My type 2 diagnosis was in 2014 and my first reaction was, "how could this happen?" I was fairly active and had reasonably healthy food habits. However, some Q&A with the doctor revealed that family history of this condition, among other things, had its role to play in my case. Almost overnight, I pulled myself together, determined to take control.
I started making notes on what worked for me, and what didn't. As I educated myself and interacted with other diabetics, I found that there were others like me who were looking for information to help deal with this condition better. Having done my share of study, I made it my mission to help others like me cope better. I also started a blog where I posted bite-sized tips for living with diabetes.
Truth is, most people with diabetes handle maintaining normal blood glucose levels and blood glucose monitoring differently and there's no one-size-fits-all regimen. For instance, standard rules of diabetes will tell you to stay away from carbohydrate-rich foods such as rice and pizza, which are known to spike blood sugar levels. This is true for my uncle, but I can often get away with having a slice of pizza! This, then, begs the question, what's the best way to manage diabetes and achieve normal blood glucose levels? While carb counting, managing portion sizes can seem intimidating, everyone who lives with diabetes must set goals and work towards them.
Here's what worked for me.
My Diabetes Management Strategy
When I was diagnosed with type 2 diabetes, I tried to identify what spiked or lowered my blood sugar levels and how best to gain control. Tracking my A1C levels, blood pressure and cholesterol helped because managing diabetes is easier when you know what you're dealing with and where you stand.
Then, I reworked my lifestyle to reduce stress, stay active and exercise at least five days a week, eat healthily and get enough sleep.
I also developed a routine for getting blood tests, dental checkups, eye exams, A1C, cholesterol and weight checkups. Next, I devised a plan that prioritised normal blood glucose levels to ensure adequate energy levels, faster healing and fewer infections, all while lowering the risk of complications caused by diabetes.
One of the biggest challenges of living with diabetes is the "what to eat" conundrum. The dos and don'ts can be so confusing. While certain fruits can spike blood sugar, this may not be the case for everyone. Timing, as well as food pairing, matters. So here's what I do:
- Make meal plans for the entire week with breakfast, lunch, dinner and snack options.
- Make a shopping list based on this and shop for the ingredients.
- Whenever possible, prepare meals ahead of time.
- Explore diabetes-friendly dessert options, then make and store them according to portion size.
The interesting thing is, when I do this, I find that I am far more organized. When I am hungry, I can simply reach for something to eat rather than stress over what to eat! The common components in each meal are a huge help. One of the best pieces of advice I received about working towards normal blood glucose levels is this: Maintain regular meal times and eat at the same time every day. I try and follow this as much as I can, though on some days, it is an effort. I counter my tendency to slack off by setting a noisy alarm.
As far as food choices go, here's what works for me:
- Stick to fresh, green and leafy vegetables.
- Snack on fresh fruit to take advantage of fibre; avoid juices.
- Eat enough fibre and protein.
- Make salad compulsory with every meal.
- Do not have long gaps between meals.
- Minimize processed foods — as my grandmother loved to say, the longer the shelf life, the shorter our life.
- No white flour.
- Shop local; consume what's available in season.
- Make water the beverage of choice.
The diabetes food plate is a great guideline. On a nine-inch plate, fill:
- Half with nonstarchy vegetables (salads).
- One-fourth with protein (sprouts and lentils).
- One-fourth with starchy vegetables or whole grains (e.g., roti made from multigrain flour or millet flour).
- Depending on calorie goals, add a serving of fruit or dairy.
I always carry a small container of almonds and walnuts, an apple, a small water bottle, my ID and my medication. When I travel for more than a day, my bag includes some healthy dry snacks to combat delays in meal times.
Fitness is an integral part of managing diabetes. When I was diagnosed, I enthusiastically enrolled myself in a gym, but that wore off! So I shifted to brisk walking and invested in a pair of good walking shoes. Incidentally, I lost three kilos within a month when I dropped all processed foods from my diet.
