When I was first asked to write a piece about resolutions for the New Year, I thought, “This will be easy.” But as I sat down to think about all the things I wish I could do this year, I was a bit overwhelmed.
The first piece of advice I can give you is this popular quote, which has become my mantra: “If you do what you have always done, you will get what you have always gotten.” In other words, change is essential to making life improvements. The good news is that you don’t need to change everything all at once; small changes make some of the biggest impacts. So, are you ready to change?
If you currently smoke, this is the single most important change to make. The toxic effects of smoking are only amplified if you have diabetes. Smoking is the leading cause of avoidable death in this country causing nearly a half million deaths each year. It is even postulated that smoking can lead to diabetes. Complications of diabetes occur more frequently in smokers. There are many ways to quit smoking, including nicotine gum and patches as well as hypnosis and even prescription medication.
Cut down on the “bad fat”
Of course cutting all fats out of our diet is unrealistic and really not all that healthy. There are, in fact, good fats and bad fats. Learning to tell them apart is an important step in a healthy diet.
Saturated fat and trans fats are “bad” fats because they can lead to blood vessel damage. Saturated fat is found mainly in animal sources and includes high-fat cuts of meat such as steak and lamb and palm and coconut oil. Trans fat occur mostly through hydrogenation, a process that turns liquid oils into solids. Some sources of trans fat include French fries, cookies, cakes, stick margarine and vegetable shortening. Trans fats have even been thought to impair insulin sensitivity.
Limit your saturated fat intake by switching to reduced fat products where you can. For example, you can replace red meat with beans, poultry or fish. Sprinkle chopped nuts or sunflower seeds on salads instead of croutons. Use liquid vegetable oil instead of butter or shortening.
Take care of your feet
More than half of all non-trauma-related amputations in this country occur in patients with diabetes. The good news is that the majority could have been prevented with the proper foot care. It’s estimated that one out of five people who are hospitalized have come in with a foot problem. Due to the potential for poor circulation leading to foot problems, good habits are important to follow regarding foot care, including periodic visits to the podiatrist for evaluation. Make sure you have good shoes; many health plans cover therapeutic shoes for patients with diabetes.
For more on diabetic foot care, including symptoms, prevention tips and a daily foot checklist, read this series by Diabetic Connect advocate Amy Tendrich.
Watch your blood pressure
Sometimes we can get so involved in blood sugar control, we forget the rest of our health. High blood pressure can be dangerous by itself, and if you have diabetes high blood pressure can cause significant health problems if it’s not controlled. If you have high blood pressure it is very important to take your medication regularly and periodically monitor your blood pressure at home or in stores where you find monitors available.
Blood pressure is measured as systolic and diastolic pressures. Systolic blood pressure is when the heart beats while pumping blood. Diastolic refers to blood pressure when the heart is at rest between beats.
According to the National Institute of Health, systolic pressure is high if it is consistently above 140 and diastolic is above 90. A systolic reading of 120-139 or a diastolic reading of 80-89 is considered pre-hypertension. These are general guidelines; Blood pressure, like blood glucose, is often somewhat individualized to a given patient. Your health care team will decide what blood pressure is right for you.
Exercise has gotten a bad rap over the years because of perceptions that if you don’t experience “pain” while doing it, you get no benefit. Visions of sweaty towels on treadmills evoked a panic attack from many patients whose doctor prescribed exercise for better health. We now know that exercise can take many forms such as tennis, rowing, cleaning house and walking the dog. It’s about movement. You don’t have to enter the NYC marathon to get exercise. If you love to garden, then hours spent digging and planting does not “feel” like work to you.
The U.S. Department of Health and Human Services guidelines for exercise recommend 150 minutes per week of moderate intensity aerobic activity. A 20-minute session devoted to muscle strengthening two or more days per week is also recommended. The guidelines are not meant for all patients, just as blood sugar goals are slightly different for each patient.
Before starting any exercise program you need clearance from your health care team, especially if you have been sedentary for a long period of time or have any other underlying health issues. If you are just starting to exercise after being sedentary for a while, one thing is for sure: you have to start slow. It’s easy to hurt yourself if you start an exercise program without some professional guidance.
It is critical to make sure you take excellent care of your teeth and gums to avoid getting infections, especially if you have diabetes. Regular cleanings and visits to the dentist are so important. Infections that start in the mouth can lead to systemic problems quickly.
Blood glucose control plays a role here, too. When diabetes is not controlled properly, high glucose levels in saliva create a ripe environment for bacterial growth. The bacteria releases acids derived from sugars that you eat that attack tooth enamel causing plaque build-up and cavities. Plaque that is not removed can eventually harden and cause gum problems. This can lead to chronic inflammation and infection in the mouth. Thus, diabetes often causes periodontal disease, which in turn affects blood sugar level control, creating a cycle that becomes hard to break once it starts. Gum disease has also been linked to other health problems. These include atherosclerosis, heart disease, stroke, premature births and respiratory disease.
Remember: One step at a time. Don’t try to change everything all at once. Pick something you want to change and start small. I am going to commit to flossing; I may not do it every day, but I will try. Share your first steps and resolutions in this discussion thread. We can cheer each other on to a better life.
Happy New Year to all!