Once a disease of the elderly, type 2 diabetes now strikes adults in their prime and, increasingly, children. According to recent figures from the Centers for Disease Control and Prevention, diabetes affects 25.8 million Americans, or 8.3 percent of the population (including both diagnosed and undiagnosed cases). Nearly two million Americans were newly diagnosed last year. Contributing to this epidemic? Our soaring rates of obesity. The CDC cites areas of Brooklyn and Queens as having the highest levels of diabetes and obesity, and despite a reputation as a city of “fit pedestrians,” diabetes among New Yorkers doubled during the past decade to 12.5 percent.
“Diabesity” is a preventable but deadly disease. Excess weight destroys the body’s ability to process sugar properly, with life-threatening consequences. While you can’t change having a family history of diabetes, you can do something about other risk factors, such as being overweight or sedentary (inactive). If you or a loved one has diabetes, your doctor will suggest lifestyle modifications and may prescribe medications to control blood sugar levels.
The good news is, fighting diabesity also helps you reduce the risk of long-term complications, such as heart disease, stroke, kidney or nerve damage and vision problems. To get your diabesity under control, you’ll need to consider several factors, including exercise, proper nutrition, monitoring your blood sugar, and taking medications effectively so you can reduce the risk of long-term consequences and feel better.
Tanya Kaplan, RN, a VNSNY CHOICE Nurse Care Manager in Brooklyn and registered dieticians from her CHOICE healthcare team offer the following tips to help seniors and their families keep diabesity at bay.
Understanding Diabetes
If you have diabetes, your body doesn’t produce enough insulin, or your body doesn’t respond well to insulin–an important hormone. Insulin helps your body move glucose from the foods you eat into your cells for fuel (energy). There are a variety of symptoms of uncontrolled diabetes, from fatigue to increased thirst and urination to slow wound healing. Blood sugar monitoring, healthy eating, exercise and taking doctor-prescribed medications properly are important steps in managing this chronic condition. “The VNSNY CHOICE nurse care manager can help you to understand your treatment plan so you can follow it with confidence and improve your health,” says Kaplan.
Three Steps To Beat Diabesity
“If you’re overweight, eating poorly or exercising infrequently, don’t wait until you’re diagnosed with diabetes to make lifestyle changes,” advises Kaplan. “There are three things you can manage now, whether you’ve got diabetes or not.”
1. Nutrition
This is the number one issue for someone confronting diabesity. “When a CHOICE nurse and registered dietitian create a care plan for the member,” explains Kaplan, “he or she is going to focus first on diet.” When shopping and planning meals for someone with diabetes:
• Exclude all refined sugar.
• Add fruits and vegetables to the diet, bearing in mind that for a diabetic, fruits should be limited to appropriate portion sizes. For example, one medium sized apple or a half cup of diced melon. “Green means ‘go’ for certain fruits,” says Kaplan. “Greenish bananas have much less sugar than deep yellow ones; likewise, green apples are better than red ones. Avoid grapes and raisins, which have too much sugar.”
• Avoid white flour; choose whole grains such as brown rice and whole-wheat pasta.
• Avoid salt and use moderate amounts of heart healthy fats, such as olive oil, in cooking.
• Limit juices and avoid sodas.
• Control portions and don’t skip meals. Kaplan says she tells her diabetic CHOICE members, “You can’t eat like you’re a teenager anymore.”
A caregiver should also make sure that a diabetic loved one has sugary items on hand in case of a low blood sugar emergency. “Always examine the refrigerator,” says Kaplan, “and make sure that fruit juice or soda is present, or the patient has access to glucose tablets.”
2. Hydration
Water may be the secret weapon in weight loss, say researchers in the U.S. and Germany. Although the impact is modest and the findings are preliminary, the researchers say water consumption increases the rate at which people burn calories which could have important implications for weight-control programs. Drinking water packs a one-two punch for those with diabetes, since insulin dries out the natural moisture of the skin. “Make sure someone with diabetes drinks enough water,” advises Kaplan. “Caregivers should check skin for dryness and encourage hydration.” She suggests filling a pitcher to the maximum daily requirement in the morning, dispensing water by the cupful, and making sure the pitcher is empty by bedtime.
3. Exercise
Staying active is a critical part of keeping diabetes under control. Interval training — alternating between short periods of high-intensity exercise and longer periods of low-intensity training — can be done at all fitness levels. It burns more fat and calories than trekking along at a constant pace.
Research shows that exercising like this improves endurance, strengthens the heart and has positive effects on metabolism. If you go for a walk, power-walk for a minute or two every five minutes. If you jog, bike or swim, bump up the intensity every few minutes and sustain that pace for at least 60 seconds. (Always check with your doctor before embarking on an exercise regime.)
To learn more about programs that can help you or someone you love cope with diabetes, visit www.VNSNYCHOICE.org or call 1-855-AT CHOICE (1-855-282-4642).
