According to a report released by CNN news 53% of respondents or a majority of U.S. adults opt to indulge in holiday foods to enjoy the season and may decide to address the weight gain in the New Year. Only 23% of those who responded stated they would make a major dietary change after the holidays.”
There are simple ways to make changes and incorporate healthy habits into the New Year. Remember that ultimately the change comes from you, the patient, when you are ready. Medical professionals often label diabetes patients as “non-compliant” when they see no change in their 3 month A1C blood work. As professionals, we need to move beyond that attitude and understand that even without positive blood results, everyone wants to feel better and live life without diabetes complications. We must continue to encourage each patient to finally embrace and understand that they are in charge of their diabetes – not the professional. Tolerance, time, patience and diabetes education is needed to move the “non-compliant patient” forward. According to the World Diabetes Congress “only 29% of patients with diabetes were asked about treatment input when seeing their doctor about their future diabetes plan.” With the new 2014 guidelines, prevention needs to be addressed in addition to treatment of a disease. We hope to have more opportunities to teach, motivate and encourage patients with diabetes to look ahead, live an improved quality of life and be more in charge. Teams should include a RN/CDE, dietitian, pharmacist, therapist, dentist, podiatrist, and ophthalmologist along with the team leader of M.D., D.O., nurse practitioner or physician’s assistant to offer complete knowledge for the diabetes patient. It is well documented that “when patients feel supported they are more likely to live a better life with diabetes”.
Tips for better living with diabetes in the New Year:
- Understand your medications and know when to take them – I treat at least one patient a week who takes 10 pills at one time with little knowledge about them and just hopes for the best. Most patients do this simply because they were never told how or when to take them. Always check with your health care provider when given a new medication and keep a current list in your wallet. Know the timing of the medication, with or without food, if it can be taken with supplements and do not self treat with prescription medications. Many patients take more or less diabetes medication on a daily basis to regulate blood sugars (this is not acceptable or correct). Be well prepared with enough of a medication supply. Last week I saw a patient who had no insulin left and needed a new prescription when her physician was out of the country; this could easily have been prevented.
- Do not make exercise complicated – It is proven that simple walking can help regulate blood sugars. Research has shown that a 15-30 minute walk after a meal will decrease blood glucose for up to 24 hours (exercise helps glucose get into the cells). Patients often think they need a gym, fancy equipment or a designated time to exercise but keep it simple. Fit in a 10 minute walk 3 times a day. Take the stairs. Walk to the grocery store. Start strength training and add balance moves like standing on one leg for 20 seconds. You will feel better and see improved results.
- Food changes made easy – Try to eat at home as much as possible. You will save money and lower your calories, fat, sodium and sugar content. Set aside a time for weekly grocery shopping with a prepared list when you are not hungry. Cook meals 1-2 days a week so you are ready to go when evening comes. Prepare large portions of soups, stews, casseroles or chili. These foods can be one pot/pan dinners including each food group. Combine vegetables, protein and a carbohydrate into one dish. If time gets away just make a sandwich with some crudités and dinner is ready.
- Always be ready – This week I treated 4 bus drivers since school was on break for the holiday. Each one shared that they are usually hungry and never prepared when on the bus. Granted their hours are different but carrying foods that are easy to eat can be a blessing. We talked about carrying apples, bananas, granola bars, cheese or peanut butter on crackers or nuts and raisins. Cheap and easy to transport without suffering from a low blood sugar. They now will carry glucose tablets as well.
- Say yes to vegetables and fruits – Fiber is wonderful and it definitely makes you feel full. Japanese researchers have found that fiber from fruits and vegetables decreases the risk of stroke in patients with type 2 diabetes. New research states that women who eat more acidic foods including meat and dairy have a higher incidence of diabetes as opposed to those who eat a more basic diet of fruits and vegetables. Add sliced vegetables to a sandwich including lettuce, sprouts, onions, tomatoes and cucumber slices, and take out that extra slice of meat or cheese. Add new fruits and vegetables to your diet – persimmons, pomegranates, blood oranges or Clementine’s (when they are in season) and they may help you tame your sweet tooth.
- Do not skip meals – Eat your 3 meals and combine 3 food types – protein, vegetables and carbohydrates – at each meal. I often treat patients who eat just chicken or meat for a meal and are hungry 2 hours later. You will always feel best when combining foods. Skipping a meal only leads to a bigger meal later in the day. Remember – your pancreas can no longer handle large amounts of carbohydrates at one time and the extra glucose will just circulate in your blood stream and cause damage before it is stored as fat. Eating on a schedule or at about the same time daily has been shown to decrease blood sugars and cholesterol. Consider small snacks between meals for blood sugar control.
- No calories in beverages except milk and alcohol (when allowed) – This recommendation has finally been added to the American Diabetes Association (ADA) nutritional guidelines. Patients often think soda is the only beverage off limits. Drinking Gatorade, High–C, Kool-Aid, 100% fruit juice, sweet tea, fruit smoothies, and mixers are all the same. Skip these and stick to water, sparkling water, seltzer, Crystal light, low fat milk (counts as a carbohydrate), coffee or unsweetened tea.
- Eating out can be tricky – If you decide to eat out, make it about the social experience instead of the food. Split the entreés, take home half the entrée or eat an appetizer as your main course. Skip fried foods, creamy sauces, and eat less fast food. Losing 5-10% of your body weight can help you improve blood pressure, cholesterol, and glucose.
- Yes to a bedtime snack – Many patients think that they should not eat after the magical hour of 6 or 7 pm. You should include a bedtime snack within an hour of sleep. Eat a protein and carbohydrate – a half of a sandwich is a great choice to keep you asleep and your liver from over producing glucose at night.
No one is perfect – even after New Year’s Day – but simple and consistent changes that come from you can be a benefit. Surprise your health care provider at your next visit with easy changes which will impact your blood sugars and improve your general health! Enjoy!
NOTE: Consult your doctor first to make sure my recommendations fit your special health needs.
She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past.
She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.