ There are several key observations that you must make on a regular basis, daily or even more often.
Blood glucose monitoring is probably the most well known self-test that diabetics take.�¯�¿�½ Testing and recording your blood glucose levels is vital if you are going to prevent present and future problems.�¯�¿�½ Blood glucose monitors are very easy to use, and most of them require such a small blood sample that the pain is minimal, usually about the same as a mosquito bite.�¯�¿�½ You and your doctor should work out a plan to determine how often you show monitor your blood glucose level.�¯�¿�½ Recommended levels are 80 to 120 milligrams glucose per decaliter of blood for a fasting test and 100 to 140 mg/dl for a random test.�¯�¿�½ You should make these levels your goal and concentrate on meeting them as often as possible.
Foot inspection is a very important aspect of health monitoring for diabetics.�¯�¿�½ As diabetes progresses, hands and feet become numb.�¯�¿�½ It is easy to injure your feet and not know it.�¯�¿�½ It is especially important to use a mirror to inspect the soles of your feet every day.�¯�¿�½ Blisters can rise, break, and become infected in a short time if not detected and treated immediately.�¯�¿�½ As with blood glucose monitoring, you must make a habit of inspecting your hands and feet every day.
There are two blood test that your doctor should schedule regularly, usually every three months: a cholesterol measurement and an HbA1C.�¯�¿�½ The A1C, short for glycosylated hemoglobin A1C, measures average blood glucose levels over a long period of time.�¯�¿�½ Your A1C level should be below 7, below 6 if possible.�¯�¿�½ High cholesterol, or hypercholesterolemia, is a common adjunct to diabetes.�¯�¿�½ You should monitor cholesterol levels carefully and take action immediately if they begin to rise.
Diet
The three legs that compose a diabetes treatment plan are diet, exercise, and medication.Ã?¯Ã?¿Ã?½ Of these three, diet usually causes the most change in a diabetic’s lifestyle.Ã?¯Ã?¿Ã?½ In developed countries, our diets have become far too heavy on simple carbohydrates like sugar and refined flour, far too low in fiber, and far too high in fat.Ã?¯Ã?¿Ã?½ Aside from these considerations, the proportions of carbohydrates, protein and fat that we eat are out of whack, as are portion sizes and distribution of meals through the day.Ã?¯Ã?¿Ã?½ It is vital for you, as a diabetic, to become diet-conscious and to make possibly radical changes in what you eat, when you eat, and how much you eat.
First, I want to dispel the Great Sugar Myth.�¯�¿�½ Sugar is not poison for diabetics, neither is it forbidden.�¯�¿�½ Sugar is simply a carbohydrate just like bread or potatoes.�¯�¿�½ The problem with sugar is two-fold.�¯�¿�½ First, it is highly concentrated calories.�¯�¿�½ In order to have sugar in your diet, you must make room somewhere else.�¯�¿�½ Second, the calories are empty of any nutrition.�¯�¿�½ Sugar contains no vitamins or minerals and, thus, has no benefit.�¯�¿�½ With the advent of artificial sweeteners such as Equal and Splenda, sugar has become very much a non-essential.
The goal of diet in your diabetic treatment plan is three-fold: to keep your blood sugar levels within recommended ranges, to keep your blood sugar levels as steady as possible, and to manage your weight.�¯�¿�½ By managing your diet responsibly, you can take control of these three factors and live a much healthier and longer life.
A good diabetic diet involves balancing calorie intake and managing the proportions of carbohydrates, proteins, and fats consumed.�¯�¿�½ An ideal diet requires eating six equal meals every day, one approximately every three hours.�¯�¿�½ This is not always possible, given the way our modern lifestyles revolve so tightly around three meals a day.�¯�¿�½ The best compromise is three small meals and two or three snacks.�¯�¿�½ I try to stay on an 1800-calorie-a-day diet by eating approximately 300 calories six time each day.
