July 30, 2011
Error 6 - Making Poor Food Choices
When it comes to food, excellent diabetes management is a must. Learn to maintain logs of what you eat, when you eat, and the blood glucose levels before and after eating, especially within the first few months. Be aware of the problem of going off an eating plan. It is the long term unhealthy eating habits that need to be broken and replaced with healthy eating habits. This can take time, but steady progress needs to be a priority.
Carbohydrates become the requirement and you meter needs to be your friend while learning what foods you need to eliminate, reduce in quantity, or that are okay to eat. Since each person can handle different foods, you should talk to your doctor about classes or at least a meeting with a dietitian for guidance and directions for healthy eating. Forget about what you think is healthy eating, it may be more harmful that you imagine.
Learn to read nutrition labels. This will help you calculate the proper amounts of the foods you choose to eat and may provide you with clues as to why you are having problems with your blood glucose levels. This may be more important that you realize now, but eating at a regular time and intervals will assist you in better management of your blood glucose levels.
Do not skip meals as this is the downfall of many people with diabetes. Often you will think that because you skipped a meal, you have a built in deficit of carbohydrates – wrong! The skipped meal does not calculate into allowing for extra carbs later in the day – your liver has taken care of the blood glucose deficit, but adding blood glucose to your system to compensate for the skipped meal. Whether you like it or not, the skipped meal has gained you no carb allowances.
If you doubt me, use your meter to help you see what is happening. Depending on your medication, you may be also creating hypoglycemia and have a blood glucose low which can be dangerous. Skipping medications because you are skipping a meal is also dangerous. This is another reason to learn all you can about the medications you are taking. This can point out the problems, side-effects, and dangers of missing a dose. Plus this may also point out the dangers of not eating or skipping a meal.
Some medications are meant to operate for a set period of time in your body while others have a longer period of operation. All of this means that skipped meals can affect the medications and do more harm that you are expecting. Some combinations of medications create even more troubling complications if you skip meals.
This is why, even though I have blogged about these points separately, they are all interlinked and can be very much part of the integral plan of diabetes management. It is important to remember this and review these on a regular basis. Remember diabetes itself does not cause the complication – it is the lack of diabetes management that does the damage. If you need to reread the article - it is here.
July 29, 2011
Error 5 - Misunderstanding and Misusing Medications
Managing diabetes is very dependent on how well you manage your medications. Do not fall into the trap that many do and just assume because you are feeling good that you may stop your medications. This is one of the mistakes that can really do damage to your body by letting diabetes manage your body.
Warning – unless you are able to manage your diabetes with nutrition (diet) and exercise and the doctor agrees that you are, learn to take you medications when instructed to take them.
Many people fall into this problem while in denial and stop taking their diabetes medication. Diabetes will love you for this. This means that it can do unlimited damage to your body. Retinopathy will develop, neuropathy will accelerate, wounds in your lower legs and feet will not heal properly and amputations are possible. Nephropathy will start to accelerate doing damage to the kidneys and hearing problems can become worse as small blood vessels are damaged in the inner ear.
If this doesn't give you cause for concern, it should. That is why medications are so important to the management of diabetes and the better the management, the less likely you will have problems with the complications of diabetes.
One of the largest problems is people forgetting to take doses. This is a problem that can do considerable damage to your management of diabetes. This should always be a discussion item every time you meet with your doctor. Another item that should be discussed is insulin.
Forget about the insulin myths, your health is more important and insulin can be used very successfully with excellent management outcomes. This should always be considered as a medication and not the medication of last resort. Too many doctors do not understand insulin and know very little about using it. Therefore, if you are having problems with diabetes management, consider insulin and possibly getting an appointment with an endocrinologist specializing in diabetes.
In all meetings with your doctor, discuss problems that you are having so that the doctor can help devise the best treatment plan for you and one that fits your needs to make your management more effective. Yes, I am saying you need to communicate with the doctor to get the best treatment plan. This is why having a doctor that you feel comfortable in talking to about diabetes is very important. If you are not comfortable and confident about your doctor, you may not receive the best treatment plan.
This is one reason many people change doctors several times to find a doctor that will work with them and they feel comfortable about. Diabetes is that important and your health is worth it.
