OK, It’s A New Year, Now What?
You may have decided that it was ok to have a laid back attitude towards your diabetes care during the holiday season. Many of you may have splurged on all the goodies and tasty treats without blinking an eye and put your daily exercise on the back burner. There were too many obligations and needs that came before dealing with diabetes. The holiday season is now over and whether you were naughty or nice no longer matters. You may have lost momentum but now is the perfect time to get back to being pro-active about your health.
Today is the first day of the rest of your life and a great time to take charge. The holidays are a time when just maintaining weight is acceptable, but after the season is the time to refocus on shedding those unwanted pounds if you need to. The most important aspect of New Year’s resolutions is to make them stick. Do not let the initial motivation wear off. Try to make changes so they are realistic, specific and action oriented so they can be maintained. Let’s look at some easy things we can do to help make this New Year great while still controlling your diabetes:
Back to the Basics
These are the most basic things you can do to get back on track with your diabetes after the holiday season. Get your A1C checked every 3 months so there are no surprises later on. Since type 2 diabetes is progressive, what worked for you at one point may not work forever. I have counseled patients who went on “automatic pilot” practicing the same things with their treatment without getting their A1C routinely checked. Months later after developing hyperglycemic symptoms such as increased thirst, urination and hunger, along with fatigue and blurry vision, their blood sugars were checked and were way out of control. Test and record your daily blood sugars as well with a home glucose meter. Decide with your physician /diabetes educator when and how many times to check your blood sugars as it depends on certain factors including activity level, illness, medications and current A1C levels. Keep blood pressure and LDL cholesterol levels in check by going to your routine visits and using a home blood pressure monitor. Make sure to have a urine test for micro-albumin yearly and have a renal function test. Know your GFR and creatinine levels. Get a flu shot, through March, and by all means stop smoking if you smoke. Have a yearly dilated eye exam, see your dentist who will also evaluate your gums, brush and floss daily, and do not do “bathroom surgery” on your feet but do seek care from a podiatrist. Keep your feet covered at all times.
Even if you over-did it during the holidays, now is the perfect time to take action. Be familiar with the term “portion distortion.” This term, reported in a British medical journal, reinforces the use of a salad plate for meals along with smaller utensils often used by children. It is estimated that making this simple change can make the difference between “consuming 2000 calories per day down to 1420 calories a day regardless of the type of food.” Consider other simple tools including dry measuring cups or a small kitchen scale. Buy a Tupperware plastic plate with compartments and a lid. These tools help you “guesstimate” portions until you will be able to actually eyeball them. Do not cut back drastically during meals which will lead you to over-eat between meals or at the following meal. Eating erratically will play havoc with your blood sugars. Combine food groups and eat according to the plate method for simple meal planning. Generally a cup of starch such as sweet potatoes, quinoa, brown or wild rice, plus 4-6 ounces of a protein-skinless poultry, fish, or grass fed beef and 1/2 a plate of non-starchy vegetables, raw or cooked, should keep you satiated, help with weight control and blood sugars. The ADA recommends between 2-4 servings of a carbohydrate per meal but this may be too much if you are trying to lose weight and maintain good blood sugars. Check with a registered dietitian who specializes in diabetes to find out what is right for you. They can guide you if you are a vegetarian or vegan to still maintain proper blood sugar control. Remember, even eating protein in huge portions will add unwanted fat and calories. Learn to eat to satiation not to feel full, bloated or stuffed.
It is time to get a bit creative so you do not feel completely deprived after the holidays. Go online to reliable sites and search for snacks that are appropriate for people with diabetes. Drink a cup of chocolate-flavored, calorie-free tea with a cinnamon stick and a few drops of peppermint extract. This tastes like the holiday season without the calories, carbohydrates and sugar – compare that to a chocolate snack cake. Purchase mini chocolate rice cakes and top one or two with a teaspoon of natural almond or peanut butter. This beats a regular chocolate bar for better nutrition, blood sugar response and without the energy let down. Eat a small pear with a mini chunk of room temperature blue cheese for awesome flavor and wholesome goodness. Whole fat cheese does have saturated fat but also rich and delicious taste so eat in small amounts. Prepare homemade kale chips (kale leaves baked with a bit of olive oil and sea salt at 400 degrees until crispy) and serve with salsa made up of fresh onions, tomatoes, garlic, peppers and lemon juice. Healthful snacks are endless. They can be satisfying and ward off hunger. Get out of your snack rut which can help you forget about donuts and other empty snacks.
