Hello there,

Welcome to another time with Big Jake.

Because I am a wonderful man, I promised I would be dropping some health topics from time to time and that’s why we are here.

 

Last week, we looked at diabetes in general. We talked about how it comes about, the types, causes, symptoms and some myths and facts about diabetes.

If you missed it, don’t worry, you can read all about it with the link below:

https://aaron-ansah-agyeman.com/2022/05/28/what-you-need-to-know-about-diabetes/

Today, we are looking at how diabetes can be managed and the complications that can arise if the condition is not managed well.

Being diagnosed with diabetes can be a traumatic experience, but like any other chronic illness, it is not a death sentence. With the right management measures, one can live a long, healthy life.

 

To control diabetes, you need to learn about it. You need to know what it is, what type you have, etc to help you know how to deal with it.

 

Then, you need to manage your blood glucose levels with an A-One-C (A1C) test, which shows your blood sugar levels over a period, e.g. three months.

High blood sugar levels over a period can harm your blood vessels, kidneys, liver, heart, eyes and other vital organs of the body.

 

Also, you need to keep close tabs on your Blood Pressure. The goal for most diabetics is 130/80. Anything higher over a period of time could lead to heart failure, stroke or kidney disease.

 

Then, you have to control your cholesterol levels. The build-up of bad cholesterol (usually referred to as LDL) can clog the blood vessels and lead to life-threatening emergencies.

 

Thus, managing diabetes requires a rigorous treatment plan, diet and exercise.

Diabetes Treatment Options

There are two treatment options available to people living with diabetes and this largely depends on the type you have. These are Oral Medication and Insulin.

 

Oral Medication

This comprises different types of pills that can be used to lower blood sugar levels. In most instances, just one type of pill will work just fine but in other cases, a combination of pills would be recommended by your doctor to keep the sugars down.

Interesting facts you should know about the pill include:

• Only people with type 2 Diabetes use pills to manage the illness
• Pregnant women with type 2 diabetes cannot use pills to manage their diabetes since it has been established that it is not safe.
• Pills do not work for everyone
• Pills work best with diet and exercise
• Pills sometimes stop working and your doctors or healthcare givers would try other options to help you manage your condition.

 

Insulin

This is an injection used to control blood sugar levels. The idea is to help those whose pancreas for some reason cannot produce either the required amount the body needs or those whose pancreas does not produce insulin at all.

 

It is worth noting that insulin comes in different types and this largely depends on how they are made, how they work and how much they cost. Your health caregiver will be the best person to recommend what will work for you.

 

Managing Diabetes with Diet

Findings from research by a panel of scientists, doctors, endocrinologists, diabetes educators and dieticians found that everyone’s body reacts differently to different types of food and diets. What this means is that what will work for A might not work for B.

 

With that in mind, one can safely say that there is no single diet for managing diabetes. However, one can follow some guidelines to narrow in on what works best to reduce blood sugar levels.

 

The American Diabetes Association introduced the Diabetes Plate Method to help in a bid to regulate meals. Using this method, you can perfectly blend food from the major food groups i.e. Carbohydrates, Proteins and Fruits and Vegetables to make a healthy meal that would help keep your blood sugar levels in check.

 

Below is a picture of what a typical plate method combination will look like:

To use this method, you need a moderately sized plate, about 9 inches across.

Then, you fill half of the plate with non-starchy vegetables. These are high in vitamins, minerals and fibre and low in carbohydrates. Examples of non-starchy vegetables are cauliflower, okra, cucumber, carrots, mushrooms, green beans, cabbage, tomatoes, peppers, eggplant, asparagus, etc.

 

Next, fill a quarter of the plate with lean protein foods such as chicken, turkey, eggs, salmon, tuna, tilapia, cod, lobster, shrimps, lean beef, lean pork, cheese etc.

 

Next, fill the remaining quarter of the plate with carbohydrate foods such as grains, starchy vegetables, beans and legumes, fruits, yoghurt and milk.

Examples of grains are brown rice, oats, corn food, brown bread, etc.

Starchy vegetable examples are sweet potatoes, yam, plantain, peas, etc.

 

Finally, add water or a low-calorie drink to your plate. Even though water is the best choice, you can consider other zero or low-calorie drinks like unsweetened tea, flavoured water, diet soda etc.

The important thing is to keep monitoring your sugar level with each meal and eventually find the food combination that works best for you.

 

Diabetes and Exercise

Exercise is a major component in managing diabetes. A sedentary lifestyle has been cited as a cause for the increasing cases of diabetes among Ghanaians.

Physical activity has been shown to:

• delay the atherosclerotic process, thereby reducing the risk of subsequent cardiac events in cardiovascular disease
• increase physical function in arthritis
• improve glycemic control in type 2 diabetes
• enhance the quality of life in patients with NCDs such as Diabetes

 

It is vital to note that medication, diet and exercise have to be combined for the best results. It is therefore good to start moving, but you have to start safely. Let’s look at what exercise is safe.

