July 11, 2012

Back to Diabetes Basics – Part 6

Exercise Is a Key in Diabetes Management

Maybe some of us emphasize this too much and too often, but it is one truth that many people with diabetes just feel they can ignore. You will get tired of this as well; many type 2 people just say, “Apparently the doctor did not feel it was important as he/she did not talk about it.” I am beginning to believe these people need a hearing test, but I do know a few doctors that are afraid to say anything also. This is a deadly set of circumstances to work with in attempting to get people to exercise.

Always consult with your doctor before beginning any exercise regimen. If you are on medications, your doctor may want to give you different dosages to use under different circumstances to prevent hypoglycemia. Even if you are not on medications, the doctor may have other health concerns that you may need to consider. I have discussed blood glucose levels for safe exercising in my blog here. Knowing this information will save you from problems while you exercise.

I have more information about how a neighbor made me realize how important exercise is. He has had the second operation and is walking with a cane today. He is still unable to drive, but he walks just about everywhere and will not accept a ride. Yes, I have driven when he has too far to walk or needs to travel to another town. Even when he needs groceries, he walks and shops for only what he can carry. You have to admire him for his determination. If anyone could have given up, he could have been the person, but he has met every opportunity to educate others and show them what a person can do.

Lifestyle Changes

Do you know what this means? Many people have some idea, but it can be very general. This may be just semantics; however, I would like to clarify some parts of the term “lifestyle”. The definition from an on line dictionary says lifestyle is a way of life, the attitudes, tastes, moral standards, economic level, etc., that comprise an individual or group.

This of course says nothing about diabetes and managing diabetes. In my reading, blogging, and participation in a few diabetes forums, I have seen lifestyle described many ways. I have a slightly different perspective as most writers start with diet. I believe the elements of lifestyle change should start with exercise if you are physically and medically able. It is the key that generally makes the rest of lifestyle fall into place.

What you need to recognize is that all are interlinked and bypassing one part of lifestyle change will normally make other changes generally unachievable. What different writers choose of emphasize depends on their philosophy and how they view their career. Most that work in the medical profession, be they doctors, nurses, educators, dietitians, or licensed caregivers, must follow the guidelines of the American Medical Association, the American Diabetes Association, and other professional medical groups if they want to have their license updated and current.

Since I answer to myself and a few bloggers that agree exercise should be listed first, this is where I will start. This is the list I have pulled together from various sources. It may not agree with everyone's list, but for me, the list needs to be updated as changes are found that affect the way we look at diabetes and lifestyle.

The main elements of lifestyle should or must include the following: exercise, food, sleep, food, medication, weight loss, illness, hormones, stress, heart health care, and two other elements, alcohol and smoking.

Exercise – If you are physically and medically able, get your doctors okay to exercise, and remember to exercise good judgment and don't do something that will be wrong and cause injury. Start out slowly and build up gradually. Regular exercise helps make insulin more readily available and reduces insulin resistance. Find a form of exercise or a mix of routines that you enjoy and follow through with it.

Food – Healthy eating is important and even more important if you are medically unable to exercise. It is good to be consistent in eating times and amount of food. Whether you eat low carb or another way, learn to use your meter to determine how different foods affect your blood glucose. Learn to coordinate your food with the medication you are taking. Also, learn to eat to your meter and learn to trust it.

Sleep – Where did this come from? It is not included on most lists, but should be after a study I wrote about here. I keep being surprised how important sleep is to our well-being as a person with diabetes. That is the main reason I am adding it to lifestyle and encouraging all to get the sleep needed. If you are having trouble getting enough sleep, change your habits and if that does not help, talk to your doctor about doing a sleep study to determine if you have a form of sleep apnea.

Medication – Be sure that you follow the doctor’s instructions. Yes, I know that you want to avoid all medications. This is an excellent goal if you are diagnosed early on and can make this work. Remember that you need to consider getting the diabetes managed as soon as reasonably possible. Do discuss with the doctor getting off medications if you do it. If you do bring diabetes under good management and the doctor wants to keep you on medications, then ask yourself if a change in doctors needs to be considered.

Heart health care – Because people with diabetes are at 50 percent risk of having cardiovascular events, many of the same changes for diabetes help with heart health. It may still be necessary to consider medications for heart health. Exercise and food choices become primary for heart care and managing cholesterol and hypertension.

Weight loss – This is easy for some people, while others struggle with this every day. The first goal should be stopping gaining any weight. Then adapt your food intake to help start reducing weight. Generally if you are overweight, a high carbohydtate, low fat diet will not help you reduce weight. There are more and more writing about low carb, high fat. However, you need to find what works for you in assisting to bring down the weight. I will not suggest how, since I am still working on this myself.

Illness – This was a little surprising until I thought about how illness affects our diabetes management. Therefore, as an element of lifestyle change we need to learn to take our medications timely and know when to talk to the doctor about variations like illness which can cause problems unless we know not to take certain medication to prevent hypoglycemia. This means having a plan with your health care team of what medications to take or not take during an illness.

Hormone levels – This is normally for women who have problems with blood glucose swings related to the monthly menstrual cycle. I personally think the authors failed to talk about the change in life for women and problems some men can have when male hormones cause problems and can affect blood glucose as well. You need to talk about this with your doctor to be prepared for these changes.

Stress – This is definitely a lifestyle change that affects everyone with diabetes. When stressed, almost anyone can toss aside their usual good diabetes management practices, forget to eat healthy foods, and lose control of your blood glucose. Prolonged stress may prevent insulin from working properly which also creates additional problems. Some find logging your stress level (1 to 10 scale) each time you log your blood glucose level helps them see patterns and allow you to adjust accordingly. Learn about ways to relax and find ways to reduce stress.

Alcohol – This can be a bad one if not thought out. First, you need to talk this over with your doctor. Alcohol can aggravate diabetes complications like nerve damage and eye disease. If your diabetes management is excellent, and the doctor agrees, an occasional alcohol drink with a meal may be okay, but a daily drink is generally discouraged.

Smoking - This is a habit that must be broken. Many writers do not want to cover this lifestyle change that needs to happen and the sooner the better. Not only does this increase the effects of neuropathy, but it can affect an increase in cardiovascular risks. Do not take this lightly; the effects of continuing to smoke do not make blood glucose management easier.

To sum up, these are the lifestyle changes that need attention for those of us with diabetes.

Series 6 of 12

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