A sweet way to handle diabetes

Diabetes is a wake-up call for a healthy way of living, too obvious to be missed, and too important to be ignored, writes Dr Arun R Vadavi

It is said that the best way to overcome your demons, is to face them. Diabetes is one such entity that can silently and progressively cripple good health. Good practices for a healthy lifestyle have their place at the very heart of diabetes care. For people with diabetes, sustaining motivation for a healthy lifestyle over time requires determination and perseverance. Simple measures for sustaining good health can be summed up as ABCDE.
A: A1c control
B: Blood-pressure control
C: Cholesterol control
D: Diet control
E: Exercise
Home-based monitoring of blood sugar and blood pressure levels can bridge vital gaps in continual access to healthcare. However, home-based care cannot replace thorough risk assessments, which may also be required on a periodic basis. If you are using a glucometer at home:

Before a prick, wash hands with soap and water, and dry them well. Avoid alcohol-based sanitiser before a prick, as alcohol tends to dry the skin and cause pain.

Use a sterile lancet to prick the fingertip.

Use a different finger each time.

Place the strip with the blood, in the glucometer, as per the device guidance.

Maintain a meticulous record of all test readings, as per the recommended timetable.

Ensure proper disposal of the lancet and strip in a trash container. Do not share the used lancet with anyone.

A post-meal assessment should be ideally done two hours after a meal, whereas fasting blood sugars are tested within 15 minutes of waking up, before going for a morning walk. The reading may be inaccurate in some situations, like in the presence of anaemia.

Self-monitoring of blood pressure

Sit comfortably, feet resting on the ground and proper back support. Relax for a few minutes, before taking a blood pressure reading.

Place elbow and forearm on a flat surface. Make sure that the arm is placed at the same height as the heart.

Three readings of blood pressure should be taken at 1-minute intervals. Record the average of the three readings.

Make sure to enter the dates of the readings and try to measure the blood pressure at around the same time every day.

Blood pressure readings may be higher if taken after physical activity, heavy meal, coffee, smoking, or in an anxious state of mind.

Good practices to facilitate blood pressure control include avoiding table salt, ceasing tobacco consumption in any form, stress management, limited alcohol intake, weight loss, healthy eating, and regular physical activity. Some healthy dietary practices:

Consume fibre-rich foods like cucumber, cabbage, carrot, green vegetables.

Restrict the consumption of table salt and sugar.

Follow healthy cooking methods like baking, boiling, or steaming, rather than frying.

Avoid packaged foods, sugary drinks, aerated beverages, juices, bread, sauces.

Avoid using saturated fat and trans fat like vanaspati, dalda, coconut oil, ghee

Oils containing unsaturated or polyunsaturated fatty acids must be consumed, like mustard, sunflower, or safflower oil. The use of two or more oils in the rotation is healthy.

Rice has a high glycemic index, which can be unhealthy if consumed in excess; brown rice should be preferred over white rice.

Low-fat dairy products like double-toned or skimmed milk should be consumed.

Restrict alcohol consumption, red meat, and tobacco.

Extreme diets like ketogenic low‑carbohydrate diets should be attempted only under the supervision of a doctor/nutritionist, over a short period.

Exercise & physical activity

Physical activity and muscle mass play a vital role in metabolic health. Insufficient physical activity is a key reason for developing diabetes and heart disease. Patients with diabetes or pre-diabetes are in general, recommended daily physical activity for at least 60 minutes, including:

At least 30 minutes of moderate-intensity aerobic activity, like brisk walking.

10-15 minutes of muscle-strengthening exercise, like dumbbells.

10-15 minutes of work-related activity.

It is important to avoid sudden commencement or acceleration in physical activity or high-intensity exercises. Since every patient may have unique health priorities, all decisions regarding exercise regimens should be taken in consultation with the doctor. Diabetes may not be an immediate event of disease; however, it poses a major predisposition for various diseases in the long run.

(The author is a consultant diabetologist.)