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Diabetes Management

How lifestyle, daily routine affect blood sugar

Diabetes management requires awareness. Know what makes your blood sugar level rise and fall - and how to control these day-to-day factors. Keeping your blood sugar levels within the range recommended by your doctor can be challenging but with a well-balanced diet and adequate exercise along with frequent blood sugar monitoring and following your doctor’s advice diligently will go a long way in controlling your blood sugar levels. That's because many things make your blood sugar levels change, sometimes unexpectedly.

Food

Healthy eating is a cornerstone of healthy living with or without diabetes. But if you have diabetes, you need to know how different foods affect your blood sugar levels. It's not only the type of food you eat but also how much you eat and the combinations of food types you eat.

What to do

  • Learn about carbohydrate counting and portion sizes; ask your doctor or dietician for these
  • Make every meal well-balanced
  • Include plenty of fiber-rich foods in your diet such as green leafy vegetables, as they help in delaying the absorption of glucose form the gut thus blunting spikes of blood sugar in the blood
  • Reduce the amount of fat-rich foods in your diet; have white meat and sea food instead of red meat
  • Coordinate your meals and medications as advised by your doctor
  • Avoid sugar-sweetened beverages and junk foods as they are very rich in fat and calories

Exercise

Physical activity is another important part of your diabetes management plan. When you exercise, your muscles use sugar (glucose) for energy. Regular physical activity also helps your body use insulin more efficiently. These factors work together to lower your blood sugar levels. The more strenuous your workout, the longer the effect lasts. But even light activities - such as housework, gardening or being on your feet for extended periods - can improve your blood sugar levels. Make sure that you do the right kind and amount of exercise for the durations adequate for you based on your doctor’s advice or the advice of your health counsellor. Do ensure that you don’t over-exercise or get injured while exercising.

What to do

  • Talk to your doctor about an exercise plan to understand the type and duration of exercise
  • Keep a daily exercise routine
  • Talk to your doctor about what blood sugar levels are appropriate for you before you begin
  • Check your blood sugar level before, during and after exercise and maintain a record in your diary
  • Drink plenty of water or other fluids
  • Always have a small snack or glucose tablet with you during exercise
  • Adjust your diabetes treatment plan as needed

Medication

Insulin and other diabetes medications are designed to lower your blood sugar levels when diet and exercise alone aren't sufficient for managing diabetes. But the effectiveness of these medications depends on the timing and size of the dose. Medications you take for conditions other than diabetes also can affect your blood sugar levels.

What to do

  • Strictly follow your doctor’ prescription on a regular basis. Store insulin and other medications properly; Insulin that's improperly stored or past its expiration date may not be effective. Insulin is especially sensitive to extremes of temperature.
  • Report problems to your doctor If your diabetes medications cause your blood sugar level to drop too low or if it's consistently too high, the dosage or timing may need to be adjusted.
  • Be cautious with new medications if you're considering an over-the-counter medication or your doctor prescribes a new drug to treat another condition - such as high blood pressure or high cholesterol - ask your doctor or pharmacist if the medication may affect your blood sugar levels.

Dental health

To prevent dental problems if you have diabetes, taking good care of your gums and teeth is very important.

What to do

  • Maintain good blood sugar control.
  • Tell your dentist that you have diabetes.
  • Brush and floss your teeth at least twice a day.
  • Have a dental check-up every six months.
  • If you smoke, quit.

Foot Care

Caring for your feet is an important aspect of your diabetes care as food infections and disorders lead to a tremendous amount of disease burden. High blood sugar levels lead to more infections and infection that spreads can also increase the levels of blood sugar. As you may have insensitivity due to diabetes induced nerve damage in your feet, even minor injuries that are ignored can lead to problem. Daily foot care routine can go a long way in preventing all these.

What to do

  • Wear comfortable shoes that are well lined or padded and don't rub or pinch
  • Always wear socks, preferably cotton socks
  • Never walk bare feet
  • Check your shoes for wear and tear, for stones or grit before you put them on.
  • Examine the sole of your feet daily using a mirror for any minor injuries; consult your doctor immediately if you see even a minor problem
  • Pare your nails regularly and gently, preferably after a bath as they are softer and easier to pare at that time

What to Do

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What Not to Do

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Complication of diabetes

People with diabetes have an increased risk of developing a number of serious health problems if they do not control or manage their blood sugar levels adequately. Consistently high blood glucose levels can lead to serious diseases affecting the heart and blood vessels, eyes, kidneys, nerves and teeth. In addition, people with diabetes also have a higher risk of developing infections. In almost all high-income countries, diabetes is a leading cause of cardiovascular disease, blindness, kidney failure, and lower limb amputation. Long-term complications of diabetes develop gradually. Maintaining blood glucose levels, blood pressure, and cholesterol at or close to normal can help delay or prevent diabetes complications. Eventually, diabetes complications may be disabling or even life-threatening. Therefore, people with diabetes need regular monitoring.

