Managing Diabetes

I recently attended a class on how to manage diabetes.  Much of what is said here may apply to Type 1 diabetes as well, but it is specifically addressing those who have Type 2 diabetes.  When I found out I had diabetes, I decided to do everything I could to reverse it, including losing weight.  Many guys who get diabetes still wish to gain.  It is possible to gain with diabetes.  This article will be just how to manage diabetes.  Whether you gain or lose weight doing it is your own choice.

If you have been diagnosed with diabetes, I assume that you know basically what it is.  Your body has become resistant to the insulin that it makes.  In severe cases, your pancreas may also have stopped producing enough insulin as well, making you dependent on insulin injections.  Monitoring your blood glucose level is key to keeping your diabetes under control.  The units for blood sugar that I will use are the ones used in the USA, which are mg/dl.  Other countries use mmol/l.  Here is a conversion calculator.

Blood Sugar
You should check your blood sugar when you wake up, after you haven't eaten anything for hours and before you eat breakfast.  This is called your fasting blood sugar.  It should be less than 100.  A fasting blood sugar of over 120 is when a person is diagnosed with diabetes.  You should also measure your blood sugar right before eating and then again 2 hours after eating.  You don't have to do this with every meal every day, but the more often you check your blood sugar the better.  Before eating it should not be over 120 and after eating it should not be over 180.  Normal range is under 140.

Carbs
There is a lot of misinformation about carbs, sugars, and how they affect diabetes.  The truth is that all carbs are the same.  Whether they are simple sugars or complex carbohydrates, they will turn into sugar in your blood stream.  That being said, also know that simple sugars immediately enter the blood stream and complex carbs take 2 hours to turn into sugar and enter the blood, but 2 hours after eating, all of the carbs you ate are now in your blood stream.  So 20g of sugar is the same as 20g of bread.  Carbs are carbs, count them all the same.  But if, for example, your blood sugar is low (under 60), then you should eat some simple sugars.  Have a spoonful of jam or a candy bar or something that has sugar to immediately raise your blood sugar back into the normal range of 70-120.

All carbs are the same.  However, some sources are healthier than others.  For example, a whole fruit is a better source of carbs than a lollipop because it has fiber and vitamins and minerals.  So you may consider getting your carbs from healthy sources rather than refined sources.  More on that here.

Exercise
If your blood sugar is consistently high, try eating fewer carbs and exercising more.  Exercise is good for diabetes for two reasons.  One is that it uses up sugar in the blood stream.  So, if your blood sugar is too high the fastest way to reduce it back to a normal level is to workout to use that sugar up.  Also, exercise increases insulin sensitivity.  Remember that diabetes (Type 2) is insulin resistance, so increasing sensitivity to insulin means reducing the resistance, which means controlling (or reversing) your diabetes.  More about diabetes and exercise here.

Weight
As I said before, some guys want to keep gaining even after being diagnosed with diabetes.  Other guys (like me) want to lose weight.  You can gain weight with diabetes, but you should know that the bigger your body is, the more likely you are to be resistant to insulin.  Which means that as you gain weight, you are more likely to become (if you weren't before) or remain diabetic, and the diabetes may become progressively worse as you gain.  This is just a general rule of thumb.  Being obese does not cause diabetes.  But, the more fat you have stored in your fat cells the more likely those cells are to resist insulin that is in your blood.  Also, the more often you have insulin spikes (due to eating large amounts of carbs often), the more likely your body is to resist that insulin.  Think of it like a broken record.  Your cells keep getting the insulin over and over and after a while they just get tired of it and ignore it.  So, it is easier to manage your diabetes when you weigh less.  But it certainly is possible to manage while gaining as well.

Remember that the most important factors to keep track of are your blood sugar levels.  Monitor them at home with a blood glucose meter (I know the test strips are expensive--try Walgreens or CVS brand for cheaper test strips).  Also, you should go to your doctor and have your A1C tested every 3 months.  You want an A1C of no more than 7, preferably under 6.5.  It is entirely possible to gain weight and still keep your A1C down.  It just depends on diet and lifestyle.

Diet
The main thing to watch out for when you have diabetes is carbs.  It doesn't matter if they're sugars or complex carbs, just keep track of carbs.  If your blood sugar levels are continually high (over 180 two hours after eating) you should think about decreasing the amount of carbs you eat.  Do NOT stop eating carbs altogether.  A zero carb diet is not healthy.  Your body needs carbs for energy.  Simply decrease the amount of carbs to help keep your blood sugar in a normal range.  Your target is no more than 140 two hours after eating.  If you want to keep gaining, then make up for the decrease in carbs by eating more fats and proteins.

Another important thing to remember is that blood pressure and cholesterol are also important things to watch out for when you have diabetes.  Limit the amount of sodium that you intake.  Don't eat out because restaurants (especially fast food places) put a ton of salt in everything.  Salt makes you retain water, which makes your blood pressure go up.  Season your foods with other spices and use salt very sparingly.  More about blood pressure and heart disease here.

Cholesterol levels can be improved by eating natural sources of omega-3 fats.  These include nuts, canola oil, fish.  Salmon and tuna are very good.  Replace red meats with white meats.  Limit the amount of saturated fats you eat and do not consume any trans fats, because they increase your bad cholesterol levels.  Omega-3 fats increase good cholesterol and decrease bad cholesterol.  More about Omega-3 fats here.

Complications
When you have diabetes, you should know that you are at high risk for many health complications.  Some of those include heart disease, kidney failure, liver disease, blindness, and loss of limbs.  If you choose to gain when you have diabetes, be aware of all of the risks.  It is important to keep your blood sugar levels at normal because when they are consistently too high it is toxic to your body and it can damage your organs and your nerves.  It is common for diabetics to lose feeling in their feet.  It is important to take good care of your feet.  It is important to monitor your vital signs and visit your doctor regularly.

Again, it is possible to gain weight and manage your blood sugar.  It requires extra effort and attention, but it is possible.  The key indicator is your A1C and your day to day blood glucose monitoring.  As long as those numbers are good, you are managing your diabetes.