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Diabetes Management Tips - Managing Diabetes

November 5th, 2012 Healthy Living

Diabetes Myths Debunked

There are many myths that persist about diabetes. Here are four myths you may have heard that are simply false:

Myth: People with diabetes should eat special diabetic foods. Fact: If you have diabetes you should eat the same healthy, balanced diet as anyone else. There are no special benefits for people with diabetes if they eat foods labeled as "diabetic" or "dietetic." Usually the only difference in these foods is that they are sugar-free or made with sugar substitutes.

Myth: You can catch diabetes from someone else. Fact: Diabetes is not a contagious disease. Some data suggest that there may be a genetic predisposition to diabetes, especially to type 2, but the research is limited.

Myth: Eating too much sugar causes diabetes. Fact: Diabetes of either type is caused by a combination of lifestyle factors and a genetic predisposition. If you are overweight, you are increasing your risk for developing type 2 diabetes, but that has to do with your overall calorie intake, not your intake of sugary foods specifically.

Myth: People with diabetes are more likely to get colds or the flu. Fact: If you have diabetes you are not more likely to get a cold or the flu than anyone else. But doctors do recommend that you get a flu shot if you have diabetes (especially if you have type 1) because any type of infection can interfere with blood glucose management.

Got Diabetes? Treat Your Feet

People with diabetes must take particular care of their feet. Why? Diabetes can cause poor circulation that makes them more susceptible to foot problems, from corns and calluses to severe foot and leg ulcers.

At the very least, a doctor should check your feet once a year as part of a regular checkup. Be sure to take off your shoes and socks while waiting for the doctor to arrive in the exam room (or ask the nurse to help you remove them). This will remind both of you that the doctor should examine your feet for cuts, corns, or calluses. If you have any of these problems, they can be taken care of immediately.

You can keep your feet healthy by following these simple steps:

  • Wash your feet every day. Be sure to dry them thoroughly and take extra care to dry between your toes.
  • Wear good shoes. Avoid tight shoes and high heels, and choose shoes that are made of leather or other natural materials instead of synthetic materials. The natural materials allow your feet to breathe.
  • Keep your skin soft by rubbing a thin layer of lotion on the tops and bottoms of your feet (but not between your toes).
  • Check your feet daily. Call your doctor if you have cuts, blisters, swelling, or other problems. Don’t forget to check the bottoms of your feet. Use a hand mirror if you have problems seeing the bottoms of your feet, or ask someone to check them for you.
  • Don’t walk barefoot. Wear socks and shoes or slippers whenever you are walking.
  • Put your feet up. When you’re sitting and watching TV, elevate your feet on a footstool or on the other end of the sofa. Wiggle your toes every now and then to increase circulation to your feet.

Mind Your Diet To Help Manage Your Type 1 Diabetes

Type 1 diabetes is also known as juvenile-onset diabetes (although adults can develop it, too) or insulin-dependent diabetes. If you have type 1 diabetes, your pancreas doesn’t produce insulin, which your body needs to process the energy from food (glucose) and to transport glucose to the cells in the body. People with type 1 diabetes must take insulin (by injection or by using an insulin pump) to help the body process energy from food. As a result, people with type 1 diabetes must pay attention to their diets to make sure that the food they eat is balanced with insulin intake, other medications, and exercise to keep blood glucose levels stable.

Although the basic principles of healthy eating apply to people with type 1 diabetes, the American Diabetes Association’s (ADA) food guide pyramid differs slightly from the pyramid promoted by the U.S. Department of Agriculture. For example, the ADA puts starchy veggies such as potatoes, peas, and corn in the same group with breads and grains because of the high carbohydrate content of these vegetables. The diabetes pyramid recommends 6-11 servings of starchy veggies or grains daily, as well as 3-5 servings of less starchy veggies, 2-4 servings of fruits, and 2-3 servings of milk or dairy products. Protein is a smaller part of a healthy diet for people with type 1 diabetes; the ADA recommends keeping protein to 4-6 ounces of meat or meat substitute daily. Alternatives to one ounce of meat include a tablespoon of peanut butter, one egg, ¼ cup of cottage cheese, and ½ cup of tofu.

