Managing the risk of diabetes

Because of their sedentary lifestyle, wheelchair users may battle with diabetes. Janene Sacks provides some insight into managing the disease

Diabetes affects the body’s ability to make or use insulin properly. Type 1 diabetes is often a condition from birth in which the body doesn’t produce insulin. Type 2 diabetes can be developed later in life and affects how the body responds to insulin – the hormone that helps cells store and use energy from food.

Insulin enables glucose, or sugar, to enter the cells so they can use it for energy. If you have diabetes, unused glucose collects in the blood; thus your body is not getting the energy it needs. Also, the high levels of glucose circulating through the body can damage cells along the way. Diabetes increases the risk of having a heart attack and stroke or sustaining kidney, eye and nerve damage.

Being overweight is a risk factor for type 2 diabetes. In overweight individuals with diabetes, modest weight loss may help improve insulin resistance and glycemic outcomes. Modest weight loss means losing about five to seven percent of your total body weight. For example, at a weight of 80 kg, modest weight loss would equate to shedding four to six kilograms.

In addition to body mass index, other physical measurements, such as body fat percentage, distribution of body fat and waist circumference, are important methods of assessing overweight and obesity.

You can prevent or delay type 2 diabetes by making diet changes, maintaining an ideal body weight and being active. These steps also lower your risk for diabetes complications. Visit a registered dietitian to learn about lifestyle changes that can reduce your risk for diabetes, and consult a biokineticist for advice on exercises that take your disability into account.

Once diagnosed, diabetes is manageable with a few lifestyle changes. First, it is important to keep blood glucose levels within a normal range (or as close as possible) to prevent or reduce complications, including the risk of heart disease and stroke.

In addition, the patient should keep their blood pressure within a normal range, ensure a healthy cholesterol level and take steps, such as losing weight, to prevent or slow complications. People with type 2 diabetes can help control blood sugar levels through diet, physical activity and, in some cases, a combination of medication and insulin injections.

Choosing nutritious food and watching your portion sizes can help you control blood sugar levels. General healthy eating tips for a healthy weight and to control blood sugar levels include eating a variety of foods from each food group every day; limiting foods with added sugar; eating smaller portion sizes spread out over the day; and choosing whole grain, fruit and vegetables over sugary drinks and refined, processed foods.

It isn’t necessary to cut out carbohydrate-rich foods, but there should be a balance spread evenly throughout the day. Saturated fats can be swapped for healthier alternatives such as avocados, olive and canola oil, and nuts. Choose lean meats such as poultry and fish whenever possible.

Bake, broil, roast, grill, boil or steam food instead of frying it. Also, stick to low-fat or fat-free dairy products. Limit your consumption of alcohol. Use less salt and more pepper and herbs for seasoning. Avoid skipping meals – this can make you more hungry, moody and unable to focus.

Learn what works best for you. Some people like three meals a day, others enjoy two meals and two snacks. Find an eating pattern that is healthy for you and stick to it.

If you have been diagnosed with diabetes, a registered dietitian can create a simple eating plan for you, which will consider your medications, lifestyle and any other health problems. Expert advice can help you manage your diabetes while ensuring you get the nutrients your body needs as well as the correct amount of carbohydrates, proteins and fats in your diet.

Janene Sacks is registered with the Health Professionals Council of South Africa and the Association of Dietetics in South Africa, and is a DNAlysis practitioner. She has been in private practice for more 20 years and strives to improve the health and wellbeing of her clients through personalised nutritional advice and counselling.

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