What’s the Game Plan?
There’s no getting around it: Once you have diabetes, you’ve got it for life, and no operation, therapy, or drug can cure it (at least, not yet).
The good news is that controlling it can almost be like a cure in that lowering high blood sugar can stop diabetes in its tracks and reduce your risk of developing the health problems that go along with it.
Bringing diabetes under control is an important task-and there’s no one better qualified to do it than you. Taking charge of diabetes doesn’t have to be a full-time job, but you have to be mindful of it throughout your entire day, whether you’re eating, doing yard work, or getting ready for bed. You’ll have a team of other people to help you, but the doctors, nurses, and specialists aren’t your primary caregivers-you are. And your success ultimately depends on managing a treatment plan that puts you squarely in charge. These are the key steps you need to take to get your diabetes under control.
Start Damage Control Immediately
Think about what happens when you spill honey: It gets on your fingers, sticks to everything you touch, and generally gums up your entire kitchen counter. Now imagine a honey spill taking place inside your bloodstream-which is essentially what high blood sugar is. What happens? Cells, proteins, and fats get stickier, slowing circulation, holding back tissue repair, and encouraging material to adhere to your artery walls and cause clots. In short, excess blood sugar gums up your entire body.
You don’t leave honey on your countertop. Likewise, you should clean up blood sugar as quickly and thoroughly as possible because the “stickiness” only gets worse. Doing so can make you feel better right off the bat. And even if you have no symptoms of diabetes, taking this action will start to reduce your risk of such problems as these:
- Damage to delicate blood vessels at the back of the eye (the retina), which can lead to vision problems
- Ruined capillaries in the kidneys that filter waste from your body via the bloodstream
- Impaired nerve function due to less nourishment from damaged blood vessels
- Damage to artery walls that makes them more likely to snag blood clots and plaque that can cause heart attack, stroke, and high blood pressure
These complications wreak all kinds of havoc, including impaired healing, infections, lack of sensation that can lead to injury (especially in the feet), loss of vision, swollen ankles, fatigue, sexual dysfunction-the list can be long. Fortunately, the following steps will help you clean up the excess blood sugar and halt this parade of problems.
Know the Problems and the Solutions
That’s the operative rule in business, sports, and politics, and it’s just as important when you’re fighting for your quality of life-if not for your life itself. The power to tame diabetes is within your grasp, but to use it, you need some know-how. Without a doubt, that means grappling with a lot of information-about your particular type of diabetes, medications, insulin varieties, blood-sugar tests, meal planning, and exercise, to name a few. But the details are not insurmountable, and you’ve got plenty of people to give you a hand-including specialists whose sole purpose is to impart knowledge and clear up your confusion.
Keep Tabs on Blood Sugar
Diabetes is a silent disease because you can’t feel your blood sugar unless it becomes extremely high or low-two situations that you definitely want to avoid. How can you tell what’s going on with the blood inside your body? Only one way: Get a bit of blood outside your body and do a little analysis. This isn’t something you need to run to your doctor for (though certain tests should be performed on clinical turf). Handy, easy-to-use, and relatively painless lancets, test strips, and blood-glucose meters let you check your own blood sugar anywhere, anytime. Some people take blood-sugar readings four or more times a day, depending on their needs.
The blood-sugar readings that you-not your doctor-gather every day are a fulcrum by which you gain leverage over your disease. They provide data that will be a critical component of your care by allowing you to see how your blood sugar varies throughout the day and how much it swings in response to food, exercise, stress, or anything else that may affect it. They will help guide everything from which drugs you take and when you administer insulin (if you need them) to what you eat for breakfast.
Lose Body Baggage
Nothing signals more clearly that you’re at risk for type 2 diabetes than being overweight (which accounts for 9 of 10 cases of the disease). Excess baggage-especially in the gut-makes you more likely to develop insulin resistance, a condition in which cells don’t use glucose (a form of sugar from food) as well as they should. The result: Glucose accumulates in the blood. Wearing a spare tire also increases the body’s demand for insulin, which the pancreas (the maker of insulin) may have trouble meeting-again resulting in high blood sugar. Of course, there are other dangers in being overweight-high blood pressure, high cholesterol, and heart disease among them. One recent Boston University study found that obese people with type 2 diabetes had an alarming 99 to 100 percent chance of developing heart disease by age 85.
