Living well with diabetes

Being diagnosed with diabetes does not prevent anyone from living a fulfilling life.

Even though there is no cure for diabetes, it can be treated and controlled, and some people may go into remission.

Diabetes management is about reducing complications so that you may live your life as normal as possible.

For starters, you have to get your head over the issue. Be mentally prepared and muster support towards this lifestyle change you’re about to go through.

Family, friends and support groups can help provide you with the ample encouragement and motivation that you will need to succeed.

The key point is to manage your blood sugar levels. When taking your medications, balance your food intake with the medications.

You need to perform regular exercise, manage your stress levels and cultivate good sleep habits, as these are essential lifestyle habits to keep blood sugar levels as near to normal as possible every day.

Eating sensibly

People with diabetes know that they need to take control of their eating habits because blood sugar levels in the body are directly affected by the foods we eat.

While there are no special diets for diabetes, it is prudent to choose foods sensibly, but not at the expense of not enjoying food.

A diabetic diet is an eating plan that is high in nutrients and fibre, low in fat, sugar and salt, and moderate in calories – now, doesn’t that sound like a healthy diet for everyone? The only difference is that you need to pay more attention to your food choices.

Controlling carbs: Carbohydrates are the body’s main source of glucose (sugar), which provide energy that fuels the brain and muscles.

If you have diabetes, excessive intake of carbohydrates will lead to high blood sugar levels and poor control of diabetes.

Do not stay away from carbohydrates; instead, remember that in order to maintain your blood glucose at a stable level, your carbohydrate intake should be consistent for each meal.

Eat about the same amount of carbohydrate-containing foods for each meal as advised by your dietitian.

It is advisable to choose starchy carbohydrate foods that are high in fibre to prevent sharp rises in your blood sugar level. These are options such as wholegrain bread, brown rice, oats, chapati, wholegrain noodles/pasta and wholemeal biscuits.

In addition to these starchy foods, fruits, beans, milk, yoghurt and sweets are also sources of carbohydrate that you need to control in your diet. Eat these in small amounts according to your meal plan.

Load up on greens: Loading up on vegetables, especially green leafy ones, will assist in blood sugar and weight control, and promote a healthy heart.

Ensure at least half of your plate or bowl is filled with vegetables (preferably lightly sautéed and not too oily) and always have a serving of fruit after every meal.

Choose wisely when eating out: If you eat out a lot, go to restaurants that offer a variety of menu choices, so that it is easier for you to follow your meal plan.

Reduce your food portion size by requesting for less noodles/rice, and avoid dishes with thick gravy (for example, sar hor fun or mee ladna) or fried foods with flour/bread coating (for example, chicken chop) as they add on carbohydrates and fat.

Order lower-fat options such as steamed, braised or roasted dishes. Order more vegetables and have a serving of fruit for dessert.

Regular mealtimes: For individuals who are on fixed doses of insulin and/or taking oral medication for diabetes, it is important to maintain regular mealtimes to prevent fluctuation in blood sugar levels and to optimise the effects of the medication.

Regular meal timing also helps to regulate appetite and assist in weight control efforts.

Maintaining a healthy weight

Type 2 diabetes and obesity are closely linked; reduction of body weight improves blood sugar control and decreases risk of heart disease and other complications of diabetes.

Losing just 5% of your body weight through exercise and sensible eating can improve blood glucose levels, reduce blood pressure, reduce blood cholesterol levels and make you feel more energetic and healthier.

Be active: The reason exercise is so important is because it increases cell sensitivity towards insulin. This means that cells are better able to use any available insulin to take up glucose during and after each physical activity.

This helps you to have better blood glucose control and maintain a healthier body weight.

Brisk walking is one of the safest exercises to perform, especially if you have never exercised before or haven’t done so for a long time.

You can start slowly with a 30-minute brisk walk three times per week and work your way towards a more intensive regime.

If you feel uncomfortable at any point while exercising, slow down until you feel comfortable. Always warm up before you start any activity and cool down when you finish with your activity.

If you have diabetic complications such as heart disease, nerve problems or kidney failure, seek the advice of your doctor or an exercise specialist about appropriate exercises to do.

Shoes that fit: Comfortable footwear is also important as diabetes causes nerve insensitivity in the feet.

The elevated blood sugar level interferes with the nerve signals from the feet to the brain.

Poorly-fitted shoes can lead to foot complications such as ulcers, blisters or corns.

Make sure that your shoes fit you well. For exercising, walking shoes with soaks are recommended.

When you start wearing a new pair of shoes, try to avoid wearing them for long periods of time. Wear them for an hour or two, and check for any cuts or blisters.

Always consider getting new shoes once the heels start to wear down or if the inner lining of the shoes is torn.

Treatment matters

Stick to medications: In order to ensure blood sugar targets are achieved, most people with type 2 diabetes will require oral medication and/or insulin, along with living a healthy lifestyle.

It is very important to follow the medication dose and timing prescribed by your doctor. It is dangerous to skip medication, or adjust medication dosage and timing without checking with your doctor.

It can cause fluctuations in your blood sugar levels, causing it to become too high or too low.

It is recommended that you visit your doctor regularly for check-ups every three months.

Keeping clinic appointments: You need to take a proactive role in the management of your healthcare in order to prevent or delay the development of diabetic complications.

This includes ensuring you follow up and see your diabetes healthcare team as scheduled. The frequency that you see each member of your healthcare team varies.

In general, individuals with diabetes should have comprehensive physical examinations once a year and have their diabetes assessed at least every three to six months.

Self-monitor blood sugar levels: Regular monitoring of your blood glucose gives you a basic understanding of how your diet, medication and physical activity affects your body and how you can manage it.

This can be achieved via regular self-monitoring. Without it, you will be forced to rely on physical symptoms (which can be inaccurate) to tell you when your blood glucose is too high or too low.

By keeping daily records of your blood glucose levels, you can provide your doctor, nurse and dietitian with a clearer picture of your condition.

They will be able to provide you with a more concise and accurate guide for your physical activity and food intake.

Ensure a good night’s sleep

Too little sleep can increase the risk of diabetes, and if you already have diabetes, sleep deprivation can lead to poor blood sugar control.

Long-term sleep deprivation may lead to elevated levels of the stress hormone, cortisol.

Elevated cortisol hinders the action of insulin, and thus, undermines blood sugar control in people with diabetes. Hence, most adults require about seven to eight hours of sleep to feel well rested.

In essence, practise these eight golden rules to live healthy and help manage your diabetes better:

Learn more about diabetes

• Learn more about diabetes 

• Eat sensibly

• Be active

• Maintain a healthy weight

• Adhere to medications

• Monitor blood glucose

• Go regularly for check-ups

• Ensure adequate sleep time at night

So, take charge today, and don’t let diabetes get the better of you!

Prof Winnie Chee is a member of the Nutrition Month Malaysia Steering Committee & president of Malaysian Dietitians’ Association. This article is contributed by Nutrition Month Malaysia (NMM) 2015. It is an annual initiative jointly organised by the Nutrition Society of Malaysia, Malaysian Dietitians’ Association and Malaysian Association for the Study of Obesity. 

NMM 2015 is supported by Legosan (Malaysia) Sdn Bhd, Malaysia Milk Sdn Bhd (Vitagen), Nestle Products Sdn Bhd, Serba Wangi Sdn Bhd and Yakult (Malaysia) Sdn Bhd. To learn more about preventing diabetes and other interesting nutrition information, drop by the Nutrition Month Malaysia Facebook page or visit www.nutritionmonthmalaysia.org.my.