Staying stress-free is a critical part of diabetes self-care. I do this with my hobbies, which include blogging, photography, travel, yoga and maintaining a daily gratitude journal. I take time out to appreciate myself.
Regular Health Checkups
I monitor my glucose levels once a month because this helps me adjust food habits and medication. I test both fasting and blood sugar levels after eating to understand how food affects me. I stick to my usual diet, but reduce fried and processed foods and take medications as advised. Regular visits to the doctor entail routine blood tests every three months to ensure everything is stable.
So, on a typical day, my routine looks like this:
- Wake up at 6 a.m. and have coffee.
- Fifteen minutes later, I take my medication, followed by breakfast in half an hour. Breakfast includes oats, broken wheat porridge, cooked oatmeal or a large salad with sprouts. I add a handful of nuts (e.g., walnuts, almonds, sunflower seeds, melon seeds). Getting enough protein during breakfast keeps me fuller longer and helps blood sugar management.
- My meals for the day are ready by 8.30 a.m.
- I start work at 9 a.m., but take frequent breaks and move around.
- Around 11 a.m., I have a cup of coffee with some fruit — an apple, a small banana or a bowl of pomegranate.
- Lunch is at 1 p.m. and this includes a large bowl of salad with cucumber, tomato, capsicum, shredded cabbage and sprouts. One cooked vegetable and rotis or brown rice are followed by a cup of curd or glass of buttermilk. This is sometimes repeated for dinner with a larger vegetable component and fewer rotis.
- I work from 2.30 to 4.30 p.m. and then take a short tea and snack break. This usually comprises khakras, oats and nuts mixtures.
- I head out for a walk at 5.30 p.m. and aim for 5000 steps on the pedometer app I've downloaded, which usually means 45 minutes. I finish with some stretching exercises.
- Around 7.30 p.m., I take my medication and then eat dinner with the family at 8.
- I'm usually in bed by 10.30 p.m., but sometimes I do stay up to watch TV.
In 2013, my A1C was 11.7 percent and the cholesterol levels were unmentionable. I pledged to bring this to the normal range, which is ideally less than 7 percent.
Here, I must emphasise the importance of diabetes education, as it helps us understand why and how to monitor and manage the condition.
Blood glucose monitoring, as we already know, is key to diabetes management. If you have diabetes, you probably self-monitor with a glucometer and take the HbA1c test, which offers the three-month weighted average blood glucose.
However, the HbA1c alone is not enough to manage diabetes. This is because two people with similar HbA1c can have different blood glucose levels during the day. Detecting the pattern of blood sugar lows (hypoglycaemia) or highs (hyperglycaemia) is important in determining treatment.
Today, this is possible through another parameter called "Glycaemic Variability" which assesses the patient's daily glucose patterns, and in combination with the HbA1c, indicates two things:
- how well the patient's blood sugar has been controlled
- the risk of long-term diabetes complications
Glucose variability is analysed through self-monitored blood glucose, continuous glucose monitoring, and HbA1c. The latest technology for studying glucose variability is the AGP or Ambulatory Glucose Profile, which is similar to the ECG in cardiology. AGP reliably tracks glucose variability to assess how close it is to the target range, thereby paving the way for making the necessary changes in diet and medication for better diabetes control.
Today, I've managed to control my blood glucose levels through lifestyle changes and oral medication. My HbA1c is currently 6.8 percent. It takes determination and discipline and sometimes it's hard to stay motivated, but I know that my self-care routine will help me prevent the long-term complications that can accompany diabetes.
Roping in family members to follow a healthy diet and lifestyle is more fun, for sure, especially because the support and encouragement are welcome! At the end of the day, it is about living a happy life, and I believe we owe it to ourselves to rewrite our diagnosis.
Disclaimer: This publication/editorial/article is meant for awareness/educational purposes and does not constitute or imply an endorsement, sponsorship or recommendation of any Products. Please consult your doctor/healthcare practitioner before starting any diet, medication or exercise.