Diabetes Survival Guide

Diabetes, Diabetes Type 1, Diabetes Type 2, Healthy Living
on November 1, 2011

November is American Diabetes Month. The numbers are staggering: Nearly 26 million children and adults in America are living with diabetes and another 79 million are prediabetic, which puts them at a high risk for developing the disease. And the count, alas, is growing by leaps and bounds. In fact, nearly two million new cases are diagnosed each year, in part due to the combination of increasing obesity and decreasing physical activity. So what exactly is diabetes, why don’t more people talk about it, and given the stupendous statistics, what can we do to better manage the illness and reverse the trend?

Simply stated, diabetes is a defect in the body’s ability to convert glucose (sugar) to energy. Glucose, the main source of fuel for our body, is absorbed from the intestine and travels around the blood. But it can be effective only if it gets into the cells. Insulin, the pancreatic hormone that regulates blood glucose, is the key to opening these cells. For a person with diabetes, this process is impaired. In the chronic and more serious Type 1 diabetes, which generally occurs during childhood and adolescence, the insulin produced is virtually absent. In the more common Type 2, which usually affects adults over 45, insulin either is not produced in sufficient quantities or it just doesn’t work well.

While celebrities, singers, and sports stars such as Halle Berry, Nick Jonas, Jay Cutler, Salma Hayak, Mary Tyler Moore, Bret Michaels and even a Miss America, have gone public about their diabetes, there are countless others from every walk of life who still keep it a secret. Teenagers fear ridicule from their peers. And adults think that they may be considered social outcasts, treated differently by their friends as if their illness was somehow caused by improper behavior.

My friend Cathy claims she stopped telling people because she was tired of always feeling obliged to say either, “Yes! I am a diabetic. And Yes! I can eat that.” Or, “No! I didn’t get it because I ate too much sugar.” She also didn’t want her co-workers constantly hovering around her desk to hit her up for food because she had the best snack drawer in the office.

On the opposite end of the spectrum is Lauren Powers, a charming and articulate sixteen-year-old high school junior who was diagnosed with Type 1 just a year ago. Although she needs an insulin pump—what she refers to as her “bionic pancreas”—she wanted to share her experience to help and inspire others. “Diabetes can be difficult to deal with,” she admits. How did Lauren way out of what she calls “diabetes depression”? “Tell yourself that you are strong, you have survived this and you are going to survive no matter what,” she states emphatically. “It might be hard now, and it will be hard for the rest of your life, but listen when I say that diabetes doesn’t have to define you. You are not your injection scars, your medicine bills or your test results. You are not the shakes, nausea and hunger caused by low blood sugar. You are a normal person and this does not have anything to do with your beautiful spirit on the inside. So keep your heads up, fellow diabetics—and your blood sugar down.”

Despite the soaring numbers of diabetes diagnoses, there is a silver lining. “The good news is that if you develop diabetes today, all the tools are already available to turn it into a minor inconvenience rather than a major health issue,” says Dr. Alan Rubin, a leading diabetes expert and author of the Diabetes for Dummies series of books. “Diabetes should not stop you from doing what you want to do with your life. But to maintain a glucose level that is as normal as possible, you have to better manage your lifestyle and reverse any bad habits.” The following are 12 suggestions that will help make your life better, if not sweeter.

Doctor’s Orders

Help your doctor help you.Although huge strides have been made in the medical community, lifestyle modifications such as losing weight, adopting a healthy diet and exercising regularly can make an enormous difference in avoiding the more serious complications of diabetes such as heart attacks and strokes, says Dr. Robert R. Henry, president of medicine and science at the American Diabetes Association. “It doesn’t take a lot of weight loss and exercise to have dramatic benefits,” he says. “Start by simply losing 20 pounds or five to 10 percent of your body weight by eating a diet that is low in calories, saturated fats, cholesterol and simple carbohydrates.” Stop smoking, he suggests, to cut heart attack and stroke risk even more, and exercise 30 minutes five days a week. ”Be it walking, bicycling or swimming, itwill have a positive effect on both your lipids and glucose level,” he says. Since millions of children in this country are obese or significantly overweight and therefore at risk of developing the disease, Henry has advice for parents as well. “A healthy lifestyle does not only mean diet,” he says. “It’s up to you to drastically curtail TV, computer games and X-Box time and encourage your kids to go out and exercise.”

