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A Roadmap for Managing Diabetes

November 20, 2010 6:00:20 PM PST
Are you in the driver's seat? The CDC recently reported that diabetes could double or triple in the U.S. by the year 2050.

That means up to one third of adults could have diabetes by then. The current prevalence in the U.S. is one in 10 adults, or about 24 million people, having mostly type 2 diabetes.

November is American Diabetes Month, and Melissa Joy Dobbins MS, RD, CDE, a registered dietitian and a certified diabetes educator and spokesperson for the Illinois Dietetic Association, visited ABC 7 to share some tips on managing diabetes and living a healthier life.

Have you been diagnosed?

If you are not sure if you have diabetes, ask your doctor to do a fasting blood sugar test or a Hemoglobin A1C. The American Diabetes Association (www.diabetes.org) now recommends the A1C test as a way to screen for pre-diabetes. Pre-diabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Because the A1C test is a simple blood test that does not require fasting, people may be more willing to take this test than others. (Source: Diabetes and You, Walgreens, Spring 2010).

Small changes -- big difference
Small changes in lifestyle habits really can make a big difference when it comes to diabetes. Small reductions in weight, blood glucose and blood pressure can result in significant improvements in health outcomes.

Should you be taking a more active role in your diabetes management? Your doctor can provide you with a roadmap, but you should be the one to take the wheel.

Here are some tips and tools to get you started on your journey:

Make sure you know the rules of the road: Check out the new AADE7 Self-Care Behaviors handouts in English and Spanish: http://www.diabeteseducator.org/DiabetesEducation/Patient_Resources/AADE7_PatientHandouts.html.

Here's how I like to explain it:

  • Get behind the wheel: You are the most important person on your healthcare team. Educate yourself about diabetes by reading books, magazines and websites from credible sources (such as registered dietitians, nurses, physicians and reputable diabetes organizations). Ask your healthcare provider questions about your treatment plan and be an active participant in the process.
  • Fuel up: Eat more healthfully-- more fiber, less fat, salt, and sugar. Lose weight if needed or maintain a healthy weight. Even a small amount of weight loss can significantly improve blood sugar levels and some people can even decrease or go off their diabetes medications (with a doctor's supervision, of course).
  • Start your engines: Get physical activity every day. It can be as simple as a daily walk. Find what works for you and stick with it. Aerobic activity, such as walking or swimming, is best for heart health, but strength training can be very effective for weight control, too.
  • Follow the directions: Take your medications as directed. This is a problem that often gets overlooked. There may be many barriers to taking medication, such as negative feelings about them, fear of side effects, or financial reasons. However, diabetes pills and/or insulin are often necessary to control blood sugars and should always be taken as prescribed.
  • Check the speedometer: Monitor your blood glucose levels. Blood sugar results are your own personal "speedometer" and it is valuable information. Don't view these numbers as "good" or "bad" but instead use the information to learn how food, exercise, stress and other factors affect your blood sugars. Then use that information to make changes in your habits.
  • Put the brakes on smoking: Or at least cut down as much as possible. Every little bit helps.
  • Pay attention to detours ahead: Diabetes is a progressive disease so it is normal to make frequent changes in your diet, medication and exercise plan. These changes can be upsetting if you're not aware that adjustments to your care plan are normal and necessary to stay on top of the disease. In addition, learn how to deal with roadblocks: healthy coping strategies are just as important as diet and exercise.
  • Perhaps the most important step you can take to better manage your diabetes is to work closely with your diabetes care team for guidance and support. Just remember, you are not alone and you are, in fact, in the driver's seat. The more input you have in navigating your diabetes care plan, the better!
  • For handouts on the above self-care behaviors, visit http://www.diabeteseducator.org/DiabetesEducation/Patient_Resources/AADE7_PatientHandouts.html.

    To find a diabetes educator near you: http://www.diabeteseducator.org/DiabetesEducation/Find.html.

    To find a registered dietitian near you: http://www.eatright.org/programs/rdfinder/

    What should you be eating?
    This menu is an example of one day's worth of food for someone who needs approximately 1,800 calories per day. By working with a dietitian and diabetes educator you can learn to make substitutions such as swapping out 1 tablespoon of regular salad dressing for 2 tablespoons of reduced fat dressing, 2 teaspoons of regular mayonnaise for 2 tablespoons of reduced fat mayonnaise, or one-half cup fruit juice instead of 1 piece of fruit.

    1800 Calorie Menu

    BREAKFAST
    1 slice whole wheat toast
    1.5 c bran flakes
    1 small banana
    1 c fat-free milk
    1 tsp margarine
    coffee or tea

    LUNCH
    2 oz tuna (in water)
    2 tsp mayonnaise
    One-quarter cup chopped celery
    2 slices rye bread
    1 c low salt chicken noodle soup
    1 c carrot sticks
    One-half c apple slices
    Iced Tea

    AFTERNOON SNACK
    1 oz cheese
    6 whole grain crackers

    DINNER
    4 oz grilled chicken
    1. 5c green beans
    Two-thirds cup whole grain rice
    1 c low-fat yogurt
    1 and one-quarter cup strawberries
    1 c fat-free milk
    green salad
    1 Tbsp salad dressing

    Try this "hand-y" measuring chart to help you estimate portion sizes:

  • 1 cup = fist
  • 3 ounces = palm of hand
  • 1 teaspoon = tip of thumb
  • 1 tablespoon = length of thumb
  • (Note: These are based on a woman's hand size)

    More information about blood sugar testing and other medical tests:
    Watching the speed limit: When to check your blood sugar levels
    You and your diabetes care team will decide when and how often to check, but here are some suggestions to consider:

  • When you wake up, to see if your blood sugar is staying under control while you're asleep
  • Before meals or large snacks, to know what your blood sugars before you eat
  • 1 or 2 hours after meals or large snacks to see how the food you eat affects your blood sugar
  • Before and 15 minutes after physical activity, to see how being active affects your blood sugar
  • It's important to write down your blood sugar results so you can discuss with your healthcare provider and determine what makes them go up or down. Ask your diabetes care team for a logbook, create your own on the computer or in a notebook, or download the http://www.onetouchdiabetes.com/logbook

    Ask your doctor or diabetes educator about Continuous Glucose Monitoring (CGM) to see if it is right for you. With CGM you can keep a close eye on your glucose levels and how they change over the course of your day. You may be able to improve your diabetes control and make more informed decisions about your diabetes care plan. For more information go to www.minimed.com/products/guardian/benefits.html

    Be sure to get "periodic maintenance" and refer to this suggested schedule of tests if you have diabetes:

    Every 3 months:

  • Regular office visit
  • A1C test (if your blood sugar is not stable)
  • Blood pressure
  • Weight
  • Foot exam
  • Every 6 months:

  • A1C test (if your blood sugar is stable)
  • Dental exam
  • Every year:

  • Physical exam
  • Comprehensive foot exam
  • Blood fat and cholesterol tests (if your levels are normal)
  • Kidney tests
  • Dilated eye exam
  • Flu shot
  • For information, visit:
    CDC: http://www.cdc.gov/
    CDC report: http://www.cdc.gov/media/pressrel/2010/r101022.html
    American Diabetes Association: http://www.diabetes.org
    Illinois Dietetic Association: http://www.eatrightillinois.org/
    Melissa Joy Dobbins: http://www.eatrightillinois.org/MediaRelations/m_dobbins.asp
    Hemoglobin A1C test: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/a1c/.


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