Diabetes Mellitus
Diabetes Mellitus is a chronic disease that due to insulin deficiency or lack of inulin causing hyperglycaemia. It has become a major public health concern globally over decades and now is the time to become aware and modify lifestyle accordingly. Knowing of the factors that make your blood sugar rise and those that make it fall and also the day to day factors that need to be modified, controlled and devised.
TYPES : Diabetes mellitus is mainly 3 types
- Type 1 DM :There is no production of insulin in your body. It’s a congenital disease and you need to take insulin everyday for the rest of your life.
- Type 2 DM : There is low or little production of insulin. Sometimes your body can’t use the insulin due to insulin resistance. You need to take oral anti diabetic drugs and insulin if needed.
- Gestational Diabetes : In this case the blood sugar level rises during pregnancy. Most of the time, after giving birth, it is auto corrected but sometimes it doesn’t go away. In other cases, both mother and child develop diabetes in later stages of life.
Diabetes management: Diet, Lifestyle and Risk Factors
1. DIET :
Food is the key factor for our living, with diabetes or without it. Diabetic people have to be much careful about the foods and drinks they would have. Not only the foods in large amount matters, but also the varieties of foods and the combinations in which you take them.
Amount of Carbohydrates and Size of Meal
The amount of carbohydrate management is a key factor for diabetic diet. Among the other components of foods, carbohydrate is the most impactful on your sugar level. For those who are on oral anti diabetic drugs or insulin before meal time, the knowledge about the amount of carbohydrate in your food is very essential. Because of the dosage of the drugs and Insulin Varies depending on your diet and blood sugar level.
Portion size of Food
Co-ordinating with diabetic diet chart, adjust what portion size appropriate for different foods. Everyday write down what food do you eat in which amount. This will help you in measuring the amount of carbohydrate you take in everyday. You could use measuring cups or different kinds of measuring scales. Accuracy of carbohydrate count and proper portion size is a mandatory in management of diabetes.
Keeping a balance in Meals
The amount and the mixture proportion between starch, protein, fat ,fruits and veggies should be according to the diabetic food and nutrition chart. Too much of anything could be harmful or affect your blood sugar level and metabolism.
Foods with low carbohydrates and fibre are more beneficial for your health than the ones with more carbohydrates. For example, Green Vegetable and fruits.Your doctor or dietician will make sure that you take the right ones, according to your need. So don’t forget to visit them when you are in a fix.
Co-ordination of meals and medications
If you go to an invitation and take a huge meal, your blood sugar is bound to rise higher. But if you don’t take insulin or appropriate measures accordingly, you might get sick. Even overdose of insulin could cause life threatening hypoglycaemia which could even lead to confusion like state or come or even death. So the meals and medications need to have a co-ordination. Your physician and dietician play a greater role in this aspect.
Avoidance of beverage with high sugar
There are various types of beverages containing high sugar which are very detrimental to health even if you are not a diabetic patient. They make your sugar level rise rapidly and this it’s advisable to avoid such drinks and beverages, especially if you are diabetic.
But in case of hypoglycaemia that is when the blood sugar level is very low, it could be used to treat such condition.
2. EXERCISE:
Daily exercise and physical activities play a great role in the day to day management of diabetes. Regular exercise not only make your muscles utilisesugar and but also enhances the insulin function in the body. As a result, the more you work out, the longer the anti-sugareffects lasts. Even light activities make your body utilise sugar.
Plan for a daily exercise
You could always take professional help for in order to devise an exercise plan. A normal person needs around 150 minutes of weekly exercise. So, a 30 minutes activity everyday is enough for a diabetic patient in order to stay healthy.
But if you lived a sedentary life without any exercise for a long time, your doctor might suggest you to take some tests before you start exercising. A right balance of exercises and regularity could get you the desired outcome.
Make a schedule for work out
A schedule for workout is really necessary for your daily life. It should be planned according to your diet, medication and physical condition.
Regular blood sugar level check up
It is pretty much a must for diabetic people to measure their blood sugar before and after exercise. And those who are on oral antidiabetic drugs or insulin, he should never begin an exercise without prior blood sugar check.
As it is stated above that physical activities decreases blood sugar, you could get ill suddenly when that happens. The symptoms might be like feeling weak, body shaking, palpitations, dry throat, vertigo, tiredness, anxiety or confusion
If your blood sugar comes below 5 mmol per litre before you start, you should take something sweet or a snack quickly. It will prevent your blood sugar level go further below.
Hydration :
Drinking right amount of water is important. Because of dehydration could affect your sugar level anytime.
Preparedness :
A blood Sugar machine should be managed and snacks should always be kept with you.
