Upon diagnosis of type 2 diabetes mellitus, lifestyle changes are usually recommended for patients. These changes help in the control of blood sugar to target levels, hence preventing diabetes-related complications (diabetes management).
These lifestyle changes include:
- Dietary changes; increase intake of vegetables, high fiber foods, whole grains, and decrease or complete avoidance of refined carbohydrates. Reducing the amount of saturated fats intake is also a major change in diabetic diets.
- Weight loss to attain a desirable body mass index
- Increase physical activity. Begin physical activity gradually and then increase the intensity with time
Diabetes patients should be conscious of the fact that whatever they eat affects their blood glucose levels. As such the type of food they eat and the quantity of food they eat is important. The general advice is to eat food low in fats and refined sugar and high in dietary fiber by eating more vegetables, fruits, and beans.
Overweight patients should decrease portion sizes in other to curb the number of calories consumed.
What to do:
- Reduce total fat intake, especially saturated fats found in biscuits, crisps, and chips. Choose lean meat such as skinless chicken and turkey. Also, replace pork and beef with fish. It is advised to eat less processed meat
Alternatively, grill and steam food instead of frying or roasting them. This will decrease the uptake of saturated fats
- To reduce calorie intake, decrease portion sizes. Using the diet plate can help with this reduction.
Learn about carbohydrate counting. Carbohydrates raise blood sugars faster than other macronutrients like fats and proteins will. The quantity and quality of carbohydrates you eat will affect the process of diabetes management. Counting carbs helps the patient to keep track of the carbohydrate intake. Dieticians will help you figure out how many grams of a particular carbohydrate you should eat, depending on the glycemic index and glycemic load of the food
· Make your meals balanced. As much as possible, plan for every meal to have a good mix of starches, fruits and vegetables, proteins, and fats (1). Low glycemic index carbohydrates are better than refined sugars. Whole grains, beans, and lentils will increase the bulk of dietary fibers and help to maintain target blood sugar levels and also in weight loss
- Coordinate your meals and medications. Your food intake should be proportionate to diabetes medications. Little food in proportion to medications may cause hypoglycemia while too much food in proportion to drugs can lead to hyperglycemia. Your doctor or counsellor will help with the coordination.
- Avoid sugar-sweetened beverages. Sugar-sweetened drinks can cause a spike in blood sugar. Using sugar-free, no added sugar or diet fizzy drinks/squashes instead of sugary versions can be an easy way to reduce the sugar in your diet. Sugary drinks are best used as a treatment for hypoglycemia
For patients with a sedentary lifestyle, it is recommended that they begin the exercise with low intensity and gradually increase the intensity and time. Your goal should be 30 minutes of activity that makes you sweat and breathe a little harder most days of the week. An active lifestyle helps you control your diabetes by bringing down your blood sugar. It also lowers your chances of getting heart disease. Plus, it can help in weight loss and decrease anxiety
Moderate-intensity physical activity includes:
- Brisk walking
- Cycling on relatively flat terrain
- Water aerobics
- Using a manual lawnmower
Vigorous physical activity may include:
- Swimming lengths
- Cycling either rapidly or over steep terrain
The services of a professional instructor may be useful during these activities.
What to do:
- The doctor will perform some relevant assessments like heart health especially if you have high blood pressure and blocked arteries.
- Also worth considering will be diabetes-related complications like neuropathy. The doctor will help you figure out which exercise routine best suits the patient’s needs
- Ease into it. Set realistic goals before beginning with exercise. Start slow, and gradually increase the amount and intensity of physical activity. If you’re inactive, you can begin with 15minutes of exercise and then gradually work up to 25 and 40 minutes a day.
- Drink lots of water to stay hydrated and take along some carbohydrate snacks (fruits, drinks) in case of hypoglycemia (low blood sugar).
- Check your blood sugar before exercise. If you have to work out for over an hour, check your blood sugar regularly to ensure you are not hypoglycemic. Also, check your blood sugar after work out to ensure it is within the target range.
