Tips on managing your diabetes well

Regular exercise is the mainstay of managing diabetes. -- fotoBERNAMA (2018) ALL RIGHTS RESERVED

By Emeritus Professor Datuk Dr Mustaffa Embong, consultant diabetologist at the National Diabetes Institute (NADI)

KUALA LUMPUR (Bernama) -- You have been told by your doctor that you have diabetes. It is shocking, unexpected news for you.

You may feel sad, angry or scared with the thought of living with this chronic disease for life.

Do not despair. Having diabetes is not the end of the world for you. You can still live a healthy, meaningful life till a ripe old age.

All you need to do is to make a little adjustment to your (perhaps, presently unhealthy) lifestyle and empower yourself to face the challenge. Read on to see how you can achieve this.

HEALTHY, BALANCED DIET

People with diabetes can take the same meals as others with only minimal adjustment. Indeed, there is no need to prepare separate meals or buy special foods. Family members can enjoy the same healthy and nutritious meals together.

Start by going for variety from each of the food groups in the food pyramid but without compromising taste or nutrition. If you are obese or overweight, opt for foods that are low in fat and calories (and salt, to reduce the risk of high blood pressure). Aim to take more fruits, vegetables and whole grains and drink plenty of water. Make it a habit to take at least two servings of fruits and three servings of vegetables such as carrots, cabbage and cauliflower each day.

Drink six to eight glasses (about two litres) of plain water daily, instead of juice or carbonated drinks. 

Do include a sufficient amount of fibre (about 20 to 30 grams per day) in your diet. Good sources of fibre include oat bran, unpolished rice, whole-grain bread and cereals, beans, peas and lentils, and fruits and vegetables. Foods high in fibre help lower your blood glucose level after a meal and also your blood cholesterol levels, thus reducing your risk of heart disease.

When taking a meal, it is good to adopt the “Healthy Plate” guide:  fill half of your plate with fruits and vegetables, one quarter with protein such as fish or chicken, and one quarter with (complex) carbohydrate, for example, rice or bread.

Of course, you will need to use a smaller plate (without topping-up), if you need to lose weight.

Consult your dietician if you need more help with your diet.

BE PHYSICALLY ACTIVE

Like eating a healthy diet, regular exercise is the mainstay of managing diabetes. Diet and exercise can help control your weight and the latter also lowers your blood glucose levels by making your muscle cells more sensitive to insulin.

Exercise can lower your blood cholesterol and high blood pressure levels, thereby reducing your risk of cardiovascular (heart) disease.

Additionally, it will help you feel better about yourself (through the release of a feel-good hormone, endorphin, from your brain) and increases your overall health (especially the health of your heart, lungs, muscles, bones and joints).

You do not need to join a fitness club or buy expensive equipment to get good exercise. Brisk walking is great exercise. You can also jog, cycle, swim or do press-ups and/or aerobics in the privacy of your living room.

Before you start, please check with your doctor to find out if you are fit for an exercise programme and which activity is safe for you.

If you are just starting out, begin with five minutes a day and gradually add more time. Aim for a total of at least 30 minutes of moderate intensity exercise, three to five days per week. You will need to exercise longer and more frequently if you are aiming to lose weight.

It is worth noting that you do not have to keep specific times to exercise. You can incorporate physical activity in your daily life. For example, taking stairs instead of the elevator is a good thing to do.

In the evenings or over weekends, you can wash the car or clean the house yourself. Getting the whole family involved in being physically active by exercising together not only ensures a healthy family but also strengthens family ties.

REDUCE BODY WEIGHT

Studies have shown that if a person with diabetes is obese, a 10 percent weight loss can increase his/her life expectancy by lowering risk of dying from all diabetes-related causes (including heart attack and stroke).

Losing the excess weight also helps to control your diabetes by making your body more sensitive to insulin, thus lowering your blood glucose levels. It can also improve your blood lipid profile and reduce high blood pressure.

A recent study has suggested that with weight loss, one can even reverse his/her (type 2) diabetes.

In order to lose weight, you must eat less and be more active physically. The idea is to reduce your energy intake from food (by reducing food intake and avoiding fats or oils in your diet).

You can expect to lose about 0.5 kilogramme per week by eating 500 calories less each day. To make a comparison, one big burger contains about 540 calories.

It is reasonable to aim to lose 0.5 to 1.0 kg per week through dieting and exercise until you reach your ideal body weight.

MAKE SURE YOUR BLOOD GLUCOSE LEVEL IS NORMAL

Diabetes affects your daily blood glucose level. Persistently-raised blood glucose level damages your body and may lead to complications. Keeping your blood glucose within the normal (recommended) range can help avoid or delay these dreaded complications.

You can now easily monitor your blood glucose level at home or at work by using a portable glucometer. All it needs is just a slight prick on your finger (or arm) and you can get the result in less than a minute.

Monitor your blood glucose level according to your doctor's advice. Some diabetes experts recommend checking it before meals and two hours after meals, before or after exercise, before going to bed and when you are not feeling well.

Checking at different times gives you an idea of how your blood glucose level is affected by the food you eat and your physical activities, thereby helping you (and your doctor) to manage diabetes the best way.

Importantly, with regular blood glucose testing, you will also be able to detect low blood glucose levels (hypoglycaemia), especially if you are on insulin.

Always record and discuss your self-blood test results with your doctor.

Every three months or so, your doctor will also request for a HbA1c test to check how your diabetes control was like over the last two to three months.

In general, it is recommended that you keep your blood glucose levels between four to six mmol/l during fasting (on waking up in the morning) and six to eight mmol/l two hours after your main meals.

You should also aim to have your HbA1c reading at less than 7.0 percent (or better still, less than 6.5 percent).

(This article is courtesy of the 'Fight Diabetes' programme organised by the National Diabetes Institute (NADI) and endorsed by the Ministry of Health Malaysia. It is not in any way intended to substitute professional medical advice. When in doubt, please consult your doctor.

(For enquiries, please contact NADI at enquiry@nadidiabetes.com.my or tel: (03) 7876 1676.)

Edited by Rema Nambiar

BERNAMA