Making changes to meet your diabetes management goals

Making changes to meet your diabetes management goals can have many long-term health benefits.  Most people select one thing to work on at a time: weight loss, exercise, or smoking cessation are cited as 3 of the top ten. For people with diabetes, these changes to achieve a healthier lifestyle can pay big dividends in the long run. Better-managed diabetes can reduce the risk of stroke, heart attacks, kidney damage, nerve damage, blindness and foot problems. There is also evidence to suggest better brain health in those adopting a healthier lifestyle. As for immediate benefits, better energy level, improved mood and improved blood glucose levels may be felt within a few weeks of making the change.

What is the impact of weight loss on blood glucose levels?

If the change to achieve weight loss is to choose food choices low in carbohydrate more often, blood glucose levels will improve as a result.

Weight loss in the range of 5% of total body weight has been shown to improve blood glucose levels.

What is the impact of physical activities on blood glucose levels?

When the body engages in physical activity, it allows insulin to work more efficiently. This is what happens: glucose will leave the blood stream and enter the target cells, mainly muscle cells with greater ease to provide energy, and blood glucose levels will improve as a result.

In people with diabetes that are not on glucose-lowering medication, physical activity improves the action of insulin that the body makes, while in those who are taking glucose lowering medications, it makes the medications work better.

When blood glucose levels start to improve as a result of physical activities and/or healthy eating, it may be necessary to adjust the type/dose of diabetes medications to ensure hypoglycemia (low blood glucose) does not occur.

Making changes to meet your diabetes management goals safely

1. Talk to the diabetes care team or your health care provider about the planned change. Ask for input to develop/assess the plan to make the changes.
2. Get to know the glucose-lowering medications. Identify those that are associated with a higher risk of causing hypoglycemia e.g. insulin secretagogues and insulin.
3. Continue taking your diabetes medications while making the changes
4. Make use of the diabetes tool - the blood glucose meter

• Monitor blood glucose levels before making the changes. Select testing times to fit your schedule. The “baseline” blood glucose levels and the pattern can help identify areas that require improvement.
• Keep monitoring blood glucose levels once the changes have been started. Compare results to baseline to note improvements.
• If the weight loss is achieved by severe restriction on carbohydrate food, perform blood glucose testing around the meal when the change is made to detect hypoglycemia if any.
• If you are taking an insulin secretagogue and plan to increase physical activity, consider carrying a supply of fast-acting carbohydrate to treat hypoglycaemia in case it happens during the period of activity.
• Perform blood glucose testing before and after the activity to note changes in the blood glucose levels.
• If the person is receiving insulin and plans to increase physical activity, ask the diabetes care team or health care provider for advice on the safest times to do the activity and appropriate times to monitor blood glucose levels after the activity.
• Consider carrying a supply of fast-acting carbohydrate to treat hypoglycemia in case it happens during period of activity.
• If hypoglycemia is detected as a result of changes in eating habits or during/after periods of activity, contact the diabetes care team or your health care provider so adjustments can be made to the meal plan and/or the most responsible diabetes medication.

Blogs written by experts on Diabetes Diet and Physical Activity are great resources.

We are all creatures of habit, changes to lifestyles require planning and perseverance, and being slow and steady will increase one’s chance to win the race.