Most Artificial Sweeteners Won’t Impact Insulin Levels

Calorie-free artificial sweeteners such as aspartame, xylitol, and saccharin are as safe for people with diabetes as for anyone else (except for people with phenylketonuria, who should not consume aspartame). Calorie-free sweeteners such as aspartame, sucralose, and saccharin won’t impact your blood glucose level and won’t add calories, so foods made with these products are helpful for people with type 1 or type 2 diabetes.

Lower-calorie foods made with these products are especially good to have on hand if you don’t eat well during the day and find yourself craving a late-night snack. But the sugar alcohols such as xylitol, sorbitol, and mannitol do have some calories and will have a slight impact on your blood glucose level although they won’t raise it as much as other carbohydrates.

To figure out how to count carbohydrates in foods made with sugar alcohols instead of sugar, subtract half of the sugar alcohol grams from the total carbohydrate and count the remaining grams of carbs. For example, if a snack bar contains 15 grams of total carbohydrate and 6 grams of sugar alcohol take half the sugar alcohol grams (3) and subtract it from the total (15) and you get 12. So count that snack bar as 12 grams of carbohydrate.

Eating anything late at night promotes weight gain. If you eat and then go to sleep immediately, you don’t give your body a chance to burn any of those calories and they are more likely to be stores as fat.

If you are diabetic, late-night snacking can cause insulin levels to rise overnight and leave you with a blood sugar in the morning. That doesn’t mean you absolutely can’t eat after a certain time of night, but be aware of the reaction and adjust accordingly.

Small Changes Add Up When Setting Healthy Lifestyle Goals

If you have diabetes and you are working to adopt a healthier lifestyle, keep in mind that small changes that focus on achievable goals will help keep you motivated and give you a sense of satisfaction.

When you are setting goals for healthier living, remember that you can’t change everything at once. Keep your goals realistic. Think about these points when setting goals:

  • Is it specific? For example, “I will eat more fruit” is general, and hard to follow, but “I will eat one apple at lunchtime each day” is more specific and easier to achieve.
  • Is it realistic? For example, “I will lose 20 pounds this week” is nonsense, but “I will lose two pounds this week” is possible if you are diligent.

Here are some other ideas for small changes that can add up to big improvements in your health and your ability to manage your diabetes:

  • Order the small. If you go to a fast food restaurant, order the single hamburger and small fries, rather than the triple hamburger and huge fries. You’re not depriving yourself, but you are making a change for the better by keeping your daily calories under control. Next step: Make a healthier food choice and make sure your burger has lettuce and tomato on it, and choose mustard over mayonnaise.
  • Move a little more. Although 30 minutes of exercise is optimal, start with 15, or even 10 minutes. If you watch two TV programs in the evening, stand up and walk around the house for 5 to 10 minutes between programs. That’s a small step, but any activity gets your blood flowing and promotes better health. And who wants to watch commercials anyway? Next step: Take a walk after your TV program ends.

Sugar, Sugar: Sweets Aren’t Taboo If You Have Diabetes

Once upon a time, doctors thought that sugary foods would cause a rapid spike in glucose levels, and people with diabetes were warned to avoid sweet treats, or to stick to sugar-free desserts. We now know that it’s the total carbohydrate in a meal or snack that impacts glucose levels, not the sugary nature of a food.

If you have diabetes, you can have your cake and eat it, too, as long as you factor the carbohydrates from a dessert into your daily diet the way you would any other carbohydrate. If you want a dessert, cut back on another carbohydrate in the same meal or during the same day. For example, if you have a turkey sandwich for lunch and you want to have two cookies, swap the two slices of regular bread for a low-carb bread, one slice of bread, or a low-carb tortilla wrap instead, and have the cookies. The total carbohydrate amount for the meal will be approximately equal.

The same principle applies to any sweetener with calories, such as sugar, honey, or molasses.

And remember that low-calorie artificial sweeteners, including aspartame (found in NutraSweet and Equal), saccharin (found in Sweet ‘n Low and Sugar Twin) and sucralose (found in Splenda) are freebies for people with diabetes because they make food taste sweet without adding calories, and they don’t contain carbohydrates or fats, either. These artificial sweeteners have been approved by the Food and Drug Administration, and the American Diabetes Association accepts that they are safe for people with any type of diabetes.

