Daily management of diabetes

Healthy Diet

In the past, most people were engaged in labor work. Walking or cycling were their main means of transportation. The food people taken daily could only provide them with the necessary energy. In China, there were more than 10 million people who died of famine. Nowadays, because of the development of science and technology, a lot of manpower have been replaced by machines. Except in certain industries, most people work in comfortable offices with air-conditioning. Mass transportation and cars replace walking and cycling. The number of calories needed from food for modern people is reduced, however, the food they took is actually too rich. Food with high-lipid and polysaccharides are popular. In addition, people in modern society work for long hours, live under high pressure and lack of exercise. Various "rich diseases" were emerged with the development of modernization.

The most well-known food pyramid was introduced by the United States Department of Agriculture in 1992. The food pyramid was divided into four layers with six sections according to the amount of food required, and as a general guide for the proportion of the daily intake of various types of food.

The new food pyramid relaunched in 2005 no longer focused on the proportion of food intake. Instead, it recommended individuals should adjust the proportion of food intake according to the individual's age, physical condition and work nature, which also emphasized the importance of exercise to health. The Healthy Eating Guide designed by the Harvard School of Public Health in 2002 suggested reducing the consumption of red meat, potatoes and refined cereals such as white bread.

Diet control is also very important for people with diabetes. Besides controlling the consumption of carbohydrate and sugar, the source and quality of food are also very important. Fresh foods with no additive are the best choices. According to this principle, here are some tips for buying, cooking, and dining out.

Food Selection

Cooking Style

Eating out

Exercise and Health

To maintain physical and mental health, exercise is important for anyone. Regular and appropriate exercise can not only help maintain one’s body weight at an ideal level but also enhance an individual’s cardiopulmonary capacity, improve one’s overall physical fitness. When we exercise, our body cells will need more oxygen and nutrients. The lungs will allow more oxygen to enter the body, the heart will jump faster to facilitate the blood circulation of the whole body, thus the cardiopulmonary capacity is enhanced by constant exercise, thereby the risk factors of coronary artery and heart disease are reduced. Exercise also helps to prevent osteoporosis by strengthening our bone growth. Exercise accelerates blood circulation, promotes the absorption of minerals and nutrients, thereby effectively increasing bone density. Exercise also awakens bone cell and bone growth factors, thereby stimulate bone growth. In addition, exercise helps to sooth pressure and comfort emotions. During exercise, the body produces endorphins, which promotes the feeling of happiness.


Precautions

If diabetics have exercise contraindications, they should seek professional rehabilitation advice. Under normal circumstances, patients should not exercise after taking drugs to avoid hypoglycemia. If the fasting is too long, it is not advisable to exercise for too long. Diabetic patients who need insulin injections should not do intense exercise at dusk or at night to avoid hypoglycemia after sleeping. The best time for exercise is one hour after the meal. Under the premise of ensuring safety, patients should select a suitable form, duration, intensity, frequency of exercise (such as 5 days/week). Health indicators such as blood sugar and blood pressure should be closely monitored during exercise. The criteria for the termination in case of abnormality during exercise (such as hypoglycemia symptoms) should also be set.

Diabetes and exercise

Choice of exercise

  1. Adams OP. The impact of brief high-intensity exercise on blood glucose levels. Diabetes Metab Syndr Obes. 2013;6:113-122.
  2. Colberg SR, Sigal RJ, Fernhall B, et al. Exercise and Type 2 Diabetes. Diabetes Care. 2010;33(12):e147-e167.

Emotion, Stress and Health

When something happens, or the external environment changes might affect one’s feeling, emotion emerges. But why do different people have different emotions with the same incident? This much depends on how you interpret the matter. Each of us has a database of information that is used to interpret everything. Our own personal experience, the experience of others, the knowledge we learned, and our own character are the source of our database. This information affects our thoughts, which leads us to have different feelings on different things, resulting in different emotions.