Cardiovascular disease

Affects the heart and blood vessels and may cause fatal complications such as coronary artery disease (leading to a heart attack) and stroke. Approximately 75 percent of people with diabetes will die of heart disease or stroke, and they are likely to die at a younger age than people who do not have diabetes. High blood pressure, high cholesterol, high blood glucose and other risk factors contribute to increasing the risk of cardiovascular complications.

Each year 12,000 to 24,000 people lose their sight because of diabetes. Consistently high levels of blood glucose, together with high blood pressure and high cholesterol, are the main causes of retinopathy. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma. It can be managed through regular eye checks and keeping glucose and lipid levels at or close to normal.
About 60 to 70 percent of people with diabetes have mild to severe forms of diabetes-related nerve damage which can lead to lower limb amputations. Diabetes can cause damage to the nerves throughout the body when blood glucose and blood pressure are too high. This can lead to problems with digestion, erectile dysfunction, and many other functions. Among the most commonly affected areas are the extremities, in particular the feet. Nerve damage in these areas is called peripheral neuropathy, and can lead to pain, tingling, and loss of feeling. Loss of feeling is particularly important because it can allow injuries to go unnoticed, leading to serious infections and possible amputations. People with diabetes carry a risk of amputation that may be more than 25 times greater than that of people without diabetes. However, with comprehensive management, a large proportion of amputations related to diabetes can be prevented. Even when amputation takes place, the remaining leg and the person’s life can be saved by good follow-up care from a multidisciplinary foot team. People with diabetes should regularly examine their feet.
Women with any type of diabetes during pregnancy risk a number of complications if they do not carefully monitor and manage their condition. To prevent possible organ damage to the fetus, women with Type 1 or Type 2 diabetes should achieve target glucose levels before conception. All women with diabetes during pregnancy, Type 1, Type 2 or gestational should strive for target blood glucose levels throughout to minimize complications. High blood glucose during pregnancy can lead to the fetus putting on excess weight. This can lead to problems in delivery, trauma to the child and mother, and a sudden drop in blood glucose for the child after birth. Children who are exposed for a long time to high blood glucose in the womb are at higher risk of developing diabetes in the future.
10 to 21 percent of all people with diabetes develop kidney disease. Diabetic nephropathy is the leading cause of end-stage renal disease (kidney failure), accounting for 43 percent of new cases. The kidneys contain millions of tiny blood vessel clusters (glomeruli) that filter waste from the blood. Diabetes can damage this delicate filtering system. Kidney failure requires the patient to undergo dialysis or a kidney transplant in order to live. Maintaining near normal levels of blood glucose and blood pressure can greatly reduce the risk of kidney disease.
Cavities and gum disease Whether you have type 1 diabetes or type 2 diabetes, managing your blood sugar level is the key. The higher your blood sugar level, the higher your risk of: Tooth decay (cavities). Your mouth naturally contains many types of bacteria. When starches and sugars in food and beverages interact with these bacteria, a sticky film known as plaque forms on your teeth. The acids in plaque attack the hard, outer surface of your teeth (enamel). This can lead to cavities. The higher your blood sugar level, the greater the supply of sugars and starches - and the more acid wearing away at your teeth. Early gum disease (gingivitis). Diabetes reduces your ability to fight bacteria. If you don't remove plaque with regular brushing and flossing, it'll harden under your gumline into a substance called tartar (calculus). The longer plaque and tartar remain on your teeth, the more they irritate the gums. In time, your gums become swollen and bleed easily. Advanced gum disease (periodontitis). Left untreated, gingivitis can lead to a more serious infection called periodontitis, which destroys the soft tissue and bone that support your teeth. Eventually, periodontitis causes your gums to pull away from your teeth and your teeth to loosen and even fall out. Periodontitis tends to be more severe among people who have diabetes because diabetes lowers the ability to resist infection and slows healing. An infection such as periodontitis may also cause your blood sugar level to rise, which makes your diabetes more difficult to control. Preventing and treating periodontitis can help improve blood sugar control.