This diet plan has two goals: to keep blood sugar levels steady through the day and to keep you from getting so hungry that you overeat at meal times.Ã?¯Ã?¿Ã?½ Some good ideas to keep in mind are to eat a high-fiber diet with lots of whole grains, fresh vegetable, and fresh fruit.Ã?¯Ã?¿Ã?½ Raw vegetables – leafy salads, cut broccoli or cauliflower, carrots, and celery, for instance – are ideal.Ã?¯Ã?¿Ã?½ This kind of diet runs counter to modern customs, and you can expect to take some teasing about it.
You should limit simple carbohydrates like processed flours, sugars, and potatoes.�¯�¿�½ Simple carbohydrates have a high glycemic index, a measure of how fast they cause blood sugar levels to rise, and cause your blood sugar to spike and then fall precipitously.�¯�¿�½ This not only causes stress for your body in dealing with the excess glucose, but can also lead to hypoglycemia.�¯�¿�½ Try to always choose complex carbohydrates like vegetable and whole grains and always add a little protein and fat to the meal or snack to moderate the rate of digestion and the variation in blood glucose levels.
Also essential to blood sugar and weight management are controlling the proportions of carbohydrates, proteins, and fats in your diet.�¯�¿�½ A good mix is 70% carbohydrates, 20% protein, and 10% fat.�¯�¿�½ You do not have to mess around with complicated food exchange systems to achieve this.�¯�¿�½ I do just fine by paying attention to package labeling and thinking a little bit ahead.
Protein is essential to a healthy diet, but only in moderation.�¯�¿�½ High-protein diets are very much not recommended for diabetics.�¯�¿�½ The reason is that large amounts of protein place a major burden on the kidneys.�¯�¿�½ Kidney disease is a high-risk complication of diabetes, and you should avoid placing any undue strain on an already stressed organ.�¯�¿�½ Another reason for limiting protein intake to reasonable levels is that proteins contain more calories per gram (nine) than carbohydrates (four).
Good sources of protein in your diet include meat, especially poultry and fish, beans, and milk and dairy products (watch out for fat).�¯�¿�½ Approximately four ounces of meat make a good serving size.�¯�¿�½ This is a piece of meat about the size of a deck of playing cards.�¯�¿�½ Be sure to choose lean meats and skinless poultry to limit your fat intake.
Avoid the temptation to eliminate fat from your diet altogether.�¯�¿�½ A proper amount of fat is essential for the proper functioning of your body.�¯�¿�½ Fat helps lubricate joints, among other things, which will help you in maintaining your exercise program.�¯�¿�½ The trick is to choose the proper kinds of fats and eat them in the proper amounts.
There are four main types of fats that you must be aware of: saturated, monounsaturated, polyunsaturated, and trans fats.�¯�¿�½ To avoid getting technical, I will just say that you should avoid saturated and trans fats in favor of monounsaturated and polyunsaturated fats.�¯�¿�½ Again, reading the nutrition information on food labels will help you make this decision.�¯�¿�½ Though trans fats are being listed more often, scanning the ingredients list for any hydrogenated or partially hydrogenated oils, which contain trans fats, will be helpful to you.�¯�¿�½ Also, any solid fat like butter, meat fats, or cheese should be highly suspect.
Good sources of the unsaturated fats include fatty cold-water fish like salmon, trout, and tuna, and vegetable oils like canola and olive oils.�¯�¿�½ These should be your fist choices for providing fat in your diet.�¯�¿�½ The wrong fats or too much fat in your diet can lead to heart disease or stroke, both very high-risk complications for diabetics.�¯�¿�½ Again, prevention is vital, since cure is impossible.
Good diet for diabetics is all about balance.�¯�¿�½ A proper mix of vegetables, whole grains, fruits, lean meats, and unsaturated fat will contribute to a healthier life with fewer complications.
Exercise
A balanced exercise program serves the same purpose as a balanced diet: blood sugar management and weight management.�¯�¿�½ A good exercise program will do this in two ways.�¯�¿�½ First, a 20-minute aerobic workout at least three times per week will help with short-term glucose control.�¯�¿�½ Second, a weight training or other muscle-building program helps keep blood sugar levels stable over the long term.
