DIABETES MANAGEMENT

1. DIET CONTROL

There is clear evidence that diet control and weight loss in obese Type II diabetics, leads to improved carbohydrate metabolism, thereby reducing the amount of medication required to control glucose levels. Special attention should be paid to periods of illness, exercise and travel. Diet planning by a professional should be sought, but as a general guide:


• Diet should include foods from each of the basic food groups.

• Saturated fats less than 10% of total calories.

• Carbohydrates 50-60% of total calories.

• Protein 15-20% of total calories.

• Consume 20-35 g of dietary fibre from a variety of food sources.

• Diet should contain adequate vitamins and minerals.

• Cholesterol limited to <300 mg per day.

• Sodium intake limited to < 2 g per day if hypertensive as well.

• Abstain from alcohol.

• Use of artificial sweeteners within safe limits.

2. EXERCISE & WEIGHT LOSS

Maintain a sensible exercise plan to suit your age, aptitude, fitness and interest. Your doctor will often do a pre-exercise evaluation. If you have not been exercising for a while, start off slowly then build up intensity and duration as your fitness level improves.

Guidelines For Exercise:

• Frequency : 3-5 days per week (daily if exercise of low intensity)

• Intensity : 60-85% of maximum heart rate (or until you feel warm and sweaty)

• Duration: 20-60 minutes each time

• Type: Aerobic exercises such as brisk walking, jogging, cycling, swimming

Precautions For Diabetics When Exercising:

• Use proper footwear to reduce chance of blisters and other foot injuries

• Adequate hydration before, during and after exercise

• Avoid exercise during periods of acute illness or if severely hyper or hypoglycaemic

• Dose of medication may have to be reduced prior to exercise. This should be discussed with your doctor

• In patients with severe diabetic retinopathy, activities such as weight-lifting and heavy competitive sports should be avoided.

3. MEDICATION

Oral diabetic medication helps control blood sugar levels in those whose bodies are still able to produce some insulin.  Remember, from our previous discussions, type II diabetics either don't make enough insulin, or have tissues with increased resistance to circulating insulin (or a combination of both).


Over time, type II diabetics may develop into what is known as "beta-cell failure" - when the beta cells, which are responsible for insulin production, can no longer produce insulin.  When they reach this stage, they will have to depend on insulin injections, either in combination with oral diabetic medication, or on its own.

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