- Make exercising a habit. To prevent hypoglycemia, exercise, eat and take your medications at the same time every day
- Exercise with someone aware of your health status, so that they will know what to do if your blood sugar gets low
Overweight diabetics are advised to lose weight gradually until they attain a healthy body mass index (BMI).
The range for a healthy BMI is between 18.5 and 24.9
With a BMI above this range, it is recommended that you lose weight gradually until you reach the target. A loss in weight by 5% to 10% over a year is impressive.
Weight loss is mainly achieved by food portion control, and in some rare cases where BMI is greater than 30, weight loss pills might be prescribed.
Weight loss helps to reduce the risk of developing diabetes in healthy people and ensure control
Weight loss can help type 2 diabetes patients to better control blood glucose levels.
Stress is a risk factor for type 2 diabetes. When an individual is stressed, the body responds with some changes including the release of stress hormones. These hormones cause a rise in blood sugar
Constant stress can make blood glucose control very difficult, particularly if an individual is unaware of when they are getting stressed (2). Also, stress can affect diabetes management; when patients are anxious, they may forget to eat right, exercise or take medications
What to do:
- Look for patterns. Log your stress level on a scale of 1 to 10 each time you log your blood sugar level. A pattern may soon emerge.
- Take control. Once you know how stress affects your blood sugar level, fight back. Learn relaxation techniques, prioritize your tasks, and set limits. Whenever possible, avoid common stressors. Exercise can often help relieve stress and lower your blood sugar level.
- Get help. Learn new strategies for coping with stress. You may find that working with a psychologist or clinical social worker can help you identify stressors, solve stressful problems, or learn new coping skills. (2)
In the case of hypoglycemia, the liver usually releases stored sugar as a remedy. However, in a situation where the liver is busy metabolizing alcohol, the patient might become hypoglycemic. Alcohol can lower blood sugar after it is drunk until about 24 hours later.
What to do:
- Drink only on the doctor’s approval. Alcohol can aggravate diabetes complications, such as nerve damage and eye disease. But if your diabetes is under control and your doctor agrees, drinking once in a while is ok.
- Do not drink alcoholic beverages on an empty stomach especially if you take insulin or other diabetes medications. Eat before you drink or drink while eating to prevent hypoglycemia.
- Choose your drinks which have fewer carbohydrates and calories like dry wines and light beers
- Tally your calories. Count calories from alcohol in your daily calorie count. Ask your doctor or dietitian how to incorporate calories and carbohydrates from alcoholic drinks into your diet plan.
- Check your blood sugar level after drinking. Because alcohol can lower blood sugar levels long after you’ve had your last drink, check your blood sugar level after drinking and before going to sleep. If your blood sugar isn’t between 100 and 140 mg/dL, have a snack to raise your blood sugar level.
Upon diagnosis, insulin and other medications are prescribed to patients. These medications together with diet and exercise help to lower blood glucose to target levels. Their efficacy depends on the timing and size of the dose. Medications you take for conditions other than diabetes also can affect your blood sugar levels (2)
What to do:
- Store insulin properly. Insulin that’s improperly stored or past its expiration date may not be effective. Insulin is especially sensitive to extremes in temperature.
- Report problems to your doctor. If your diabetes medications cause your blood sugar level to drop too low or if it’s consistently too high, the dosage or timing may need to be adjusted.
- Be cautious with new medications. If you’re considering an over-the-counter medication or your doctor prescribes a new medication to treat another condition, ask your doctor or pharmacist if the medication may affect your blood sugar levels.
Get constant checkups
See your doctor regularly. Check for factors that can lead to responsible complications of diabetes such as heart disease, kidney disease, blood cholesterol, blood pressure, and glycated hemoglobin (average blood sugar over 3 months). Get a full eye exam every year. Visit a foot doctor to check for problems like foot ulcers and nerve damage.
Upon diagnosis, type 2 diabetes patients will gradually modify their lifestyles as required. Patients just need to know what factors cause a rise or drop in blood sugar levels and control them. This will prevent blood sugar surges or hypoglycemia (low blood sugar).