Aerobic exercise is essential to a healthy lifestyle.�¯�¿�½ By exercising your heart, you make it stronger, fight plaque buildup in your arteries and oxygenate your blood.�¯�¿�½ Working muscles use more glucose for energy, lowering the amount in the bloodstream.�¯�¿�½ This also encourages the liver to release glucose into the blood, depleting its supply.�¯�¿�½ This helps control blood sugar levels later by delegating more glucose to the liver to replenish its stores.�¯�¿�½ You must be careful to monitor your blood glucose carefully before and after exercise, since a good workout can use glucose at a rate that might cause the level to fall too low, leading to hypoglycemia.�¯�¿�½ If your blood glucose level is within recommended range, you might want to eat some carbohydrates before beginning your program.
For long-term effect, your exercise program should include some form of muscle-building and toning routine.�¯�¿�½ I prefer weight training using low weights and lots of repetitions, but you doctor can advise you on a program that fits your unique needs.�¯�¿�½ You do not need to try to bulk up and become muscle-bound, just convert some of your excess fat into muscle.�¯�¿�½ Fat tissue uses no calories and, thus, no glucose.�¯�¿�½ Muscle fiber uses glucose, even when it is at rest, helping to regulate the level of glucose in your blood.�¯�¿�½ This helps you avoid the spikes and dips that cause diabetics so many problems.
Medication
The third leg of your treatment program may include medications.�¯�¿�½ Not all Type II diabetics need medication, at least at first.�¯�¿�½ Many never need medication and can control their diabetes through diet and exercise alone.�¯�¿�½ However, for those of us who do need extra help, medications are indispensable.�¯�¿�½ It really helps to know about your options in this area.
Diabetes medications, sometimes known as hypoglycemic medications, aim at controlling blood sugar levels through three fundamental means: raising insulin levels, increasing cells’ sensitivity to insulin, which enhances their ability to use glucose, and blocking starch digestion.Ã?¯Ã?¿Ã?½ The different medications use different methods to accomplish these goals, but that subject is far too technical for this article.Ã?¯Ã?¿Ã?½ Instead, I want to point out some of the major types of medications and how they work in general terms.
The major groups of medications that raise insulin levels are injectable insulin, the meglitinides, the D-phenylalanine derivatives, and the sulfonylureas.�¯�¿�½ Besides injectable insulin, the sulfonylureas are the most commonly prescribed of these drugs.�¯�¿�½ This group includes such common brands as Glucotrol, Glucotrol XL, and Glucovance.
Of the medications that help your body make better use of the insulin that is available, the most widely used are the biguanides, including GlucoPhage, and the thiazolidinediones, which include Actos and Avandia.�¯�¿�½ Both groups of drugs work by increasing insulin sensitivity and by lowering sugar production in the liver.
Less widely used are the Alpha-glucosidase inhibitors, such as Precose and Glyset.�¯�¿�½ This class of drugs slows absorption of carbohydrates in the intestines, which helps reduce the rapid rise in blood sugar after a meal or snack.
These medications are most often used in combination to achieve maximum benefit.Ã?¯Ã?¿Ã?½ Most commonly, a sulfonylurea will be used in combination with either a biguanide or a thiazolidinedione.Ã?¯Ã?¿Ã?½ This combination gives a one-two punch that increases insulin production and increases cells’ sensitivity to that insulin at the same time.Ã?¯Ã?¿Ã?½ This combination can lead to hypoglycemia, or low blood sugar, so exercise caution until the proper dosages can be determined.
Commitment
The harsh fact is that diabetes is presently an incurable disease.Ã?¯Ã?¿Ã?½ The good news is that by making a commitment to your health, you can manage your diabetes and, in many cases, arrest its development.Ã?¯Ã?¿Ã?½ It is not easy.Ã?¯Ã?¿Ã?½ Managing diabetes requires significant lifestyle changes and the ability to resist the temptation to continue to live just like “normal” people.
Your health is more important than other people’s opinions of your lifestyle.Ã?¯Ã?¿Ã?½ Your commitment to proper diet, a good exercise plan, taking your medications every day, and keeping close tabs on your blood sugar and your health will pay off.Ã?¯Ã?¿Ã?½ By committing yourself to intelligent changes now, you can give yourself the chance for a long, healthy, complication-free life.
