Managing diabetes: good practices for diet, exercise, and care
November 8, 2022
For plan members, sponsors, and administrators
Pavithra Ravi is a practicing pharmacist and teaches at the University of Waterloo School of Pharmacy. She is also Director, Strategy and Key Accounts, for Manulife Group Benefits.
Managing diabetes can feel overwhelming. However, there are small steps we can take to help better manage the condition.
Some key areas to focus on are nutrition, exercise, and monitoring. Here are my recommendations to help you manage your diabetes.
First, it's about how much you eat:
When we consider diabetes nutrition, most people jump to what type of foods they should start or stop eating. However, for a diabetes diet, a simple first step you can take is decreasing the size of your meals.
Eating smaller and more frequent meals throughout the day will help prevent peaks and lows in blood sugar1. Smaller meals will help diabetes management for type 1 or type 2 diabetes. You’ll have an easier time maintaining both weight and blood sugar with smaller meals.
But it is important to remember that each person's portion sizes differ. Make sure you understand the right portion size for you2.
Next, it's about what you eat:
What you eat plays a significant role in managing your blood sugars. Various recommendations may be customized to your body, beliefs, and behaviours.
Speaking to a dietitian as part of your health journey can help you understand what nutrition is right for you. Check if your health insurance has coverage for dieticians to get the most out of this support.
Getting personal advice from a healthcare professional is best, but here are some general food recommendations to help your diabetes management.
Choose whole grains where possible for your diabetes diet. Whole grains are beneficial in managing blood sugar. They have more fibre and take longer to digest in your body. This reduces the number of blood sugar peaks and crashes you might experience1.
Here are some foods you can try for more whole grains1:
- whole wheat flour
- brown rice
You should also choose low-calorie produce. Not all produce is created equal. Look for bright and deep-coloured fruits and vegetables1:
- green or red lettuce
- sweet potatoes
These produce options tend to be fewer calories with higher nutrition1.
Don’t forget to think about what you drink:
Food shouldn’t be your only consideration. You should also be mindful of what you’re drinking and how it may impact your blood sugar.
Try to avoid sugar-heavy drinks, like soft drinks. Instead, drink water or unsweetened teas rather than beverages containing corn syrup and high sugar content1.
Exercise is another essential component of diabetes management. It can seem overwhelming to figure out where to start or how to get to your fitness goals.
Start small. If you push yourself too hard, you’ll burn out on your exercise routines. It is essential to start small and create manageable consistency. Small increases in physical activity are all it takes.
Talk to your healthcare provider about what is safest for you. Do not overexert yourself. The recommended amount is to start with 20 minutes of exercise about three times a week1. Over time you can try for the Health Canada recommendation of 2.5 hours of activity every week3.
Wellness programs based on behavioural science can also help you develop good fitness routines. If you have group benefits with Manulife, you may already have access to our Vitality program. Check out the program and see if you can get rewards for activity that’s also important for your diabetes management.
Diabetes places you at higher risk for heart disease, eye disease, stroke, kidney disease, cardiovascular disease, and nerve damage. If you smoke, you have even higher chance to develop these health issues. Smoking can also make it more difficult to exercise and manage your diabetes4. Speak to your healthcare provider about what smoking cessation options are available to you.
Monitoring: Know your numbers
Monitoring your blood glucose levels is an essential component of diabetes management. Understanding your blood sugar level, and how your body reacts, is vital. It can empower you to better manage your diabetes.
Knowing how your blood sugar rises and falls is an important aspect to monitoring. Tracking this throughout the day is essential.
Low blood sugar can cause these symptoms5:
- Fast heartbeat
- Nervousness or anxiety
- Irritability or confusion
Be aware of these signs and take steps accordingly when your blood sugar drops. Keep sugar tablets or high sugar juices readily available when you get signs of low blood sugar. Wait about 15 minutes and check your blood sugar again to see if you have come back into range6.
Higher levels of blood sugar may not have as clear physical signs. But keep an eye out for these symptoms:
- Increased thirst and a dry mouth
- Needing to pee frequently
- Blurred vision
- Unintentional weight loss
- Recurrent infections include thrush, bladder infections (cystitis) and skin infections
If you notice these symptoms, you should monitor your blood sugar more frequently. This can help you understand the situations or circumstances when your blood sugar spikes high.
Avoiding highs and lows is important, but it is also essential to understand your time in range. Your blood sugar should ideally be between two points, a high (often 10 mmol/L) and a low (often 4 mmol/L)7. These may be individual to you but discuss what your numbers should be with your healthcare provider.
When we eat, our blood sugar will naturally rise, and when we go without eating or are tired, our blood sugar will naturally decrease8.
Staying in range is especially important for those who are on insulin. When you stay within your recommended blood sugar range, it significantly reduces your potential for developing complications such as retinopathy, which is when eyesight starts to fade9.
Many blood sugar readings will give you a snapshot at a specific time, but it’s also important to know how you’re doing over the long term. Your HbA1c level will provide a broader view on how your managed your blood sugar over the past three months. Your health care provider can check your HbA1c levels through a lab blood test.
More time spent in the recommended blood sugar range directly impacts levels of glucose bound to blood cell, studies show. Reducing these levels (HbA1c) by just 1% can reduce the risk of diabetes-related stroke, heart attack, and death10.
There are new technologies that can readily send you details about your blood sugar. Blood glucose monitoring devices can provide you consistent readings throughout the day without pinpricks and test strips. Check out my previous article to learn more on these devices.
Blood sugar levels aren’t the only number to watch. You should also regularly review your blood pressure readings, cholesterol, and weight as these can impact the management of diabetes11.
Knowing your numbers is vital making your treatment plan work for you. Work closely with your healthcare team; they can support you and help you understand what specifically helps you better manage diabetes.
These small considerations for nutrition, exercise and monitoring can make a big impact your health journey.
10. Maureen J. Lage & Kristina S. Boye (2020) The relationship between HbA1c reduction and healthcare costs among patients with type 2 diabetes: evidence from a U.S. claims database, Current Medical Research and Opinion, 36:9, 1441-1447, DOI: 10.1080/03007995.2020.1787971