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You Were Just Diagnosed

Now you are thinking. . . what do I need to do to manage my diabetes? How much should I change my daily habits? There is a lot of information out there and I am confused on how to deal with it all.

Well, you do need to change but it won't necessarily be too painful.

Whether diagnosed as Type 1, Type 2 or gestational, you need to take four important steps to start managing your diabetes:

1. Pay close attention to the things you eat
2. Exercise or start being more active daily
3. Measure your blood sugars
4. Advice from Nutritionist, Diabetes Educator and a support group will also help you get on track

But now you need to know the nutrients, carbohydrates, or exchanges of the food you eat to balance the foods you like for every meal. It is not as hard as you think. After a while, you start learning what are the right combinations and portions.

Foods high in carbohydrates (carbs) raise your blood sugar levels the most. Some of them include bread, potatoes, tortillas, rice, crackers, cookies, cereal, fruit, juice, milk, yogurt, potatoes, corn, peas and sweets.

The American Diabetes Association (ADA) states that "for many people, having 3 or 4 servings of a carb choice at each meal and 1 or 2 servings at snacks is about right."

Servings should not be large portions and you will need to be able to recognize measured portions at a glance. The USDA provides the following to help you:

• Deck of cards = 3 ounces of cooked meat or poultry
• Golf ball = 2 table spoons of peanut butter
• Baseball = medium fruit
• Hockey puck = medium bagel
• Computer mouse = medium potato
• 9 Volt Battery = one and a half ounces of cheese
• CD = size of a pancake

The challenge is for you to mix the right foods and balance them. Ideally, according to the ADA, a plate should have ¼ carbs, ¼ proteins and ½ vegetables.

Also remember that there's no limit on vegetables that are raw or prepared without fat. If you choose lean grilled or broiled meats, again you can eat as much as you like. The only caveat here is if you have kidney problems. In this case, consult a nutritionist for advice.

Following a meal plan and/or tracking everything you eat should be the first step in taking control. You will be amazed to know the amount of carbs and fats in foods you eat everyday.

If you watch the serving sizes and balance the foods you like to eat, you do not need to give up that much. A good check is to measure your sugar before a meal, log what you eat, and 2 hours later check your blood sugar again. You will be able to determine how the foods you just ate affected your sugars.

Summary

• Cut back on serving sizes instead of giving up favorite foods
• Keep track of what you eat
• Have a vegetable every time you have a meal or a snack. And replace all candy and sweets with a small fruit. If you really like that chocolate, eat a piece, but give up something else to compensate for that. Or even start walking 30 min a day to burn what you just ate. Choose solid chocolate instead of filled to reduce sugar and caloric intake
• Start cooking with less fat
• Eat smaller portions
• Buy smaller packages of pre-processed food instead of the "Family Size" options for your own consumption

You don't need to rush to the nearest fitness center to sign up, although that would be awesome. You just need to start moving more. You can select activities you like doing and make a commitment to do them, 5 days a week, even if you start with only 5 minutes a day. Is an ADA Walkathon coming up? Join it!

Any aerobic type activity increases your metabolism and helps you reduce your blood sugars. The easiest way to start is by walking. Make a point to walk every day. Maybe earlier in the mornings after your breakfast, or later in the evening after your dinner. Because activity lowers your sugars, it is better for you to do it after you eat and not before. Eating a little (remember that you are controlling what you eat), allows you to exercise and avoid a possible low blood sugar episode.

Make a quick test by measuring your sugar before exercising and 1 hour or so after, to see how much your sugars went down due to the exercise.

If you are already more active, please continue to be and if possible add a little to it. Getting and staying fit lowers your sugars and reduces the chance of complications.

Summary

• Start slow
• If you are at risk of cardio vascular disease, or if you had an episode, please consult your doctor before starting any exercise
• Increase gradually
• Do things you like so you can stick with it
• Be consistent

It's hard and sometimes painful, and yes it is costly too. But your health is more valuable than anything. A good strategy is to measure more often when you are just diagnosed to better understand how you body behaves. So measuring when you wake up before meals, 2 hours after meals and at bed time will help you chart how you are doing. But remember, to really find out how you are doing, the blood sugars need to have the meal and exercise information associated with them. This way you can see what raises and lowers your sugars and by how much.

Then you can start learning about the changes in servings and foods more accurately and start better managing your diabetes. You will see results, more stable sugars, fewer mood swings, and better blood pressure. To sum it up — you will be healthier.

Summary

• Check blood sugars more frequently, at least initially, to learn more about you
• Log your food intake and exercise to correlate the information with your blood sugar measurements
• Joslin Clinic recommends the following as normal ranges for diabetics with no complications:
  • Before breakfast (fasting), lunch, supper, or snacks 90-130
  • Two hours after meals <160
  • Bed time 110-150

can take away a lot of the administrative burden of diabetes management. Try it! You will feel a difference in 30 days.

Adapted by Editorial Staff, April, 2005
Last update, July 2008