New Year Tips for People with Diabetes

New Year’s Day is an occasion for making new beginnings. Unfortunately, these holidays are also an excuse for many of us to gorge on sumptuous food and beverages and compromise on exercise. As we prepare to start the new year, let us take a resolution to keep up the spirit, passion, strength, motivation, inspiration and good health to achieve our goals for the year. Let us also review our current behaviours and think of ways by which healthy behaviours can be enhanced, and unhealthy ones discarded.

Below are some guidelines that can one to set short- and long-term goals for effective blood sugar management.
 
1. Consult your diabetologist at least twice a year:
Talk to your doctor and plan your follow up visits in the upcoming year. Most doctors prefer to see their patients with diabetes every three months for blood tests as well as HbA1c (Glycosylated haemoglobin- an average of 3 Months blood sugars) test. Importantly, you must have a regular follow up even when the sugar levels are within targets. Schedule the check-up in such a way that you have a complete analysis of the whole body, especially eye, foot, heart and nerves over the course of the year. Do not ignore any symptoms that you may have; discuss them with your doctor. Keep a note of your medicine prescription and stick to the dosages and timing of the medications. Make sure you do not skip any medication. Keep a record of the blood sugar results, meals and exercise pattern.
 
2. Understand your blood sugar pattern:
If you test your blood sugars regularly, you will be able to track your pattern. Find out if and when the sugar levels are going too high or too low. Use a glucose monitor or a continuous glucose monitoring device, that helps to give a panoramic view of the blood sugar pattern. Make sure you record your results and bring the reports to your doctor at every visit, reporting any irregularities that you may have found. The doctor will be able to advise changes in medicine dosages, meal pattern and exercise accordingly. Always keep dextrose tablets or candies handy for use should low sugars occur unexpectedly.
Report glucose levels above 200 mg/dl or below 70 mg/dl to your doctor, if it persists for more than for 2-3 days.
 
3. Establish a small achievable plan and persist with it:
Establish a well-balanced meal plan with lots of non-starchy fibre rich vegetables, lean meats, poultry, fish, low-fat foods and whole grains. Add fruits and starchy vegetables like potatoes and yam in restricted quantities. Keep the portion sizes in check, following the healthy plate concept. Try to avoid saturated fats and trans-fats, prepacked cakes, cookies, salty snacks and processed meats. Do not drink regular soda or fruit crush. Limit alcoholic beverages. Drink lots of water to remain hydrated. Schedule a consultation with a diabetes educator or a dietician to better organise your diet plans and to monitor whether you remain on the correct track. You can have a treat once in a while – simply save it for special occasions. Try to keep that treat healthy as well.
 
4. Add exercise to your daily routine:
Incorporate a minimum of half an hour of physical activity into your daily routine. Walk a bit more on a daily basis to improve your fitness level. Use a pedometer to see how much you are walking. Keep a track of the steps and correlate it to your blood sugars. Make your fitness routine more enjoyable with Zumba, ballet bar, Pilates or yoga. Add strength training exercises as you age, since muscles start weakening unless worked out regularly.
Join a gym or a fitness centre to stay fit even if the weather is inclement. Invest in one exercise machine such as a stationary bike, treadmill or elliptical. Walk the dog or dance to music within the house. Climb the stairs many times every day in your home. Play games and sports with the youngsters in the family to remain active. Add weight resistance coaching to improve muscle strength and bone density, and it also helps to increase the metabolic rate and burn additional calories even when you are at rest. Exercise helps to reduce blood sugar, blood pressure and bad cholesterol levels.
 
5. Inculcate good habits and good hygiene:
Examine your current habits. If you smoke, try to quit within the next twelve months. Attend a rehabilitation programme if you need assistance. Brush and floss your teeth at least twice a day. Check for bleeding gums and tooth plaques and consult a dentist when there are such indications.  Chew unsweetened gum with Xylitol between meals to lower risk of cavities and gum disease. Shower on a daily basis with lukewarm water and gentle soap. Use a mild white, fragrance free moisturizer to avoid dry skin.
 
Check your feet on a daily basis for cuts, sores, red spots and blisters. Avoid soaking feet which might increase the danger of fungal infections such as Athlete’s foot. Trim nails with a clipper straight across and file the edges; keep nails short. If you have nail infection or thick, chipped nails, approach a chiropodist for help. Wear socks to shield your feet. Regularly wear shoes while outdoors as well as slippers round the house. Wear water-proof shoes for water activities and boots in fog or rain to shield your feet. Avoid flip-flops and open shoes which do not completely protect the feet.
 
6. Manage your stress levels:
Understand and determine what stress, depression and anxiety looks like to you and take many deep breaths once you begin to feel anxious. Create some “My time” once you begin to feel weak. Get seven to eight hours of quality sleep every night and avoid drinking beverages with alcohol which will cause you to feel overstrung or keep you from sleeping well. Learn relaxation techniques and schedule recreational activities with others. If feelings of stress or depression persist for many weeks, schedule an arrangement with a counsellor or psychologist for consultation.
 
7. Share Your short-term and long-term goals:
It helps to enlist the support of your friends, family and business associates. Partner up with somebody who can motivate you. Use a journal to trace your progress and create realistic goals. Be a part of appropriate support teams to seek out individuals.
 
The next twelve months may be a good time to appraise your behaviours and plan ways that improve them. Establish definitive goals and take tiny steps on a daily basis to attain them. With a small amount of effort, you may be astonished at what you will be able to achieve by the same time next year!
 

Authored by:
Dr. V. Mohan – Chairman and Chief Diabetologist – Dr. Mohan’s Diabetes Specialties Centre