Coordination of Treatment, Diet and Exercise :
If you do exercise, you may need to reduce insulin dosebeforehand. If you are on oral anti diabetic drugs, timing may also need to be changed. There is also the case of delayed hypoglycemia, where one may suffer hypoglycemia after several hours.
The amount of food consumption, when to eat before exercise and after an exercise is also important to your health and routine.
As a result, you must consult with your diabetologist regarding exercise, diet and medication on a regular basis.
3. DRUGS AND INSULIN :
Insulin and oral anti diabetic drugs reduce blood sugar level to relieve hyperglycemia in diabetic patients. Because of at a certain stage, exercise, diet and lifestyle modification are not enough to control the blood sugar level. But the effectiveness of these medications also depends upon them.
A diabetic person may also suffer from certain other diseases for which that person has to take some other medications as well. These may also affect your blood sugar level.
Insulin Storage :
Insulin is very sensitive to temperature. Hence without proper and adequate measures, the insulin may expire and lose efficacy.
Consultation with physician :
If your blood sugar level is uncontrolled and the medications don’t have the desired effect, consultation with your physician is a must. The dose and timing may need to be adjusted. Even changing the drugs or changing the insulin may be needed.
Caution about medications :
You may already be on some drugs that are affecting your diabetic state or new drugs may be added in future for other diseases. Whatever the case, as a patient you must give your full history to your doctor. Asking him if these medications affect your diabetic status or not should never is hesitated. Always cross check new medications if they could increase or decrease your blood sugar level.
4. Diseases :
There are certain hormones and chemokines in your body that are secreted when you are ill or suffering from certain disease. They help your body fight against the invading microorganism or certain physiological condition. They could increase your blood sugar level. Even when you are in stress, hormones like cortisol may secrete and increase your blood sugar level
Planning for Sick days :
Always be prepared for what to come. Co-operate with your health team to make a plan for your sick days. Investigations that are required to do monthly or yearly or how often it must be planned ahead. What to do when your medications don’t work or over work should be discussed previously. Most Importantly you need to know when you must call the doctor.
Diabetic Meal Plan :
Diabetic food chart should always be followed even if you are sick. If you feel nausea or weakness, check your blood pressure and keep a tab on your blood sugar level every hour.
You should always keep yourself hydrated. Drink water 1-2 hourly if possible. In case fever, water keeps going out of our body from skin. So hydration is very much important.
Sometimes, you will lose your appetite. But try to eat as much as possible as they are the source of your energy. Hypoglycaemia may occur if you don’t get enough food supply for your body.
Diabetic medication :
Diabetic medications must be continued. But if hypoglycaemia or hyperglycaemia occurs, follow your doctor’s advice.
5. PREGNANCY :
Blood sugar level may rise during pregnancy when the demand of insulin production is not met by the body. This is also called gestational diabetes. The more effectively the diet, exercise and lifestyle is handled, the more effective will be the blood sugar control and the less chance of complication arising in both the mother and the fetus.
In 10-20 percent of gestational diabetes, insulin is required. In the rest of the cases, properly guided diet plan by a dietician, education by a diabetic educator, medical advices, medications and exercise plan by your doctor and the specialists do the work.
Monitoring blood glucose level :
Self learning to measure blood glucose level is very essential as you may not get someone to help you in time of emergency. Your diabetic educator will help you regarding this.
Adopting healthy eating and Exercises :
Visit a dietician from the very first day of your pregnancy.Learn how to exercise with pregnancy. In this modern age, you could do that through online for example, watching videos or learning via online groups and pages.
- Eat in small amounts every two hourly
- Try adding carbohydrate item in every snack or meal like potatoes or lentils
- Choose foods that are nutritious and more likely to be enjoyable
- Foods should contain calcium, zinc, iron, folic acid, leafy vegetables and low fat
- Foods with high fibre in it
Exercises should be not be more than moderate and must be according to the guideline of your obstetrician and midwife. Without a medical condition or physical problem, exercising is not prohibited in pregnant women.
- Walk around your house or garden
- Walk with other peoples. You may do it groups so that it could be enjoyable
- Avoid elevators
- Start using the stairs
Diabetic Medications :
Only Insulin and drug named metformin ate used in pregnancy but with absolute guideline from your diabetes physician.
6. Preventing Complications :
- Commitment to yourself to educate yourself about diabetes and follow guidelines from the professionals to manage diabetes
- Stop Smoking
- Avoid Alcohol
- Keeping the Blood Lipid Profile in check and control them with the help of your physician
- Schedule regular check up with your physician and dietician
- Regular Eye Examination
- Take Care of your feet
- Take Care of your dental hygiene and teeth
- Yearly renal, cardiovascular and neurological Check up if symptoms manifest
- Lead a stress-free life