Emotional Health

Lower your stress level.“Stress has been linked to diabetes because it impacts counter-regulatory hormones like epinephrine and norepinephrine, which can lead to an increase in blood sugar.” says Dr. Richard S. Surwit, professor of medical psychology at Duke University Medical Center and author of the book The Mind-Body Diabetes Revolution: The Proven Way to Control Your Blood Sugar by Managing Stress, Depression, Anger and Other Emotions. “These hormones are those primal forces that give you zip when you really need it. But they’re also released when your body senses smaller stressors.” According to Surwit, people with diabetesare more responsive to stress than others. “Their bodies, because of their lack of sufficient insulin, cannot handle the increase in blood sugar that the hormones produce. In addition to showing up physically in the form of heightened blood glucose levels, stress may negatively impact eating behavior which can also increase blood sugar.” To counteract stress, the doctor recommends the following exercise: Slowly flex your feet as much as is comfortable. Hold them in this position for 10 seconds, thinking about the tension you feel. Then, think the word relax and let the tension go. As you do this, be mindful of the relaxation. Gradually work your way from your feet to your head, tensing and releasing each muscle slowly and mindfully.


Arm yourself.“There are four secret weapons to not only controlling diabetes, but to beating Type 2 altogether,” contends Dr. Howard Shapiro, author of the bestselling, Eat & Beat Diabetes with Picture Perfect Weight Loss.Fiber, he says, slows the process by which sugar enters the bloodstream, reducing blood glucose spikes and helping to maintain insulin levels. Phytonutrients, such as lycopene in tomatoes and beta-carotene in carrots, are “powerhouses of blood vessel protection,” important because many of the complications of diabetes result from damage to the body’s blood vessels. Soy protein helps regulate glucose and insulin levels, and lowers the risk of cardiovascular disease and its severity. And finally, monounsaturated fats found in olive oil, peanut oil, canola oil and nuts, and the polyunsaturated ones in corn oil, safflower oil and sunflower oil—also called omega-6 oils—all decrease both total and LDL cholesterol levels and may decrease insulin resistance.


Build up your body.As Henry noted, exercise leads to lower weight and overall better health and it’s also linked better blood sugar regulation. To that end, I askedcelebrity trainer Gunnmar Peterson whose clients include Halle Berry, Jennifer Lopez, Kim Kardashian, Sophia Vergara and numerous NBA and NFL stars for his advice: “While exercise may not be a cure for diabetes, it certainly helps in a big way.Not only does it lower blood pressure, but it has been shown to control and reduce blood glucose levels which are the source of energy in our bodies. Strength training in particular, because it increases muscle and reduces fat, can be extremely helpful for people with diabetes.”


Join the tea party.Celebrated skin care guru Joanna Vargas whose devotees Rachel Weisz and Zac Posen flock to her namesake spa in Manhattan suggests a creative solution for the dry, itchy skin that’s common among people with diabetes.  “Whereas many would think to just slather on a heavy cream, this will probably not handle the problem,” she says. “The itchiness is more of a symptom of sensitivity.” Avoid hot water showers and baths, which can be further irritating and drying. “I also highly recommend taking a bath once a week with chamomile tea bags and rosemary steeping in the water. It will calm the skin so you can have a great night’s sleep,” Vargas says.

Natural Remedies

Sweet dreams.And speaking of sleep: Dr. Eva Schernhammer, associate professor of medicine at Brigham and Women’s Hospital and Harvard Medical School says that poor sleep habits can throw off your biological clock, which may induce changes in blood sugar levels. “So good sleep hygiene is another lifestyle factor that can be adjusted to beneficially affect blood sugar and other important body functions.” To foster a good night’s sleep, she suggests exercising early in the day, going to sleep and waking at consistent hours and avoiding caffeine in the evenings.


