Diabetes Management: Weight, Diet, Exercise and Medicine

As a person with diabetes, it is very important for you to learn how to manage the condition well. The main goal is to keep your blood glucose at an optimal level — neither too high nor too low.

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How to Control Diabetes 

Diabetes is normally treated first with weight loss, diet and exercise. If these fail to work, oral medications will be given. If these are not enough to control diabetes or if your diabetes is long-standing, your doctor will consider prescribing insulin for you. Following these diabetes management guidelines will help keep you in the best health possible.

Maintaining a Healthy Weight 

If you are overweight, aim to trim down. Studies have shown that losing five percent of your weight can very much improve your diabetes control.

Learn what is a good weight for you by checking your Body Mass Index (BMI) here.

Food for Diabetics

There is no special diet for people with diabetes; you can enjoy the same healthy meals as everyone else. However, you have to be very careful about the amount of daily carbohydrates you eat as carbohydrates can cause blood glucose levels to rise the most. The amount of fat and protein taken has to be closely monitored too, since they indirectly affect your blood sugar levels.

Learn how to create a suitable diabetic diet meal plan for yourself with these Basic Dietary Guidelines

Exercise Regularly 

Getting fit is part of staying healthy and fighting diabetes. It does not mean you have to exercise for hours each day; you can better manage your diabetes just by being active, which could involve just a few minutes of walking a day, or even cycling for five minutes every day.

Together with your meal plan and diabetes medications (where needed), regular exercise improves and controls diabetes by lowering your blood glucose level. In addition, it helps in controlling your weight, improving your blood and has many other benefits.

How to Get Started with Exercise

Begin by talking to your doctor or physiotherapist; find out what exercises are suitable for your current condition. A physiotherapist can assess your fitness level and help you develop an exercise plan.

Set realistic goals: take small steps at first. Pick an activity you are sure you will be able to do. You can increase the frequency and intensity later when you feel comfortable.

Develop your exercise plan. You may want to use the FITT formula:
Frequency: how often will you exercise?
Intensity: how hard will you exercise?
Time: how long will you exercise?
Type: which types of exercise will you choose?

The three main types of exercises are:
Aerobic exercises: also called cardiovascular or endurance exercises. These include walking, jogging, swimming, dancing and ball games
Flexibility exercises: these include stretching, which help to loosen muscles and joints. Do these exercises slowly, holding each stretch for a few seconds
Strengthening exercises: these make your muscles stronger by working them harder. Strengthening exercises are usually done against resistance, such as lifting weights. Do not hold your breath while doing strengthening exercises

Tips from other patients about exercise:
I take part in line dancing at the community centre
I park further away in the car park to help me walk a bit more
I alight from the bus one stop earlier to walk a longer distance home
I climb the staircase instead of taking the lift or escalator

If you have trouble walking, you can try:
water aerobics
cycling
upper body stretching
lifting weights while sitting

Tips from other patients with trouble walking:
I can still sit in my chair and lift weights. I just use mineral water bottles
I do what I can. I wheel myself around instead of having someone always pushing me in my wheelchair

Example of a one-month exercise plan:

 

Safety Precautions: Before You Start Exercising

Check your blood glucose level just before you exercise. If your blood glucose level is:
Below 6mmol/L (100mg/dl) — eat a small, low-fat snack before exercise
Above 22mmol/L (370mg/dl) — do not exercise now. Drink more water

Other precautions to take:
If you are over 40 years old, or have underlying heart disease, consult your diabetes care team before considering vigorous exercise 
If your feet are numb, you can’t see clearly or have bleeding in the eye, consult your diabetes care team before exercising
If you are exercising right before your next meal, take a small snack half to one hour before you exercise
If you are on insulin, you will need even more care during and after exercise to prevent your blood glucose levels from decreasing too much. Your diabetes care team will be able to advise you on this


Oral Diabetics Medication 

There are many different types of tablets available to treat diabetes. These tablets, in addition to the meal plan and exercise plan, help you manage your blood glucose level. Store your medications in a cool, dry place and never mix them in a single container.

They work by helping:
Your pancreas to release more insulin, e.g. Glipizide
Your body to use insulin more efficiently, e.g. Metformin
To stop the quick rise of blood glucose after a meal, e.g. Acarbose

Before taking your medicine, inform your doctor if you:
Have any allergy
Are on any medication
Have heart, kidney or liver problems
Are going for any surgery
Are pregnant or planning to get pregnant
Are breastfeeding

What must I do while taking the medication?
Take your medicine regularly and exactly as prescribed by your doctor
Do not stop taking your medicine without consulting your doctor
If you miss a dose, take it as soon as you remember. However, if it is almost time for the next dose, take only the next dose. Do not double the dose. It is good to check with your doctor at your next visit for specific advice
If you visit another doctor, be sure to tell him you are taking this medicine

Possible Side Effects of Diabetes Medicine

Low Blood Glucose (Hypoglycaemia)

This may happen if you have taken your medicine but do not eat your meals on time, or have poor appetite because you feel sick. Signs of low blood glucose include sweating, trembling, fast heartbeat, feeling very hungry, double vision, weakness and dizziness.

When you experience these symptoms, you should eat some sugar cubes or drink honey immediately. Call your doctor if you still feel faint.

Stomach Discomfort/Diarrhoea

Consult your doctor if these symptoms are severe or do not go away. If you have a skin rash after taking the medicine, inform your doctor immediately as this may be an allergic reaction.

Tips from other patients about taking diabetes medicine:
I use a pillbox to remind me if I have taken my pills everyday
My doctor taught me to take my pills at the same time every day. It keeps my blood glucose level from going too high or too low
My son and I made a medication list of all the medicines I take. This makes it easy
I bring my medication list to my doctor. This helps her understand me better

Taking Insulin

There may be times when the usual oral medications are not effective, especially in long-standing diabetes. In such cases, your doctor will prescribe you insulin to control your blood glucose level. Many patients do much better on daily injections of insulin. This does not mean that their diabetes is worse or that they have “failed” in their diet and exercise regimen.

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