Diabetes Management: A person with diabetes can live a long and healthy life by taking care of themselves. Keeping the blood glucose levels within the target range is the most important aspect in diabetes management to enjoy a good quality of life without leading to complications.
The four main pillars of diabetes management are diet, exercise, self-blood glucose monitoring , and adherence to medication/insulin treatment.
A good well balanced diet is the key aspect of managing the blood glucose levels. What you eat directly affects the blood glucose levels. By choosing healthy foods and eating the right portions, blood glucose levels can be kept in control. The diet should include moderate intake of carbohydrates with low glycemic index(GI)foods ,along with adequate protein ,low fat and high fibre. Low glycemic index foods are those which do not cause a sudden spike in blood glucose levels post a meal such as whole grains, pulses and legumes, nuts and oilseeds, vegetables and whole fruits. Adding protein and fibre helps to reduce the glycemix index of the meal so every meal should have some protein source like eggs/lean meat/fish or pulses/dal,soya,curd/buttermilk. Fibre can be incorporated by adding vegetables, salads to the meal. The healthy plate format helps to control portions and choose from a variety of foods. Start with a 9-inch plate, fill half of the plate with nonstarchy vegetables, 1/4th with protein foods and 1/4th with low GI carbohydrate foods.
Being physically active goes hand in hand with healthy eating. The role of exercise in managing diabetes is well established. Exercise helps to improve blood glucose control. Additionally, exercise also helps in fat loss and therefore further improves insulin resistance People with diabetes should increase the amount of time spent in daily physical activity Prolonged sitting should be interrupted every 30 min. Exercise improves cardiovascular fitness and decreases the risk of developing coronary artery disease which is the most common complication of diabetes. Exercise acts as a stress buster. It enhances the overall quality of life by bringing a sense of wellbeing. The American Diabetes Association recommends at least 150 minutes per week of moderate intensity aerobic exercise, plus 2 days of muscle strengthening.
- Self-Monitoring of Blood Glucose(SMBG)
Regular blood glucose monitoring is the key to give you the information you need to effectively manage diabetes. Without regular testing, you won’t know how well your diet, exercise, or medication are working or when to make changes. The more you know how your blood glucose levels react to different foods or other changes in lifestyle like exercise or even stressful situations, the better you are able to take control of the blood glucose levels . Maintaining a chart of your blood glucose levels helps the healthcare provider to regulate the treatment effectively to help you control your diabetes better. The American Diabetes Association has set the following target ranges for people with diabetes
- Pre meal blood glucose should be in the range of 80-130 mg/dl
- Post meal to be less than 180 mg/dl.
Your target ranges may differ depending upon your age, complications and other factors. It is important to know your individual blood glucose targets.
Treatment for diabetes has to be customised for every individual. In the pre diabetes stage one can reverse the condition with lifestyle modification alone, but some medication may be required once a person is diagnosed with diabetes. In case of type 2 diabetes, oral antidiabetic medications can help to manage the blood glucose or insulin may be initiated for some. In case of type 1 diabetes there is a need to take insulin regularly since their body does not produce any insulin. It is very important to adhere to the medication/insulin therapy prescribed to achieve good glycemic control. Different types of insulin, as well as oral drugs, have a different mechanisms of action and so you must not change the dosage or timing by yourself and must always check with your doctor for any lifestyle change and adjustment needed in the medication.
Having diabetes may demand some healthy changes to your way of life but adherence to positive lifestyle changes, monitoring the blood glucose levels often and following up with your doctor regularly will ensure you live a good quality of life.
(Authored article by Dr Rajeev Chawla MD, FRSSDI, FACP(USA)FRCP U.K.(Edin,London), FACE(USA), Senior Consultant Diabetologist & Director North Delhi Diabetes Centre, N.Delhi)Internet Explorer Channel Network