July 28, 2011
Error 4 - Neglecting Other Problems
In your efforts to manage diabetes, do not forget about other problems you may encounter. Depression, stress, and sleep disorders also have an effect on the management of diabetes. So in the process of learning about diabetes, learn about these as well. If you have other chronic illnesses, then you have more to learn and how each disease affect the other. All can lead to increased blood glucose levels.
Because diabetes is a 24/7/365 management demand, depression can be a large part of diabetes and one creates risks for the other. Learn to recognize the signs of depression so that you can take measures to minimize the effects and possibly avoid problems as depression can make diabetes management a very difficult task.
Treatment of depression definitely improves the mental and physical health of people with diabetes. So don't ignore the benefits and let the doctor discussion this and find a good medication fit for you. Even though the article in WebMD states that people with diabetes are twice as likely to have depression, studies show that this in more like 67 percent and then another 19 percent can have serious depression. Please don't ignore depression.
Stress is a factor that many people want to ignore, but please don't as it can produce hormones that hamper the ability of insulin to do what it does. Both patients and physicians need to take this into consideration and use activities that will reduce or eliminate stress. Exercise helps relieve stress and meditation and massage have benefits in improving blood glucose levels.
Some of the tips for easing depression also are applicable to stress. Read my blog here. For stress you need to add yoga and Tai Chi as they can assist in stress reduction.
Sleep disorders such as sleep apnea, insomnia, and others can wreck havoc to your diabetes management. You need to talk to your doctor about any of these so that you can manage them as well. Improper amounts of restful sleep makes blood glucose management that much more difficult to manage. Sometimes weight loss is in order and for others, just getting adequate amount of sleep for your needs helps is diabetes management.
As promised in part 1, read the entire article here.
July 27, 2011
Error 3 - Going it Alone
In your efforts to manage diabetes, try to include those around you. If you live alone, this may be slightly more difficult, but find a friend or a buddy to assist you where possible. Others may have spouses, partners, or family members to assist in staying focused and on target with goals. While some are capable and have the ability to do some things alone, others need encouragement and support for achieving goals.
If you can afford a membership in a local YMCA or YWCA, often others that are members may be able to assist you with exercise routines and schedules. An exercise club may work for others. If you need a buddy, maybe someone from work can assist you and exercise with you.
If you are alone in life, there may be someone from your support group that you can find willing to assist in helping you keep on track and achieving your goals. I am aware of one individual that is a regular in her church and has a couple of them helping and checking on her. One exercises with her and another checks in with her on a daily basis. So don't become discouraged as often there can be someone without diabetes that is willing and looking for someone to do activities with.
There are diabetes forums online that can help with weight loss, daily record keeping and just being online for assistance. Do not forget your doctor as this person may have suggestions that may be just what is needed to get and keep you successful in your management of diabetes.
There are some individuals that can manage alone and do very well. It takes tenacity and perseverance, but some individuals exceed in these circumstances. Some individuals do not have the support and understanding of family members and must start out alone. Talk with family members and ask for their help. Sometimes it just takes the asking and you will receive help.
As you become more confident with meals and what foods do not elevate your blood glucose, if your are the cook, slowly start to change the meal plan for the entire family. This can be successful if done slowly and sometimes can be accomplished with talking to family members. If you have a spouse (and/or other family members) that accept that you need to change lifestyle habits and wants to change with you, then you are blessed. Do thank them and discuss the changes needed.
July 26, 2011
Error 2 - Expecting Too Much Too Soon
To manage diabetes effectively, learn to set realistic goals. If goals are set that are overly ambitious, very few people will be able to achieve them. This is in fact the problem for many people – not setting realistic and achievable goals. Do not set yourself up for failure. Learn to take one step at a time and have success along the way.
Just remember that it has taken you years to develop diabetes and you will not manage diabetes overnight. This is where you need to use your meter to help you decide on the foods and quantity of food that your body can tolerate without aggravating diabetes. What? Your doctor did not authorize or prescribe a meter and test strips for you? Time for you to march into the doctor's office and ask for one. Politely at first, but if the doctor hesitates or refuses, then insist on a prescription. If you still do not obtain a prescription – I strongly urge you to consider, if you are able, to find a different doctor. If you are in a rural area with few doctors, you may need to resort to other tactics to obtain a meter and test strips, but you do need them.
