Strategies for managing your diabetes the right way.
Being diagnosed with Type 2 diabetes can be a serious health setback because it is a disease that, if not well-managed, could have life-threatening consequences. While diet and lifestyle changes are necessary in diabetes management, diabetes doesn’t mean you have to run marathons and swear off your favorite dessert for life.
Physicians recommend that pre-diabetic and diabetic patients make changes to their diet and exercise routines in the management of the disease. According to Dr. Lesley Kellie, an internist with Norton Community Medical Associates-Mallard Creek, diet and exercise are the first line of care, but physicians realize that “lifestyle changes are easier said than done, and it takes a while for a change of habits to happen.”
If a patient has very high blood sugar levels or other complicating factors, such as heart disease or high blood pressure, Dr. Kellie may put a patient on prescription medicine, typically metformin, in conjunction with diet and exercise. “Metformin has been a first line diabetes medication for many years,” she says.
After being diagnosed, patients will typically meet with a nutritionist or nurse navigator, who can explain in detail the changes that need to be made to their diet and how/when to take medication.
Physicians usually want to see patients every three months to keep tabs on their blood sugar levels as well as support habit changes. However, Dr. Kellie says some patients are able to lower their blood sugar levels with just diet and exercise, and if this happens, they may be able to go six months between doctor visits.
THE DANGERS OF POOR DIABETES MANAGEMENT
High blood sugar can negatively impact many parts of the body. Dr. Kellie says diabetes impacts the body at the cellular level, which causes narrowing of and blockages in the arteries, resulting in not only heart disease but circulation problems. Diabetes patients’ feet and legs are examined during office visits to ensure wounds heal properly and numbness doesn’t occur.
Diabetes puts patients at higher risk for both fungal and bacterial infections, including pneumonia, which is one of the reasons physicians urge diabetic patients to get vaccinated against the flu virus every year.
Dr. Kellie says diabetes is even associated with depression. The microbes in the gut are impacted by high sugar levels, which then impact the production and usage of neurotransmitters in the brain. She encourages her patients to eat a Mediterranean-type diet, which is rich in fruits, vegetables, and complex carbohydrates. Such a diet is not only good for blood sugar levels, it also enhances the diversity of the gut microbiome.
MAKING DIET AND EXERCISE CHANGES DO-ABLE
Dr. Kellie says a common misconception about dietary and exercise changes is that they have to be monumental in order to make a difference. She often encourages her newly diagnosed diabetes patients to decrease the proportion of sugary foods and drinks they consume by half to begin. After they have done this for a while and have adjusted, she then encourages them to reduce their sugar intake again.
Patients often think they have to hit the gym every day in order to see changes in their blood sugar levels or waistline, but Dr. Kellie says even five-minute increments of exercise a few times a day adding up to 30 minutes is beneficial. Patients who have back problems or difficulty standing or walking can exercise in a sitting position. Dr. Kellie suggests seated marches or arm curls to increase a patient’s heart rate to help burn glucose.
By Carrie Vittitoe