As a pharmacist, I am not the health care provider who will diagnose you with diabetes. Very often though, I am the next health care provider you will encounter on your diabetes journey. You may feel overwhelmed by the new requirements of the disease and the effects it will have on your daily life. You have been launched down a path unprepared and with little knowledge other than a quick conversation with your doctor and some pamphlets on how to eat well for diabetes. This is a start, but as a pharmacist this provides me with a great opportunity to continue guiding and helping you down the path with diabetes. A diabetes diagnosis is life changing. It is scary. It will require many lifestyle changes and often daily testing to evaluate blood sugar levels. It also may require new medications. As a pharmacist I am able to help patients in many ways with starting their journey.
Diabetes. What exactly does that word mean? You will be told you have diabetes when the sugar within your blood is higher than it should be. Diabetes is often explained by using the analogy of a lock and key. Your cells are where the sugar needs to go in order to provide energy. For the sugar to enter into the cells, the “door” of the cell needs to be unlocked and opened. The so called “key” is insulin. Insulin is made by the pancreas and when sugar enters your body while eating, it triggers the release of insulin, which is supposed to go unlock the cell so the sugar can go inside. Diabetes happens when this process stops working right. Sometimes the insulin is no longer made by the body (this is usually type 1 diabetes, but eventually this will also happen later on in type 2 diabetes). Sometimes the cells no longer open when insulin tries to unlock the door. The cells become resistant to the insulin and will not open anymore. If the sugar cannot get into the cell, it stays in the blood and can be measured. When it is high enough, it will be determined you have diabetes.
When your body makes insulin but has become resistant to it working with the cells, there are things that can be done to help the cells respond again. My plan is to do a series of articles on diabetes, addressing each of the medications that are used today to help, but in this article the focus is going to be lifestyle changes. With the diagnosis of any long term health condition, the first step should always be what changes can you make in how you live every day to improve your health. Insulin resistance often is the result of carrying around more weight on your body than is optimal for your health… and this is usually caused by not knowing the right way to eat to give your body the nutrition it needs to be healthy. Extra weight also comes from not making daily movement of your body a priority. Eating real and fabulously nutritious food along with finding exercise that brings you joy are so important for having a body that works at its best.
So, pretty much you have to eat right and exercise. We all know this. The problem is that it is hard and often we don’t want to change. Sugar tastes good. It is relaxing to sit and watch T.V. Relearning the habits we have that make us happy and relaxed is tough to get excited about. What you also need to know though is that it is possible. I promise it is possible to love healthy food you make at home. It is possible to wake up and look forward to moving your body. It is possible to want to keep eating well and exercising because you will feel so good doing it that you won’t want to go back to your old ways. So much of change is all about mindset. The way to develop more motivation to make changes is to focus on what you will gain through the process.
Brainstorm. Write down a list of things that will be better in your life if you start making caring for your body the right way a daily priority. Put this list in a place you can see it. Will you lose weight and feel more confident in your body? Will you have more energy to run and play with children or grandchildren? Will you be able to think more clearly and be more effective in your work? Will you be sick less often because with better nutrition your immune system will improve? With type 2 diabetes, it is not impossible that if you make the right lifestyle changes you can reverse the problem with insulin and have a healthy response to sugar again. Even if by the time you are diagnosed it is too late to completely reverse the damage done to your body from years of high blood sugar, it is possible to greatly minimize the medications you have to take and to have better control with less long term complications.
Once you have your list of reasons taking care of yourself will improve your life, set some goals on how to make the changes. Write these down too. When you write things down and can see them, you hold yourself more accountable to achieving them. Tell your friends, family, and coworkers your goals too. Making changes involve both accountability and support, and when you share what you are working on and what you need to be successful you will find people want to help you on your journey. Some goals could be:
– I want to walk 30 minutes around my neighborhood 4 nights a week
– I want to stop eating out for lunch at work and instead pack my own healthy meal
– I want to start meal planning and prepping healthy food on the weekends to make staying on track easier during my busy work week
– I want to start taking a fitness class at my gym 3 days a week
Write them down, and start taking action every day to achieve your goals. Maybe you start with walking only 1-2 days a week and work on arranging your schedule to keep increasing the days you are able to exercise. Perhaps right now you are too busy to really prep all your food for the week, but you know on 2 nights a week you have time to make a healthy dinner, so you start there for now and keep striving to get more nights in. Change isn’t all or nothing, change can be gradual improvements in the direction of your goal.
To wrap up this discussion on motivation and healthy goals when diagnosed with diabetes, I think we should discuss exercise and nutrition a little more in depth. This way you will have a better understanding of how to set your goals to achieve the best outcomes. There are 2 types of exercise; aerobic and anaerobic. Aerobic exercise is what you think of with cardio: running, biking, walking, and swimming are all examples. It is the exercise that gets your heart pumping faster. Anaerobic exercise is more about building muscle like with weight lifting, resistance band training, and push-ups. Great starting goals for better conditioning in diabetes are 150 minutes (5 days a week of at least 30 total minutes of moving) of aerobic exercise and 2 days a week of anaerobic exercise. For aerobic, it does not have to be 30 minutes all at once, but should be a minimum of 10 minutes each time to ensure the heart rate does increase. Be creative! You can walk laps through your house during commercial breaks. You can do jumping jacks and other simple exercises at different times of the day. You can find a friend and make them go to a dance class with you. Really the options are almost endless, find something that works for you and set your mind to make it happen. It takes around 30 days to develop a habit, decide to make moving your body every day a habit.
Now for nutrition. Processed food is out. Ingredients you can not pronounce are out. The focus is on what is real because that is what your body will recognize and know to use as fuel. So much of what we consider food currently is not what our body thinks is food. So much of the sugar and processed food we eat becomes fat and leads to having too much and the wrong kind of fat. It’s time to focus on what your body actually wants you to eat. Eating well has never been easier. The food is all available to purchase at the grocery store, we just need to know the right things to buy. Buy whole grains and ancient grains for your bread, waffles, and cereal. Limit your sugar, and keep it to fruit which supplies nutritional benefit, as much as possible. Dairy is ok, but consider adding in some dairy free alternatives such as almond, coconut, and macadamia nut “milk”. They all add some nutritional benefits that dairy will lack. Eat as many colors of fruits and vegetables that you can. Divide your plate into quarters, 1 quarter fruit, 1 quarter vegetable, 1 quarter protein (meat usually, but if vegetarian many options available), and 1 quarter whole grains.
Breaking up the changes into smaller parts really helps make it more achievable. You will not be able to make all the changes instantly. Pick a starting point and keep building from there, this isn’t a diet or fad to lose weight, this is a life commitment to better health for your body. It takes dedication, sacrifice, and hard work.You can do this. You can take charge of your health. Diabetes doesn’t change who you are, but it is ok if you allow it to grow you as a person and develop you into someone who is strong, resilient, and able to meet the challenges of life with optimism and action. Diabetes doesn’t define you, and you have wonderful days ahead. You may have to make changes in order to have the best health possible, but it will be worth it. Change is tough, but so are you.
Take Care
Tiffany Herring PharmD