Because we are fighting an uphill battle with our medical insurance companies that are determined to limit our testing, many people become discouraged and stop testing because of the cost. If you are able and can afford additional test strips, by all means the first several months, do regular testing to determine how foods and exercise affect your body. Learn how to negotiate with your insurance company to get the strips needed. Read this blog for testing procedures and long term goals.
Most people with Type 2 diabetes are started on oral medications. These may take a week or two to become effective and you need to be aware of this. Some oral medications also have side-effects when first taken that may make you want to stop. I am talking about Metformin. If the doctor prescribes this, ask if this is the regular or extended release version. Many people will not have loose bowels with the extended release and when taken with food.
If you are just starting to exercise, talk to your doctor to see that there are not problems you need to be aware of and make sure not to over exert yourself when starting an exercise regimen. Start slowly and increase the activity as you body and muscles become accustomed to the added activity.
A good blogger to follow if you have your heart set on managing diabetes with diet and exercise is this one by Tom Ross. Even if you are started on medications, talk to your doctor and ask questions about when you can consider stopping the medications. If your A1c's are at the right levels and the doctor can see that you are serious, he may encourage you and let you know when is may be safe. It is often an advantage to start on medications to get the management of diabetes accomplished early.
Also be aware that you can make mistakes. Learn from them and return to good management. This can happen to anyone at any time so just realize this and get back to management immediately.
July 25, 2011
Much of the following has application for all types of diabetes. However, I am concentrating the discussion to Type 2 diabetes and may expand this beyond the pointers in the WebMd article. Their point is six ways to wreck your blood sugar levels or what not to do. I would like to approach this from what to do to manage you blood glucose levels.
First I would do away with the term used by many writers “blood sugar”. This term continues the misinformation about sugar being the culprit for diabetes. In fact this can have an affect, but the larger culprit is carbohydrates which is converted to blood glucose by our bodies. And we don't measure blood sugar with our meters, but blood glucose.
Type 2 diabetes is a serious chronic disease and therefore a tough adversary requiring constant vigilance to keep ahead of it as part of your individual management plan.
The article uses the following with a short discussion: Not knowing your disease, expecting too much too soon, going it alone, neglecting other problems, misunderstanding and misusing medications, and finally making poor food choices. Yes, these are six easy mistakes to make and everyone at some time in their diabetes lives will make them. It is what we learn from these falls and how fast we recover after making a mistake that determines how well we manage our diabetes.
Error 1 - Not Knowing Your Disease
The first one can be a key for assistance in managing the rest more effectively. As a person with diabetes, you need to learn about diabetes. Andrew Ahmann, MD, director of the Harold Schnitzer Diabetes Health Center at Oregon Health and Science University in Portland, Oregon, makes a statement rarely uttered by doctors. He says “You are your own doctor 99.9 percent of the time.”
He does mean that you are the one managing your diet, making sure you do exercise, and taking your medication on schedule. Dr. Ahmann also states, “classes on coping with diabetes are an excellent but underused resource. Not enough patients seek them out, and not enough doctors send their patients to them.” People need to learn how diabetes works to be able to make more informed decisions and better manage diabetes.
The only comment I make to that is that people often receive information that they will need to adapt to their lives and needs. The people presenting the information instruct from materials and fundamentals from the American Diabetes Association which is presented as a one size fits all approach. They will soon learn that one size does not fit all and that they have individual needs as well, so learning to adapt becomes essential.
Too many doctors discourage use of the internet, and for them rightfully so, because of all the misinformation that exists on the internet. Some doctors are providing short lists of good information, but not enough to make a dent for all the people needing information. So I will encourage people newly diagnosed with Type 2 diabetes to search the internet on their own and look for reliable information – discarding information that seems to or offers cures, as this just is not possible.
The one source that had promised some assistance, the Association of American Clinical Endocrinologists (AACE) has failed in their attempt to provide reliable information. See my blog here. I will provide the site link for this blog in part four of six parts.