It’s Amber Hughes again, the fourth year pharmacy student at Altitude Drug. My last blog discussed diabetes and which medications are used to treat each type. Today I am going to focus on type 2 diabetes and ways to decrease the amount of medication one takes through lifestyle modifications. There are two words that are so easy to say and yet so hard to live by, diet and exercise. Many type 2 diabetics have developed the disease because they have made unhealthy lifestyle choices their entire lives. For many diabetics they also suffer from high blood pressure, high cholesterol and high LDL (bad fat) levels. Life style modifications can help treat the type 2 diabetes, as well as the complications.
First let’s discuss diet. Most people understand that if you only eat fresh vegetables and drink water, you won’t have excess fat or sugar in the blood. Generally whole wheats and grains make appropriate substitutes for traditional simple starches and breads. The fiber can help with digestion while decreasing the risk for colon cancer. Lower fat dairy products are great choices for calcium, protein, nutrients and even probiotics in some cases. Good meat options include lean game meat and white meat. By eating high protein, low fat meats your body will receive nutrients and build muscles, without excess saturated fat. Fish have a type of fat called omega-3, which can lower LDL levels in the blood. Some patients saturate vegetables in cheese or excessive amounts of butter. By doing so, it adds extra calories, as well as extra fat, which can lead to high level of fat in the blood. Fresh fruit tastes great and is packed with nutrients as well as plenty of natural sugars. One patient was eating about a pound of grapes a day and was wondering why she kept gaining weight. Fresh fruit and dried fruit are surprisingly high in sugar and should be consumed in moderation. While an apple a day keeps the doctor away, a 5-pound bag is excessive. Finally, there are vegetables. As a general rule of thumb, diversifying the vegetable color, diversifies the vitamins and nutrients. Vegetables are great and if you only get to fulfill your daily requirements for one food group, make sure it is vegetables. The hardest part about eating well is understanding that it needs to be a lifestyle.
On rotations, I have been living in guest bedrooms and motels, struggling to find a balance of nutrition, convenience and control. When staying with family, I’m not about to tell them that their cooking will kill me slowly, instead I fill up half of my plate with vegetables, eat a small serving of meat and keep my pasta, mayo filled potatoes, or fried sides to a minimum. I explain that while it is delicious, I feel better with a balanced diet. Little battles like this happen every day. These are the choices we are faced with, and each choice affects our health and well-being. We are what we eat, and if you want to be healthy you must eat healthy.
The next trick to controlling type 2 diabetes is exercise. As children we ran about on playgrounds and fields simply playing. As adults, I encourage everyone to find their happy ACTIVE-ity. Whether it’s swimming at the PAC, hiking to a great fishing spot, walking your dog around the neighborhood, or chasing your kids or grandkids around, increasing you movements, will consume energy. By safely increasing your heart rate through activities, individuals can decrease their blood pressure naturally over time. Muscles use glucose as energy, so the more you use your muscles, the more glucose will be used from your blood. The body will eventually start to use its energy stores, aka stored fat. The greatest complaint I always hear is, “I’ve been working hard, but I’ve only lost a pound.” For most it takes years of gaining weight to get where they are at, and for most it takes years of losing weight to get to a healthy state.
Eventually with lifestyle modifications, diabetic patients can begin to discontinue their medications under the direct supervision of their provider. I have personally seen 3 patients become motivated enough to change their life and successfully discontinue all of their medications with professional medical supervision. I have also seen two patients try to discontinue their meds on their own, only to find a steep increase in their average blood sugar three months later. I always recommend making healthy lifestyle choices and following the medical advice your provider gives.
All in all, I hope that I have helped educate you on some little changes that can make a big impact.