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Lifestyle & Management
Managing Diabetes with Diet and Exercise
Healthy eating and exercise is very beneficial for people with diabetes. They can improve your overall health, help manage your blood glucose level, and decrease your risk of the complications of diabetes.
Your healthcare providers will help you design a diet and exercise program that is right for you. They will help you increase your level of physical activity safely and gradually, so you can keep it up over time. Your diet and exercise plan will also take into account any other illnesses or physical limitations you may have. Your healthcare provider may also have you work with a dietician to help you develop a healthy food plan that you will enjoy.
Choose Healthy, Low-calorie Foods—and Watch the Calories
To help manage your blood glucose levels, you need to control the number of calories you eat each day. But you don’t have to give up taste and satisfaction! Here’s how to eat well and healthfully when you have diabetes:
- Eat smaller portions at each meal. If you eat out, share what you order with a friend or bring home part of your meal to eat the next day.
- Eat cereals, breads, and pasta made with whole grains instead of white flour. Substitute brown rice for white rice and sweet potatoes for white potatoes.
- Read labels on foods such as cereal, bread, and pasta. Choose those containing at least 3 grams or more of fiber per serving.
- Eat a variety of brightly-colored, low calorie fruits and vegetables. Aim for 6 to 9 servings a day. Especially good choices include leafy greens (such as spinach, chard, kale, collards, mustard greens, and dark green or red lettuces), broccoli, broccoli rabe, red peppers, carrots, berries, cherries, apples, pears, and citrus fruits.
- Drink water or unsweetened tea instead of fruit juices, soft drinks, or other beverages high in sugar.
- Avoid eating processed and prepared foods. These foods are often loaded with fat, calories, and sodium, plus they can contain unhealthy ingredients such as trans fats and high fructose corn syrup.
- At fast food restaurants, choose the salad option (with low-fat dressing). At family-style restaurants, choose broiled poultry, fish, or lean meat entrees with steamed veggies. Skip cheesy, buttery or creamy sauces. Choose oil and vinegar dressings on salads.
- Limit the amount of alcohol you drink.
- Less than 20-35% of your total daily calories should come from fat. The healthiest fats are found in foods such as whole grains, avocados, walnuts, almonds, sunflower seeds, peanut butter, and fatty fish (such as salmon, sardines, mackerel, herring, and trout).
- Choose olive and canola oil for cooking and salads.
- Choose foods high in protein, including eggs, low-fat dairy products, lean meats, poultry, fish, beans, and nuts.
- Your diet should also be high in fiber and appropriate vitamins and minerals.
- Save desserts and other sweet treats for special occasions. Choose fruit canned in its own juice instead of sugar syrup.
Exercise is essential for losing weight and controlling your blood glucose. Even small increases in physical activity can help.
People with pre-diabetes or diabetes should try to exercise 20 to 30 minutes at least three times a week. If you are able to, there is even greater benefit in exercising 20 to 30 minutes on most days.
Activities such as doing yard work or cleaning the house count as exercise, as long as they increase your heart rate and cause you to sweat lightly. Walking, swimming, and water aerobics are also great forms of exercise.
Exercise can be more fun if you do it with a friend or a group. Exercise classes are available at many local hospitals, community and senior centers, and adult education programs. An exercise teacher can help guide you on how to prevent injuries and modify activities for any physical limitations you may have. You may check with your insurance plan if you are eligible for a “silver sneakers” program. This program provides people 65 and over with free access to local fitness centers.
Other Important Steps in Managing Your Diabetes
Taking an Active Role in Your Treatment
Medicare pays for a visit with a diabetes educator once every year. Ask your healthcare provider to give you a referral. The educator will teach you how manage your diabetes and will work with you to develop a self-management program.
It is important that you know everything you can about how to manage your diabetes. Therefore, you should feel comfortable asking the diabetes educator as many questions as you need to, as often as you need to. Make sure you fully understand the answers to all your questions, and ask the educator to explain anything you do not understand.
If you need help, your family or other caregivers should also receive training and become involved in your diabetes self-management. Caregivers may need to take over the self-management program if an older person with diabetes begins to have mental difficulties or becomes significantly disabled.
Despite your best efforts, you could experience problems. If you have any of these symptoms, call your healthcare provider at the first sign of trouble.
Very High Blood Glucose
This is an uncommon but serious complication of diabetes that occurs most often in older adults. A spike in glucose can be caused by a sudden illness, particularly an infection, or certain medications. Watch out for these symptoms:
- Physical weakness
- Lack of energy
Low Blood Glucose
Low blood glucose usually occurs when you take too much of your diabetes medication, or if you skip a meal. Illness and infections can also cause low blood glucose. Watch for these symptoms:
What to Do
It can be easy to confuse symptoms of low and high blood sugar. Therefore, you should measure your blood glucose level at the first sign of any unusual symptoms, and then call your healthcare provider right away. If you are unable to measure your glucose, call your provider promptly.