Go with the pros.Whether you have just been diagnosed or have had diabetes for some time it is important that you find the right support team, says registered dietitian and diabetes educator Caroline Bohl of the Columbia University Medical Center. “This will help to ensure that your diabetes, blood pressure and blood fats are all kept in check as well as detecting any early signs of complications so that they can be caught and treated successfully,” she says. To that end, seek out Certified Diabetes Educators (CDEs), health professionals such as nurses and dietitians who have undergone special training to enable them to give patients valuable information on how to self-manage diabetes through proper nutrition, appropriate physical activity, medication management, risk-reduction and glucose monitoring. To locate a CDE in your area, ask your doctor or contact the American Association of Diabetes Educators. Check, too, with your doctor or local hospital about finding local support groups and topical lectures


Get in balance. “As a hospital chaplain I have witnessed diverse responses of those living out their lives with diabetes,” says the Reverend Dr. Terry L. Wilson chaplain/manager of pastoral care at the Medical University of South Carolina. “Some diabetics are compliant with their prescriptions, dietary restrictions and daily exercise while others are not. Life is fragile and we are stewards of this precious gift. One’s stewardship in regard to a life with diabetes has the potential of life threatening consequences. The message of diabetes is clear: Things are out of balance and need to be restored.”


Step up to the plate. Try a simple strategy for healthy nutrition from the American Diabetes Association called “Create Your Plate.” This will help you figure out which foods to eat and how much. Here’s how it works: Draw an imaginary line down the middle of a dinner plate, then divide the left side of your plate once more into two equal sections. Now you have three sections on your plate—two small and one large. For every meal, try to fill the largest section with nonstarchy vegetables such as spinach, carrots, lettuce, greens, green beans, broccoli, cauliflower, tomatoes or cucumbers. In one of the small sections, place starchy foods such as whole-grain breads, rice, pasta, tortillas, peas, potatoes, corn, lima beans, low-fat crackers or chips or pretzels. In the other small section, put low-fat meat such as a deck-of-cards-size piece of chicken, tuna, salmon, cod, lean beef or pork; or go with high-protein meat substitutes like tofu, eggs, or low-fat cheese. Add a low-fat drink and a piece of fruit for dessert. Getting in the habit of organizing your meals this way can help make healthful eating a little easier, which can make a real difference when it comes to managing your diabetes.

Healthy Home

Be prepared. “Keeping healthy food options readily available at home helps people with diabetes follow their meal plan,” advises Dr. Judith Wylie-Rosett, professor and head of health promotion and nutrition research at Albert Einstein College of Medicine, Bronx, NY. “If the freezer is stocked with frozen vegetables and lean meats, it makes fixing a quick healthy meal much easier and reduces the temptation for high calorie take-out food.”  Also stock snacks such as low-fat yogurt, fresh fruit, baby carrots and precut vegetables, string cheese and reduced fat cheeses.


Start with small steps. “Taking small steps—such as losing a modest amount of body weight,  following a low-calorie, low-fat eating plan and building up to 30- minutes of walking or another moderate physical activity a day, five days a week can yield big rewards,” says Joanne M. Gallivan, director of the National Diabetes Education Program at the National Institutes of Health. “Millions of people could delay Type 2 diabetes for years, and possibly prevent it all together which can mean a healthier and longer life without serious complications from the disease.” Indeed, that is the important message of the Institute’s Small Steps, Big Rewards Campaign this month. For more information about the program, click onto their website, http://ndep.nih.gov/am-i-at-risk/

Giving Back

Rally for the cause.November is the time to rally individuals, communities and families to Join the MillionsSM in the movement to Stop Diabetes®. This year, the American Diabetes Association is asking individuals to take a pledge and raise their hand to Stop Diabetes. Tools are available now to help spread the word for companies, community organizers and health care professionals. Beginning this month, the public can take action by: 1) Visiting www.stopdiabetes.com 2) Calling 1-800-DIABETES, or 3) Texting JOIN to 69866 (standard data and message rates apply).