July 3, 2013

Will You Be Able to Make the Lifestyle Changes Necessary?

This is the topic for this blog. Will you be able to make the lifestyle changes necessary?

When people are first diagnosed, often they do not consider the things in their lifestyle that need to be changed. I have had one person, a friend, ask me why he needed to change anything. Granted he was not overweight and if fact was underweight by a few pounds, according to his doctor. So we went to my blog here. I will list the components of lifestyle for change and our discussion:

Weight Loss: We agreed this was probably okay for him, but I did use this to help him understand that there were different tables. He was surprised when I used it. For a person 5' 6” tall, and medium frame, this table showed that at 162 pounds, he was actually (Ideal weight range is 142 - 156.2 lbs.) marginally overweight by 5.8 lbs. This surprised him and he declared that the doctor said he was underweight by about four pounds. I agreed that he could accept the doctor's verdict, or ask for a copy of the chart used by the doctor. He had an appointment scheduled for that Friday and afterwards, he did stop by and said I was right and the doctor had used no chart and only estimated. He had asked the doctor to pull up the chart I had used. He said the doctor had and when he saw it went through the process twice and his weight on their scale had been 160 pounds or 3.8 pounds overweight. The doctor thanked him for the site and said that was good to have. My friend felt better now and said that he would attempt to bring his weight into the ideal range.

Exercise: Here he said that at least six days per week he was walking for about an hour, either outside, or during bad weather, he was using his treadmill. We agreed he had this under control. 
Food: This was a different discussion and I advised him to do some reading of what others were saying about the high carb, low fat diet he was on. I suggested that he consider a medium carb, medium fat food plan, and not increase the amount of protein. He admitted that he would consider this since the high carb had caused some of the weight increase he had recently.

Sleep: On this, my friend did say that he was only sleeping for about six hours a night. Any longer was difficult for him and it seemed to him that no matter when he went to sleep, he was wide-awake after six hours. I suggested that he have a good discussion about this with his doctor. I said that he should be getting more sleep, but that it did vary from person to person. I said I would be watching for studies about this for him.

Medication: My friend said he was taking his metformin as the doctor prescribed it. He was taking 500 mg in the morning, 1000 mg at the noon meal, and 1000 mg at the evening meal. His doctor had decreased his noon to 500 mg at his last appointment and said that if he continued his improvement, he may be able to get off all medications in six months.  I said this was a good goal for him to pursue.

Heart health care: My friend felt good after his last appointment where the doctor had lowered the dose of the statin he was taking. He had been instructed to purchase a blood pressure measurement device and check his own BP twice a day and record these for the doctor. If he continued to show improvement, he would be taken off that medication.

Illness: Here he said this was not a problem.

Hormone levels: My friend said his doctor was testing him and that he was in the correct range.

Stress: My friend said he did not realize that this was a lifestyle change. I asked him if he felt stressed, and he said almost all the time except at home. He said work was very stressful and that he would be retiring at the end of the year when he was over 65. I said this would be good and should help his diabetes management considerably. I suggested that he should also cover this with his doctor and consider remaining on metformin until the A1c results after his retirement. He admitted this might be wise.

Alcohol: He said this is not a problem as he does not drink and hasn't for over 15 years.

Smoking: My friend said he has never smoked and therefore this was not a problem.

He asked about the logs he should keep. I asked if he had the software program for his blood glucose meter and he said he was not aware of one. Since he uses the same meter that I use, I said there was and we looked on the internet. When he saw the price and the cable price, he said he would be ordering these that evening. I knew he was testing more that once a day, so I asked if he was purchasing extra on his own. He said he was and that the pharmacy was aware of this and that under Medicare he would be limited to two. He said his insurance limited him to one per day so that would be a help. I asked him is he had asked the doctor to write a letter to his insurance company and he said no. I told him to do this and see if that helped.

We talked about food logs and daily health logs. He said that his wife was keeping the daily food logs for both of them since she was interested in preventing diabetes for herself as well. She had diabetes on her father's side. Daily health logs he did not know about. I showed him mine and then my spreadsheet and he asked for copies. I converted them to his system and attached them to an email to him. Then he asked to look, if I did not mind, at my health logs. He said that he could understand why I did it and said he would show the spreadsheets to his wife and maybe together they could do them.

I mentioned the support group I was a member of and asked if he was interested. He said not at this time, but that after he retired, he would be interested. We discussed this and he was surprised by the number of people he knew in the group. I also told him there were two other groups in our town and a little about each. He admitted he had not realized there were this many with diabetes. I said this was only those with type 2 diabetes. There were also some with type 1 diabetes, but I was not aware if they had a support group.

He thanked me and said he would stay in contact.

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