If your blood sugar tests low, you should be able to raise it quickly by having some sugar. You can eat a piece of candy, have a spoonful of honey, or drink a glass of fruit juice. That’s why it’s a good idea to keep hard candies handy, just in case. However, this sugar boost only lasts a little while. Therefore, it’s important to eat a meal as soon as possible.
If your low blood glucose is frequent or severe, your healthcare provider will need to check your diabetes treatment plan and change it if necessary. You may just need a better plan for controlling your blood glucose levels. You may also need to visit your healthcare provider more frequently for check-ups, or see a diabetes care specialist.
Understanding Your Medications
You need know about all the medications you are taking, not just your diabetes medication. Ask your healthcare provider(s) to tell you about each medication prescribed for you, including:
- Why you are taking it
- How and when to take it
- Common side effects
Extreme or chronic stress can raise blood sugar levels. Though you can’t avoid stress, you can learn to manage your reaction to it.
These tips can help:
- Don’t put unnecessary demands on yourself. Try to avoid being a perfectionist or workaholic.
- Schedule time for things you enjoy, such as socializing with friends or family, gardening, singing or playing an instrument, or doing crafts or other creative activities.
- Keep a positive attitude and focus on the things in your life that are going well.
- Talk to your spouse or partner, a close friend, a family member, or a counselor or clergy member about the things you find stressful.
- Exercise. It is an excellent way to relieve stress.
- Learn and use simple relaxation techniques, such as listening to calming music or sounds, deep breathing, muscle relaxation, or meditation.
Complications of Diabetes
Over time, high levels of sugar in your bloodstream can damage your nerves and the small blood vessels in your heart, kidneys, and eyes. This puts you at higher risk for visual impairment and blindness, and for developing heart and kidney problems.
Serious health conditions that are often caused by diabetes include:
- Heart disease
- Blood vessel problems, such as narrowing of the arteries
- Nerve problems (usually burning, tingling, or numbness of the feet or hands)
- Foot problems (sores or nerve problems)
- Eye problems (including impaired vision or blindness)
- Kidney problems
- Erectile dysfunction
Cardiovascular disease is the major cause of illness and death for people with diabetes. Because heart problems are so common with diabetes, your healthcare provider will check for other conditions that can also cause heart trouble, such as smoking, high blood pressure, being overweight, high cholesterol, and a family history of heart problems. If you have high cholesterol, your healthcare provider may prescribe statin drugs. These drugs are more helpful for patients with diabetes than for those without diabetes.
Preventing and managing risk factors for heart disease in older adults with diabetes is especially important. These steps include:
- Losing weight if necessary.
- Increasing physical activity.
- Quitting smoking. The benefits of quitting are much higher in patients with diabetes. Quitting smoking is even more beneficial than controlling blood pressure or cholesterol level to reduce the risk of death.
Diabetes can cause blood vessel and circulation problems. This means that people with diabetes are at very high risk for serious foot problems. Unfortunately, these foot problems can even lead to amputation. Therefore, taking excellent care of your feet is a very important part of diabetes management.
Your healthcare provider should examine your feet at least once a year, and you should examine your feet every day. Tell your healthcare provider right away about any changes to your feet or any signs of damage, including sores or discolored toes.
You must also take good care of your toenails to prevent foot infections. Ask your healthcare provider to refer you to a foot doctor (podiatrist), especially if it’s hard for you to care for your toenails yourself.
The blood vessel and circulation problems associated with diabetes can also affect your eyes. Have a thorough eye examination by an eye doctor (ophthalmologist), every year or as often as recommended.
Other Steps to Prevent Diabetes Complications
To help monitor whether you may be developing diabetes complications, work with your healthcare provider to:
- Review all the medications you are taking that might be increasing your blood glucose, such as certain water pills (diuretics) or certain steroid medications for asthma or arthritis.
- Have a urine test every year. Having a protein called albumin in your urine can be a sign of kidney damage.
- See your dentist twice a year to keep your teeth and gums healthy.
- Get a flu shot every year. Talk to your healthcare provider about getting a vaccine for pneumonia (two different types of pneumococcal vaccine are recommended now).
- Protect your skin from the sun with hats and clothing, and keep your skin clean and moisturized. Take care of cuts and bruises to prevent infections.
Updated: January 2018
Posted: March 2012