To Pump Or Not To Pump? The Choice Is Yours

Until the 1970s, if you had type 1 diabetes, you had no choice but to take multiple injections of insulin daily. The first pumps developed in the 1970s were awkward and clunky, but today’s insulin pumps feature the latest technology in a small, safe, package that’s about the size of a beeper.

The pump works by delivering a small but continuous amount of insulin through a thin tube. The tube connects the pump to your body through a needle or catheter placed under your skin. You need to change the tube every 2 to 3 days, so you subject yourself to fewer needlesticks compared with multiple daily injections. Most people who use insulin pumps connect the tube to the abdomen, but some people choose the thighs, hips, or arms. Some pumps are waterproof and can be left in place while showering or swimming.

Other advantages of an insulin pump include:

  • Weight management. With a pump, you can adjust your insulin so that you don’t need to eat or snack before you exercise. This helps you keep your calories under control and lose weight while still keeping your blood glucose in a healthy range.
  • Flexible lifestyle. Once you set the basal rates for a pump, you don’t need to eat to match your insulin. So if you want to sleep late or skip a meal, you can, just like someone without diabetes.
  • Improved glucose control. If you struggle to keep your blood sugar in the healthy range, you may benefit from the continuous insulin flow that a pump provides.
  • Ask your primary care doctor or endocrinology if the pump piques your curiosity.

Top Three Lifestyle Changes To Control (Or Prevent) Diabetes

If you have diabetes and you’re trying to adhere to a healthy diet to manage your condition, or if you are trying to lower your risk of developing diabetes, make these three simple changes to your lifestyle:

  • Swap good fats for bad fats. You shouldn’t eliminate fat from your diet (some fat is essential for overall good health), but if you increase the amount of good fats in your diet (such as the polyunsaturated fats found in salmon, tuna, and most nuts) you may reduce your risk of developing type 2 diabetes. Bad fats (such as the trans fats found in margarine, processed baked goods, and many fried foods) can increase your risk for diabetes by causing you to gain weight and by negatively impacting your cholesterol levels.
  • Substitute whole grains for processed grains. Choose whole grain bread and pasta instead of highly processed white bread and white rice and regular pasta, which raise glucose levels more quickly than foods made with whole wheat. Substitute some whole wheat flour in place of regular flour in baked goods; even half whole wheat and half white flour makes the recipe healthier.
  • Stop smoking. This isn’t exactly dietary, but if you smoke, try to quit. Studies have shown that smokers are 50% to 90% more likely to develop diabetes than nonsmokers, regardless of their other diet, exercise, and lifestyle habits. So if you have other risk factors for diabetes and you also smoke, quitting smoking may be the deciding factor that keeps you from developing diabetes (but it's still important to eat right and exercise).

Use Diet And Exercise To Control Type 2 Diabetes

If you have type 1 diabetes, your body is unable to produce insulin. By contrast, if you have type 2 diabetes your body manufactures insulin but it doesn’t produce enough, or the cells in the body ignore it, so the pancreas keeps producing more, and you develop high blood glucose. Recent data shows that about 18 million Americans have been diagnosed with type 2 diabetes. But 90% of cases of type 2 diabetes are due to three factors that can be modified: Poor diet, extra weight, and lack of exercise.

If you have type 2 diabetes, you may not need to take insulin or diabetes medication if you pay attention to the types and proportions of foods that you eat in order to keep your blood glucose levels as close to the normal (non-diabetic) levels as possible. And if you monitor your blood glucose levels and eat healthfully, you will feel better and you may reduce your risk of developing the long-term complications associated with diabetes such as heart disease, foot ulcers, and eye problems.

If you have type 2 diabetes and you are overweight, try to identify and overcome the barriers that keep you from exercising regularly. Exercise is one of the best ways to improve your health and it can help you lose weight, too. Even moderate exercise, such as 30 minutes of walking, may reduce your risk of developing the complications that can occur with diabetes. If you don’t have a lot of time, or if it is difficult for you to walk for 30 minutes at once, don’t worry. Instead, take several short 10-minute walks throughout the day to burn extra calories and excess sugar, which keeps your blood glucose more stable and your weight in check. Even short bouts of activity will help your diabetes and improve your overall health.