Diabetes Lifestyle and Prevention

If you are living with diabetes, lifestyle is an important element of your care. It is extremely important that you eat a good balance of foods every day and exercise regularly. You will also have to learn to manage your disease by taking medicine, if necessary, and testing your blood sugar levels each day.

Diet:

Diabetes does not require special foods. A healthy, balanced diet can come from everyday foods. Certain foods are better than others, however, when managing diabetes. If you have diabetes, you should:

• Choose foods that are low in fat and salt
• Choose foods that are high in fiber (such as beans, vegetables and fruit)
• Remember to eat foods from all food groups: milk and milk products; meat, chicken, turkey, fish, beans, cheese, and eggs; bread, cereal, rice, noodles, and potatoes; and fruits and vegetables.
• Lose weight by reducing the amount of food you eat. Weight loss will make your diabetes easier to control if you have type II diabetes.

Your doctor can refer you to a dietitian who can help you plan meals that include the right foods, and recipes that taste great and are good for you.

Alcohol:

If your diabetes is under control and you do not have high blood pressure or nerve damage, your doctor may allow you to drink alcohol. You need to understand what happens when a person with diabetes drinks alcohol, however. If a person with diabetes drinks alcohol, while taking insulin or other diabetes medication, he or she risks low blood sugar. The liver will not release glucose until it first clears the alcohol, because the liver treats alcohol as a poison in the system.

If you drink alcohol, limit yourself to one drink a day if you are a woman and two drinks a day if you are a man. Remember, never drink alcohol on an empty stomach.

Smoking:

Smoking greatly increases your risk of heart disease and blood vessel disease — two of the major complications of diabetes. Stopping smoking is the single best thing you can do to decrease your chances of developing heart disease and blood vessel disease.

Exercise and Activity:

Always see a doctor before starting an exercise program. Your doctor may have good ideas about types of exercise that would be best for you. Exercise is important for people with diabetes because it does the following:

• Helps insulin work better to lower blood sugar
• Helps keep weight down, which also improves the condition
• Is good for the heart, blood vessels, and lungs
• Gives you more energy

Be aware that exercise affects your body's need for sugar. When you exercise, be sure to do the following:

• Have a snack with you in case you get low blood sugar
• Wear a tag or carry a card that says you have diabetes
• Eat a snack, such as milk or an apple, if it has been more than an hour since you have eaten
• Avoid exercising if your blood sugar is over 240 mg/dL. Try to lower your blood sugar. Please see the section on Treatment Options, "If your blood sugar is high."
• Do not take insulin to lower your blood sugar before exercising. This may result in severe low blood sugars.

If you have heart disease or risk factors for heart disease, such as advanced age, high cholesterol, increased protein in your urine, high blood pressure, or poor diabetes control, check with your doctor about whether or not you need a stress test before beginning an exercise regimen.
If you have nerve damage to your feet, be careful to wear well-fitting shoes and socks to avoid blisters. You should discuss your exercise regimen with your physician and/or podiatrist.

Managing your condition:

If you have diabetes, you have the responsibility of managing your condition.

If you need to take medicine, be sure to take it as directed. Do not change your own dosage or how often you take your medication unless you have been instructed to do so by your physician. Take it as prescribed and on time every day. Be careful not to skip doses of insulin or other medications.

Test your blood for sugar as directed by your doctor. Some people only test once a day. Those who take insulin or multiple medications may need to test four or more times a day. Talk to your doctor about how often you should test your blood sugar.

To test your blood, you will need test strips and a lancet to pierce your finger or forearm for a blood drop. You will simply prick your finger or forearm, get a drop of blood, and place it on the end of the strip. After a short time, place the strip in your glucose meter and get an exact number for your blood sugar.

People with type 1 diabetes may also want to buy urine test strips to measure ketone levels. These are substances that your body forms when you do not have enough insulin and your blood glucose levels are high. This usually happens when you are sick. You may need to test for ketones when you have a blood sugar reading of more than 240 mg/dL before you eat.

If you have a positive ketone test when you take a blood or urine test, call your doctor immediately. This may indicate a developing condition called diabetic ketoacidosis, a serious condition that can cause death if left untreated.

Finally, you should see your doctor for a hemoglobin A1c test every three to six months. This is a special blood test that gives your doctor a picture of your blood sugar over time. This test shows how much sugar is attached to the hemoglobin in your red blood cells. Ask your doctor if you have questions about your hemoglobin A1c test results. You should have a normal result if most of your blood sugar levels are near 100 mg/dL.

Managing your diabetes may take some planning. Ask your doctor how to best prepare for different situations, which may require extra insulin or even changes to your regular dose of medication:

• When you are sick
• If you are planning a pregnancy or become pregnant
• When you are traveling
• When you are at school or at work
• When you are exercising

Associated Conditions

People with diabetes of both types commonly develop high blood pressure, or hypertension and high cholesterol levels. These conditions may also require specific medications that are necessary to achieve normal blood pressure and cholesterol levels.

When these levels are not controlled, they increase the risk for large blood vessel disease, which can cause heart attacks, strokes, and lead to amputations. It is critical to control these associated conditions, as well as the diabetes.

Many of the lifestyle changes you may make to control your diabetes, such as diet and exercise, will also be of benefit in controlling your blood pressure and cholesterol. Additional changes may also be needed, however, such as lowering the salt and fats in your diet.

If you are diagnosed with one of the diabetes types, the first thing you will want to do is to find a physician, specifically an endocrinologist, to help you manage your condition. Find a doctor who will listen to you and answer your questions. Make a commitment to yourself to get educated and to make the lifestyle changes you need to make to maintain good health despite the challenges of diabetes. A great doctor, the right medication, a good diet and exercise will go a long way in ensuring your well being for many years to come

Editors:
Guillermo Umpierrez, MD
Associate Professor of Medicine
Department of Medicine
Emory University School of Medicine

Mark E. Molitch, MD
Professor of Medicine
Division of Endocrinology, Metabolism and
Molecular Medicine
Northwestern University
Feinberg School of Medicine

Last Updated: January 2008