It’s Not Just One Thing

Sarah Joy Maxwell, BSN, RN

Controlling blood sugar is not about just one thing. It’s about many things all working together to make a healthy person. Many people with diabetes tend to think that it is just about eating a certain diet but that is only part of the process. Some people tend to think that all they need to do is take their medicine—again, that’s only part of the process. As a certain very successful football coach is fond of saying, “It’s all about the process,” and the process is multifaceted. It is somewhat like an octopus with its eight legs and head. The eight legs are:
1.       Nutrition
2.       Exercise
3.       Medication
4.       Eye care
5.       Foot care
6.       Dental care
7.       Skin care
8.       No tobacco use
And then all of this is assessed with the head by knowing your numbers and problem solving.
Many people, if they are diagnosed early, can manage their diabetes successful for many years with proper nutrition and exercise. Eating a well balanced diet, in the right amount and avoiding concentrated sweets and sugar sweetened drinks, will go a long way in controlling blood sugar (blood glucose). Often weight loss, even a modest amount, will result in a significant reduction in your glucose numbers. A simple reduction in the amount of food eaten at each meal can be a very easy way to loose weight. Of course, avoiding fried foods greatly reduces caloric content and assists with weight lose. Yes, you can still have that piece of fried chicken or fried fish but make that an occasional choice, not one you have several times a week. If you want a quick was to see the difference frying makes in caloric content, stop in your nearest McDonalds and pick up one of their nutrition information sheets. These are readily available now and some of the information is even on the board menus. Look at the difference in the grilled chicken snack wrap and the fried chicken snack wrap: look at the difference in the grilled chicken sandwich and the fried chicken sandwich. It doesn’t take a rocket scientist to know which one is the healthier choice. And remember, frying not only increases caloric content from the oil but from the coating. They call it “breading” for a reason. And most oils contribute to cholesterol problems and damage to the blood vessels which is already a problem associated with high blood sugar.
Exercise is the second arm of controlling blood glucose and it goes a long way in controlling blood pressure and blood cholesterol as well. In addition, it kicks up those good chemicals called endorphins that just make us feel better. In other words, it is a win-win-win-win situation. And if we play our cards right—it’s fun, too. The “Magic Number” for exercise is 30 min. a day, and it really doesn’t matter what type of exercise you do as long as it is good, consistently moving exercise. Be sure you check with your doctor before you begin any exercise program, but for almost all people, exercise of some type is going to be beneficial. Find something you like to do. Or find several different things you like to do and then schedule them into your day. Many people say they will walk for their exercise. This is great. No special equipment is needed except for comfortable, supporting shoes. But what are you going to do on days that are too hot, or too cold, or too rainy. We have plenty of those around here. Are you really going to get in your car and drive to a mall, or Wal-mart, or Lowe’s or a Family Life Center to walk? If so, great! You are more likely to do this if you have a buddy or partner who is counting on you to do this so find a friend (or spouse, or sibling) and buddy up. You can also have other options for those yukky weather days. Exercise DVDs or Wii fit or Xbox games are good options as well as using exercise equipment like weights, bands, bikes, treadmills, etc. Before spending big bucks on equipment, you might want to check the thrift stores for some good used equipment to see if you really like doing this or that. I did that and found out that I really hate a Stairmaster. I have a friend who absolutely loves a Stairmaster. Different strokes for different folks. Using weights help build muscles and muscle tissue uses blood sugar better than fat tissue. Much research is also indicating that in addition to lowering blood sugar, blood pressure and blood cholesterol, exercise helps improve balance thereby reducing the risk of falling, and seems to reduce the likely hood of dementia and Alzheimer’s. So get busy moving. If you haven’t been exercising, start slowly and build up to 30 min a day. You might want to start by doing three five minute sessions for 3 or 4 days then kick it up to 6 or 7 min. sessions for a few days, then…well, you get the idea.
The third arm of the octopus is medication. Often some type of medication is needed to assist with glucose control. Please, realize that popping a pill is not going to take the place of eating right and exercise. It is just going to help in the management of blood sugar. Pills work to help control blood glucose in several different ways and this is why sometimes, doctors may prescribe two or more different kinds of pills. Occasionally a person will have had good control for many years then suddenly it seems to quit working. This is usually because of the progression of diabetes and it may call for either an increase in the amount of medication or an addition or change in medication. Insulin is often the best medication to control blood sugar and we have several different types these days. Some are very long acting, some very rapid acting, some intermediate, and they require being taken at very different times in relation to food intake. With insulin and with the pills, be sure you know how and when to take your medication. Your pharmacist or a diabetes educator as well as your doctor, are good resources for this very important information. Some medications occasionally have unpleasant side effects at first that usually go away but some people do not discuss this with anyone and just stop the medication and therefore loose glucose control. If you have any issues with medication, discuss them with your doctor, pharmacist, or diabetes education. Don’t just stop them!