Appropriate emotions provide important information to help people survive. Let you know: “What do you need?” When you know what you want, you can take action to satisfy your “needs”. Emotions also help to build up relationships with others, convey personal feelings. However, if a person is engaged in a negative emotion for too long, both physical and mental health will be affected. A lot of research has shown that when a person is in a negative emotional state for a long time, his lifestyle or behavioral factors might affect his health. For example, one may not take care of his own health, neglect nutrition, become isolated, making others unable to help, prone to depression or other emotional illnesses. Negative emotion may even affect our body physically, for example, when responding to grief, the immune system may release an inflammation protein, too high level of this protein for a long time is harmful to our body.

Stress usually refers to the "physiological" and "psychological" reactions to "difficulties and challenges" in the face of an external threat. The amount of stress experienced depends on how we evaluate the difficulties and threats. Pressure events, regardless of their extent, trigger the ancient "fight or flight" mechanism that activates the body's sympathetic nervous system. First, the stress hormone (cortisol) will be increased, causing a slight increase in blood pressure, making people more focused, sharp, and heartbeat accelerate. The liver will release more sugar for the brain and muscles to cope with the circumstance. While other unnecessary functions of the body will be suspended, thus mobilizing the body to cope with the crisis. When the crisis passes, the secretion of stress hormone declines. Now, another parasympathetic nervous system will be activated. This system mainly produces a balancing effect, which inhibits the excessive excitement of various organs in the body and gives them the necessary relaxation.

Short-term stress is beneficial to us. It keeps us active and alert under certain conditions, for example, coping with examination. Stress can help us concentrate on our revision. Appropriate pressure also can stimulate the immune system to initiate anti-defense mechanisms, such as promoting wound healing and resisting bacterial infections. However, long-term stress can destroy our health. If a person is under combat and anxiety condition for a long time, the digestive function will be inhibited or the secretion of digestive enzymes will be reduced for a long time, which will affect the health of the intestines. It will also weaken the activities of the immune system. Long-term stress keeps cortisol at a high level for a long time, which will increase blood pressure and blood sugar. The bone formation will be lowered and osteoporosis will result in the long run. Cortisol helps short-term emotional memory, but excessive cortisol can damage the hippocampus and affect learning ability.

Daily Glucose Monitoring

Although daily diet, exercise and stress management are important for diabetic patients, daily monitoring of blood glucose and self-test cannot be neglected. According to the “Control and monitoring guidelines” stated in the Hong Kong Reference Framework for Diabetes Care for Adults in Primary Care Settings by Centre of Health Protection, it is suggested that patients with type II diabetes who are using insulin should monitor their own blood glucose and adjust the insulin dose appropriately to prevent asymptomatic hypoglycemia and hyperglycemia. ¹

For non-insulin dependent patients, although self-test on blood sugar is unnecessary, the results of the research showed that patients who are guided by professional and develop regular self-test can help to improve blood glucose control² Patients should get advice from medical staff for the correct use of the blood glucose meter and understand those factors affecting blood glucose such as disease, stress, food intake, and exercise, and learn how to use the self-test result to adjust food intake and exercise.

If patients can adjust their diets and exercise regularly, their blood glucose can be maintained at the desired level. If the blood glucose can be kept at a normal level for a long time, or even below the desired level, patients can discuss with their doctors about a dose adjustment. This can help to reflect the treatment effect, timely adjustments to treatment, slowing and preventing multiple complications.

  1. McAndrew L, Schneider SH, Burns E, Leventhal H. Does patient blood glucose monitoring improve diabetes control? A systematic review of the literature. Diabetes Educ 2007;33(6):991-1011.
  2. International Diabetes Federation.IDF Guideline on self-monitoring of blood glucose in non-insulin treated type diabetes. [Internet]. Brussels(Belgium): International Diabetes Federation; c2010[cited 20 May 2011]. Available from: http://www.idf.org/guidelines/smbg-t2d
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