David Chew began feeling sluggish throughout the day – and sometimes exhausted – when he was in his 60s. So he turned to his doctor, and after a round of blood tests found the cause: he had diabetes.
David’s mother is also diabetic, so he immediately recognized the impact the disease was having on him. “It was a bit like investing in the stock market, where I felt greedy and scared at the same time.” He said, “Greed for a better quality of life, and fear for the consequences of the disease – blindness, kidney dialysis, amputation, and possibly worse; if I can’t manage it effectively.”
From his mother, David learned that making this “investment” meant more than just getting medication. He made radical changes to his lifestyle, including his diet and exercise habits, to try to manage his condition.
Experts say that this comprehensive lifestyle change is the best way to manage diabetes. The most effective care plans analyze the full range of a patient’s lifestyle to find out which lifestyle changes may help control the condition.
“Now we do more than just prescribe medications for patients and expect to get better. We do a full spectrum analysis and manage the disease holistically.” Dr. Margaret Powers, chair of the American Diabetes Association (ADA) Health Care and Education Section, describes.
Diabetes is all about self-management
Dr. Powers also said, “Self-care is 99% of the importance of diabetes care. Adhering to medications, checking blood glucose levels regularly, choosing the right foods, and getting regular physical activity are all things that patients themselves should make sure they do.” She believes that there are four different points in time at which patients should check whether their diabetes management plan is working:
- When a patient is diagnosed with diabetes
- Every anniversary after diagnosis
- When conditions such as other health problems or use of new medications arise
- During environmental transitions, such as when you’re first discharged from the hospital, when you’ve just moved into a nursing home, or when your child leaves home for college When you’re deciding how to manage your condition, it’s important to consider a combination of circumstances. Dr. Powers says that in addition to taking medications, everyone with diabetes should focus on two components of life: nutrition and exercise.
Diet is critical
What you eat and when you eat it affects every aspect of diabetes care. That’s why it’s important for patients to match their medications with their diet, says Dr. Powers. For example, many patients need to rely on insulin to lower their blood sugar levels, but if they don’t eat at the right time, they may be at risk for hypoglycemia. A well-balanced diet can delay the timing of increasing medication doses or combination medications. That’s David’s goal, too. He says, “That fear sustains me, and I don’t want to fall into a situation where I have to inject insulin.” However, as a Chinese-American who grew up on a high-carbohydrate diet such as rice or noodles, it can be difficult to make further adjustments. David said he has adapted foods like pasta, sliced toast and rice to his breakfast or lunch, while choosing mostly meat and stir-fried vegetables for dinner.
Managing disease through exercise
David has always been active in sports, and he enjoys playing basketball and hiking. But after being diagnosed with diabetes, he needed to get more structured with his exercise program. He chose to walk every morning at a pace of no more than one kilometer per 10 minutes. He also joined a fitness club and shoots hoops when he has time. Exercise is key to diabetes management because it can have a direct impact on the disease. For people with type 2 diabetes, it may even be possible to manage the disease through exercise without medication. Exercise can also improve the body’s insulin function and can be beneficial for people with diabetes because it can lead to a fit body. Dr. Powers said she has encountered patients who have achieved improvements in their disease by losing 7% to 10% of their body weight.
360 degrees of disease care
Besides medication, diet management, and exercise as the foundation of diabetes management, there are many other ways to stay healthy, such as:
- Skin care: Up to one-third of people with diabetes develop skin infections, itching, or blisters. Patients should keep their skin clean and dry, avoid bathing in excessively hot water, and treat any wounds immediately; if they notice an abnormal skin condition, they should seek medical attention immediately.
- Eye care: Diabetes increases the risk of eye diseases such as glaucoma or cataracts. Wear sunglasses outdoors and have regular eye exams to protect your vision.
- Foot care: High blood sugar may damage nerves in the feet, leading to localized hyperplasia of the stratum corneum, foot ulcers, and poor blood flow. Patients should check their feet daily and seek medical attention if conditions arise.
- Stress: Anxiety can raise blood glucose levels. So patients should try to seek mental relaxation, get plenty of rest, and do the things they enjoy. Don’t forget that exercise is also a good way to relieve stress. David makes sure he gets seven hours of sleep a day and is able to keep a close eye on his blood glucose levels even after a long day of intense work. This 360-degree approach to disease care has made him feel like diabetes has become central to his life. “I’ve had to learn to live with diabetes,” he says. But as long as it doesn’t get worse, I can live with it,” he says. It’s like accepting that you’re aging gradually.”