Up the Fiber
As a country, we are still below the recommended amounts of daily fiber intake. Eat non-starchy vegetables in abundance and fruit in moderation to keep fiber content high. Try to reach 25-30 grams a day. Most Americans eat around 15 grams or less daily. Fiber helps with feeling fuller sooner and helps blunt blood sugars.
Clean out the Kitchen
According to a 2015 study from Cornell University’s Food and Brand lab and published in Health, Education and Behavior “your environment plays a major role in your eating habits.” Think about what you currently keep on your counter tops for you or family members. Are there cookie jars in animal shapes or clear glass candy jars which make them difficult to avoid? Studies have shown that keeping a bowl of fresh fruit on the counter over cookie/candy jars creates lower BMIs. Instead of keeping these foods in the house as a temptation for you, let your family eat fruit in the house and candy and other treats when out. Avoid kitchen technology as much as possible whether it be a TV, computer, smartphone or any other device which will distract you from “mindful eating.” Sit down and eat with people or “in quiet” and stay focused on the experience.
Yes, don’t even say or think the word “exercise” since it often scares people. Saying you must walk for 30 minutes daily is very upsetting since certain people are not able to tolerate it. According to the most recent findings published in Diabetologia, “adults with type 2 diabetes saw lower post prandial blood sugars by taking 10 minute walks after each meal (3 a day) compared to walking 30 minutes at once at any other time. Make moving a habit by taking the stairs, gardening, or walking the dog. Get creative as long as you include some movement.
Winter is Here
It is the cold and flu season so, as always, take all the precautions you can to stay healthy during this season. The best way to guard against sickness is to wash your hands often. Use regular soap and water when you can. Eat foods flavored with spices that are anti-oxidants, anti-inflammatory, anti-microbial and some are even anti-diabetic. Add ginger, turmeric, sage, all spice, anise, cardamom and cinnamon for health promoting and disease preventing properties. Include foods with polyphenols such as frozen blueberries and cherries, green tea and yellow onions which can also boost immunity. Stay hydrated and eat hot soup to break up mucus and soothe inflammation if it settles in your throat or chest.
Lack of sleep (under 7 hours) increases cortisol levels which has a role in obesity, diabetes and heart disease. Tell your physician if you are having trouble falling asleep or staying asleep. There are lots of tricks to help you sleep including having a dark, cool room and winding down from noise and blue-light electronics at least 2 hours prior to sleep.
Beat the Post-Holiday Blues / Depression
People often feel “let down” after the holiday season since most of the friends and family gatherings are over. Social media slows down and we are not seeing so many updates through messages, group photos, vacation updates, and party invitations. These blues are also known as “Seasonal Affective Disorder”- (SAD), which affects over 10 million Americans especially during and after the holiday season. Symptoms may include: lack of self-care, feeling exhausted, uninterested, increased appetite and craving carbohydrates. This condition can be detrimental especially to someone with diabetes. It is more common in younger people especially females. Although people get off their routine during the holidays, SAD can cause them to stay off their routine which may lead to poor health. Ways to combat the blues and SAD is to get back on routine as soon as possible. Get moving and try to get involved with social affairs. Light therapy may be useful as well. This condition is more common in the northern region of the country where day light ends early about 4PM.
There is no better time to help you practice forgiveness than the New Year. Words and actions from others whether recently or the past can leave lasting feelings of bitterness, anger and the need for revenge. These feelings, which are very real to you, can eventually affect your health including rising blood pressure and blood sugars. Being able to forgive allows you to focus on the positive things instead of being consumed by the pain and hurt. Forgiveness brings “peace in your own life and existence.” Forgiveness doesn’t mean it did not happen and does not deny the other person’s responsibility for hurting you, but forgiveness helps set you free. It lowers your chronic stress, anxiety and hostility. It raises your immune system, heart health and self-esteem. Forgiveness must be a “commitment to a process of positive change.” The process is to learn forgiveness. The more aware you are, the more the process will take effect. You can work on forgiveness in this New Year by writing in a journal, praying, using meditation or speaking to a spiritual or religious leader, joining a support group, becoming a mentor, seeking conversation with a mental health counselor or loved one. You are not trying to change the other person who hurt you, but you are taking away the power the person had over you. This practice alone will improve your mental state of mind and physical health.
New Year’s is the perfect time to concentrate “on you” since you probably just spent the previous month catering to everyone else. Do not place too many demands on yourself but try to get back in the groove of love, care and respect for yourself. Remember 90% of diabetes care comes from you and how you live your everyday life. You can do this!
Have a question or comment? Post below or email me at RKleinman@adwdiabetes.com if you would like to share them with ADW diabetes.
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.