 

1. Walking – this is one of the safest to start with. For starters, it does not require any special equipment. All you need are your legs, comfortable clothes and footwear.
2. Other aerobic exercises to think about are swimming, jogging, cycling etc.

Engaging in aerobic activities for 150 minutes a week can help you:

• lower blood glucose,
• make insulin sensitivity go up thus making it work better,
• improve heart health
• reduce blood pressure
• increase good cholesterol
• reduce bad cholesterol
• improve your mood
• improve memory and other cognitive skills

3. Anaerobic activities such as muscle strengthening, mobility, flexibility, stretching, and coordination are also ways to exercise.
4. Moderate workouts with exercise videos are also worth considering.

 

To see how you are faring, it is safe to monitor your blood sugar levels before and after walks so that you don’t trigger complications. Be sure to talk to your doctor before embarking on any new exercise routine.

 

Diabetes Complications

Basically, there are two types of complications, Chronic and Acute.

 

Chronic Complications: These are the complications that build up over time.

Chronic Complications include:

1. Retinopathy– This simply means eye problem. With time, a person living with diabetes can develop retinopathy. If this is picked up early, treatment can be started to prevent eyesight loss. It is important to maintain regular diabetic health checks or attend, what are usually termed diabetic clinics.

 

2. Heart Attack– this is when the heart fails to work as it should due to damage to the blood cells. Again, this can be picked up at regular clinic checks to ensure corrective action to minimize its impact or slow it down completely.

 

3. Stroke – this happens when your brain is starved of blood because the pathways that get blood to your brain are either broken or clogged.

 

4. Nephropathy– this simply means damage to the kidneys making it difficult for the body to clear extra fluids and can lead to life-threatening situations.

 

5. Neuropathy– nerve damage which can lead to difficulty in movement, sight loss etc.

 

6. Foot Damage – also known as the diabetic foot is a serious health complication that can lead to amputation or death.

 

7. Gum Disease – making it easy for people with diabetes to get gum infections that attack the enamel and gums. It can give you so much pain and odour, one would not even want to smile or go near people.

 

8. Sexual problems in both men and women – (yea, I know you are reading this bullet with all seriousness now.) In men, having unbalanced sugar levels over a period of time can restrict the flow of blood from the brain to the sexual organs making arousal difficult. It can lead to erectile dysfunction and impotence.

 

In women, damage to blood vessels cuts the flow of blood to the sexual organs, making it lose sensation, so women with this complication cannot enjoy sex because they don’t feel anything. Sex becomes more like a chore. And women with high blood glucose tend to get vaginal infections more often, an added reason to avoid sex.

 

Acute Complications

Acute complications are those that can happen at any time and can lead to severe after-effects. There are 2 acute complications of diabetes. These are Hypoglycemia and Hyperglycemia.

 

Hypoglycemia – Hypo means low, and glycemia is blood glucose. So, hypoglycemia refers to low blood sugar levels and this can be a life-threatening complication.

A combination of factors can cause this. It is important to spot the symptoms and take urgent action to avoid tricky situations. The symptoms include blurred vision, bodily shaking, sweating, lips feeling tingly, being irritable, going pale suddenly, feeling disoriented, headaches etc.

This usually happens when one is

• taking too much medication than it’s actually needed, or 
• not eating enough carbohydrates or 
• exercising too much.
• drinking alcohol on an empty stomach can also result in hypoglycemia.

If left unchecked, Diabetic Ketoacidosis could occur. This is when the blood sugar level is woefully inadequate, thus the body starts to use fat as energy. When this happens, chemicals known as ketones are released into the blood and over time, can make your blood acidic. This is very dangerous and needs urgent medical attention.

It is good to monitor your sugar levels before and after medications, meals and exercise.

 

Hyperglycemia – this means high blood sugar levels. This happens when the body cannot produce enough insulin or cannot use the available insulin efficiently.

Symptoms of hyperglycemia include frequent urination, especially at night, blurred vision, weight loss, feeling tired and lethargic, feeling thirsty frequently etc.

 

This usually happens when one is:

• not taking enough medication as is needed, or
• eating too many carbohydrates, or
• not exercising enough.

If left unchecked, this can lead to Hyperosmolar Hyperglycemic State, where the blood glucose levels become unusually high. This is a medical emergency.

Contact your healthcare team if this happens a lot for action. They can review your medication, diet and exercise as a remedy.

 

Let me end it here.

If you have questions,

• hit me in my inbox or
• drop them in the chatroom or
• drop them in the comment box on the website.

Thanks for your time.

And before you go, I need you to tell me what topic to work on next time.

Much love.

Big Jake.

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