Living With Diabetes

Dear Steemians, much as smart lifestyle changes can help reduce the risk of progressing to diabetes, similar steps are essential to managing the disease. The goals of treating diabetes are keeping your blood glucose and other risk factors (such as cholesterol and blood pressure) under control to prevent the development of long-term complications. You'll need a personalized treatment plan that takes all of these factors into consideration - and you'll need patience and determination to follow through with that plan.

For most people with diabetes, a treatment plan entails limiting certain foods, losing weight, exercising and taking oral or injected medications. In addition, and particularly for those taking insulin every day, the treatment plan will include carefully monitoring blood glucose levels.

Most adults with diabetes should keep their blood glucose levels between 80 and 130 mg/dL before meals (preprandial) and less than 180 mg/dL after meals (postprandial). Your doctor may recommend a higher or lower range, depending on your individual circumstances. The standard way to determine whether your blood glucose levels are under control is to test your blood sugar level one or more times a day with a home blood glucose monitor and to have your doctor test your Al c level every three to six months.

WEIGHT LOSS

Weight Loss Losing weight is a key factor in controlling glucose levels - and may even lead to a remission of type 2 diabetes, according to a British study.

DIET AND DIABETES

Whatever dietary regimen you follow, it is important to control your intake of calories, saturated fat and added sugars. If you are overweight, reducing your calorie intake is particularly important. Consulting a registered dietician is recommended.

• Carbs.... Some people with diabetes think they have to greatly limit foods containing carbohydrates. That's not true. Foods that contain carbohydrates are an important source of energy, vitamins, minerals and fibre. However, it is important to monitor your carbohydrate intake and make wise choices. Opt for vegetables, fruits, whole grains and legumes rather than other sources of carbohydrates, especially refined grains. You may also hear about eating foods low on the 'glycemic index' (GI), a measurement of how much a particular carbohydrate-containing food raises blood glucose levels compared with a slice of white bread.

• Fibre.... As with diabetes prevention, people with diabetes should eat a wide variety of foods containing fibre, with a goal of consuming at least 14 grams each day per 1,000 calories. Some studies show that a diet high in soluble fibre - found in oats, oat bran, legumes, barley, psyllium, citrus fruits, and apples - lowers blood glucose and cholesterol levels. Insoluble fibre - found in whole wheat, wheat bran, vegetables and fruit - helps prevent constipation.

• Unsaturated fats.... It's also important to choose healthier fats, replacing saturated and trans fats with monounsaturated and polyunsaturated fats.
In particular, the Omega-3 polyunsaturated fats found in fatty fish such as salmon may benefit people with diabetes. It is advisable for people with diabetes to eat at least two servings of fish weekly to reap the heart benefits of Omega-3 fats. Omega-3 fats may also reduce the risk of diabetic retinopathy, according to another analysis.

• Alcohol.… People with well-controlled diabetes can drink alcoholic beverages as long as they do so in moderation. In fact, alcohol in moderation may even be beneficial. Research has consistently linked moderate alcohol consumption to reduced risk of diabetes, compared to abstention or heavy drinking. In terms of frequency, consumption of alcohol three or four days a week was linked to the lowest risk of diabetes. As in some prior studies, wine was associated with the greatest risk reduction, perhaps because of the polyphenol compounds it contains, the researchers suggested. Overdoing alcohol, of course, is associated with a wide range of health risks.

EXERCISE BENEFITS:

Since physical activity may help prevent diabetes, it makes sense that exercise is also highly beneficial for people with the disease. People with diabetes who start exercising regularly lower their sugar levels on average. Exercise also lowers heart rate, blood pressure, cholesterol and triglyceride levels. Exercise promotes psychological well-being, too, by relieving stress, improving mood, and helping counter depression. How much exercise is enough? At least 2.5 hours of moderate-to-vigorous aerobic exercise per week spread out over at least three days, with no more than two consecutive days between workouts. The guidelines also recommend strength or resistance training, which involves using free weights or weight machines to build muscle.

BARIATRIC SURGERY:

When diet and exercise aren't enough, high-risk patients who have clinically severe obesity sometimes turn to a more radical approach: Weight-loss surgery to remove or bypass parts of the stomach or small intestine. Bariatric surgery has helped many people lose significant amounts of weight and keep it off.

Bariatric surgery may be considered for adults with type 2 diabetes who have a BMI of 35 or higher, especially if the diabetes or associated medical problems are difficult to control with lifestyle and medications.

Over the years, as the procedure became more widely used, doctors discovered an added benefit: Patients with type 2 diabetes saw their disease improve or go into remission (when blood sugar returns to normal without the help of medications) after bariatric surgery.

Most recently, a study of obese adults with diabetes found that those who underwent bariatric surgery showed continued improvement in diabetes control after five years. The effect did diminish over time, but 23% of surgery patients still met control targets compared to only 4% receiving only lifestyle and medication intervention.
Undergoing bariatric surgery is a serious decision. The benefits of surgery can exceed the risks for many people, especially those with poorly controlled diabetes. Ask your doctor about the benefits and risks for you.