Lifestyle Management in Diabetes
In recent decades, India has witnessed a rapidly exploding epidemic of diabetes. India has the 2nd highest number of diabetes in the world, only after China. By the year 2045, it is predicted that India will have around 134 million people suffering from diabetes. Lifestyle Management in Diabetes is very crucial in this scenario.
Diabetes can lead to further complications in the long run which decreases longevity. Hence, the focus should be on preventing or managing diabetes through lifestyle modifications. Hence, to reduce the risk of further complications.
Lifestyle management in Diabetes is a fundamental aspect of diabetes care. This includes:
- diabetes self-management
- education and support,
- medical nutrition therapy (MNT),
- physical activity, and
- psychosocial care.
Diabetes self-management
You should be well educated and skilled in diabetes self-care. It helps you to make informed self-management decisions. The medical team (doctors, nurses, dietitians) needs to educate the patients at four critical times.
- at diagnosis,
- annually,
- when complicating factors arise, and
- when transitions in care occur.
Nutrition therapy
The most challenging part is determining what to eat without fear for diabetic patients. There is no one-size-fits-all eating pattern for individuals with diabetes. Here, the role of a dietitian is of utmost importance for an individualized diet.
Management and reduction of weight are important for people with type 1 diabetes, type 2 diabetes, or prediabetes who have overweight or obese. Healthy weight loss and the change in the daily calorie should be a gradual process.
Your carbohydrates should be complex in nature. Now, what are those? They are those carbohydrate foods that are high in fiber and raise your blood sugar slowly. For e.g, whole grains (unpolished cereals and millets), legumes, peas, beans, oats, barley. Stay away from refined carbs like refined cereals.
Carbohydrate counting
Carbohydrate Counting is one of the best and easiest methods to plan your meals. It helps in Lifestyle Management in Diabetes. Counting carbohydrate servings provides an accurate “guess” of how your blood glucose will rise after a meal or snack. We must teach this to every diabetic patient, especially type 1, by their dietitian.
Other nutrients
Protein intake should be moderate to high. You must consume high biological value proteins i.e, good quality such as egg, chicken, fish, dairy, pulses, and nuts. Avoid red meats. Supplementation of foods like cereal and pulse (4:1 ratio) can improve the protein quality and also gives satiety. For e.g; Idli, dosa, Missi roti, Khichdi, Dhokla, Khandvi etc.
Good quality fats should be included in the diet i.e, less saturated fats and more MUFA and PUFA which involves using a mixture of unrefined oils, nuts like walnuts, flaxseeds.
Added (iodized) salt should be less than 5 g/day. We should reduce intake to less than 3 g/ day for people with hypertension and diabetes. It is best to avoid alcohol and smoking. Keep in mind, alcohol can further lead to fatty liver and many other problems. we must encourage all patients with diabetes to take 6 small meals a day.
We should avoid the use of artificial sweeteners
Physical Activity and Exercise
Regular physical activity along with regulated exercise is an essential component. Benefits of exercise
- Improves insulin sensitivity, reduces the risk of heart disease, high blood pressure, bone diseases, and unhealthy weight gain
- Helps relieve stress, anxiety and prevents depression
- Increases strength and stamina
- Promotes sound sleep
- Increases metabolic rate and digestion
- Lowers lipids
- Delays the process of aging
The recommendation is about 150 minutes of aerobic activity or its equivalent /week. Include it with some resistance training at least twice a week and flexibility exercises. Moreover, there is growing evidence to suggest that yoga may benefit patients with type 2 diabetes.
Psychosocial care
Diabetes affects every aspect of a person’s life, including job, social life, recreation, and family time.
Hence, emotional well-being is an important part of diabetes care and self-management. Psychological and social problems can impair the individual's or family's ability to carry out diabetes care tasks. Therefore, potentially compromise the health status of the patient.
Stress management is essential. We can do forms of meditation, yoga, a long outdoor walk, exercise, and trying out hobbies like reading, gardening, painting, etc.
The medical care team must routinely monitor people with diabetes for diabetes distress. They should take care when treatment targets are not met and/or at the onset of diabetes complications. The patient should be referred to a mental health specialist if need be.
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