Losing weight may be the single most important thing you can do to control type 2 diabetes. There’s no need for anything extreme; a slow and steady drop in weight keeps pounds off better than crash diets you’re unlikely to stick to. And rest assured: You don’t have to slim down to supermodel size to make a difference. Dropping as little as 10 pounds can give you a significant edge over diabetes if you keep the weight off.
Deconstruct Your Diet
On the food front, it may surprise you to learn that the main issue is not the amount of sugar or other carbohydrates you eat but how many calories you get from all types of food. A dietitian can show you how to eat ample amounts of appetizing edibles (including all of your favourites, within limits of course) yet still keep calories down so you lose weight. If you have type 1 diabetes, you’ll need to balance your carbohydrate intake with your insulin injections to keep blood sugar from soaring too high or dropping too low. Whatever your diabetes type, you should put five food strategies into action right away:
- Work up a meal plan that holds the reins on your blood sugar with tools like carbohydrate counting and food exchanges (see Chapter 4 for details on these methods).
- Aim to get more-not fewer-carbohydrates in your diet; they supply the greatest amount of energy with the lowest number of calories.
- Fill up on fiber. It slows digestion and therefore controls the rise of blood sugar after a meal, keeps your appetite under control by making you feel full, and scours damaging fats from your blood.
- Cut back on saturated fat from foods like burgers and doughnuts, but allow yourself healthier monounsaturated fats in foods like peanuts and olive oil.
- Eat a variety of fresh fruits and vegetables, such as apricots, spinach, and tomatoes to make sure you get enough nutrients like vitamin C and magnesium, in which people with diabetes are sometimes deficient.
Exercise gobbles up glucose, and this immediately brings your blood sugar down. If you do it regularly, it also enables your cells to better use glucose, even when you’re not active. That can make you less dependent on insulin or medication. On top of that, exercise helps you lose weight, lowers your cholesterol and blood pressure, and makes your heart and lungs more powerful-all of which cut your risk of complications from diabetes.
Hate to exercise? Don’t worry. Your workout plan doesn’t have to be any more involved than making sure you pump up your heart rate and breathe a little harder several times a week, preferably for 20 minutes or more at a time. Classic aerobic exercises like walking, running, and biking are ideal, but ordinary chores, such as washing your car, mowing the lawn, and cleaning your house, do the trick too.
Beat Back Related Risks
Eating a healthy diet, getting more exercise, and losing weight are the most important things you can do to prevent complications from diabetes-but they’re not the only steps you can take.
- Ask about aspirin. Studies show that taking low-dose aspirin every day can cut your risk of a heart attack by as much as 60 percent. Check with your doctor to see if aspirin therapy might be right for you.
- Quit smoking. Besides making a mess of your lungs and increasing your risk of cancer, smoking narrows arteries, which raises your risk of heart attack and stroke and cuts circulation to your legs, making it harder for wounds to heal (especially on the feet). It also raises blood pressure and ratchets up your risk of kidney and nerve damage.
- Take the pressure off. High blood pressure contributes to cardiovascular disease and kidney damage. If you eat plenty of fruits and vegetables, you’re already bringing blood pressure down. You can bring it down further by eating less sodium (rampant in packaged foods) and more potassium from such foods as potatoes, yogurt, avocados, and bananas. Think about cutting back on caffeine, too: One cup of coffee can raise blood pressure for about two hours.
Get on a Schedule
It won’t be long before dealing with diabetes seems like old hat. Once you’ve gotten used to the changes in your diet and exercise habits and learned to handle medications, day-to-day life may start to seem routine again. But you’ll need to check back with your doctor regularly to make sure everything is going according to plan. Figure on getting a complete physical every year, including an eye exam, a cholesterol test, and a urine test to detect signs of kidney damage. In between visits, get a test called hemoglobin A1c, which shows your long-term average blood sugar, every three to six months.