This is the final post in a three-part series I have written about Type 2 diabetes. To read Part I, where I cover what Type 2 diabetes is and how it can be managed, click here. In Part II, I covered diet, the importance of weight management, drinking lots of water, exercising, managing stress and getting enough sleep in controlling Type 2 diabetes. Click here to read Part II. In this post, I will cover the importance of caring about your feet, teeth and eyes as a diabetic, as well as recording your blood sugar levels. I also discuss how belonging to a diabetes association can be helpful. To close, I set out some further suggested reading about diabetes.
Diabetics need to take extra care of their feet. Dry between your toes after showering. Every year, make sure the nurse at your practice checks your feet for sensation. Always wear shoes, both indoors and outdoors. This is important to remember in NZ where a barefoot culture in prevalent on the beach and around the home. Watch out for cuts as they can lead to infections.
Diabetics need to take extra care of their teeth. Make sure you visit your dentist every six months for a check-up.
If you have Type 2 diabetes, your GP should refer you Retinal screening every 2-3 years. This is where they check behind your eyes for bleeding. Not all optometrists do this so you may find that you have to go to different clinic to your normal optometrist. You might also notice that your eyes feel a lot drier since your diagnosis. Eye drops can help to relieve dry eyes temporarily.
Record your blood sugar levels
Invest in a blood testing machine. Your doctor will tell you how regularly you need to test your blood sugar. It’s a good idea to keep note of this. You might find that your morning blood sugar is higher than your evening one. Don’t worry as this is normal. Have your HBA1c tested every year.
It can be a good idea to join a diabetes association for support. Ours has monthly meetings with a guest speaker about a topic related to diabetes. You don’t always have to go to the meetings if you’re busy and/or the topics don’t interest you but if you are a member you have access to someone for support if you have any questions. The magazine they send out contains advice, recipes, tips etc which is also helpful.
There are a lot of resources about diabetes in print and electronic form. I highly recommend the book, Diabetes: A Practical Guide to Managing your Health (see below), which a former flatmate while I was living in London who had Type 1 diabetes recommended to me.
o Diabetes Strong, https://diabetesstrong.com/, a portal created by Christel Oerum who has Type 1 diabetes and who you may recall me mentioning in a previous post
o Rosemary Walker & Jill Rodgers, Diabetes: A Practical Guide to Managing your Health, Dorling Kindersley, 2004
In Part I of this series, I described what diabetes is and how it can be managed. To read Part I, please click here. In Part II, I will discuss the diet that I follow which enables me to control my condition without meds. I will also cover the importance of weight management, drinking lots of water, exercising, managing stress and getting enough sleep in controlling Type 2 diabetes.
Ideally, diabetics should aim to have between 30-50 grams of carbohydrates per meal three times daily, plus 10-15 g of carbohydrates snacks in between. Not everyone would agree with me about how much carbohydrate I should be consuming as a diabetic. Remember that everyone’s bodies process sugar differently and you need to learn what works for you through trial and error. Mum and I both find that we’re able to control Type 2 diabetes naturally without recourse to any medication such as insulin or metformin by structuring our diet around the 30-50g of carbohydrate per meal rule. This is really all thanks to mum who is a retired nurse and has a very good understanding of health and the human body.
Remember that as a matter of overall health, we all need some carbohydrate in our diet, whether we have diabetes or not. In my personal opinion, it’s best to opt for carbohydrates in moderation which are found naturally in fresh vegetables such as potatoes, sweet potatoes, parsnips and corn. They keep your blood sugar level rather than consuming highly processed packet foods which are filled with sugar and will cause your blood sugar levels to spike dangerously.
Mum and I have both eliminated sugar from our diet as it has the effect of increasing our blood sugar. There are traces in foods such as bread, crackers etc but this is generally fine.
We drink alcohol only very occasionally as it does affect our blood sugar.
The owner of a previous gym who has Type 1 diabetes suggests that diabetics avoid peas and corn, as they tend to increase your blood sugar. I find that I am able to have these occasionally, in moderation.
It is important to maintain a healthy weight if you have diabetes
Drinking lots of water helps flush sugar out of the system and maintain healthy blood sugar levels
Try to get some exercise every day. Go to the gym, for a walk, run or swim at your local pool. It really does help lower blood sugar levels, not to mention help with overall weight management
Stress can have the effect of increasing your blood sugar levels. Try to relax. Meditation can help. I took Les Mills Body Balance classes (a mix of pilates, tai chi and yoga) on a regular basis at a gym I used to go to a few years ago. It took a long time for me to learn how to relax but eventually I could see the progress. Be patient. You’ll get there in the end too.
Try to get enough sleep. I aim for at least 8 hours every night.
Back in 2016, I was diagnosed with Type 2 diabetes. Needless to say, I was devastated. Conscious that the condition runs in the family, since my early 20s, I had always made an effort to exercise regularly and maintain a healthy weight. However, the diagnosis of schizophrenia at the age of 29 meant a dramatic increase in my weight from the anti-psychotic medication that I was prescribed. This wasn’t helped by the fact that the anti-psychotic medication has a tendency to increase blood sugar levels. Before I knew it, I had developed diabetes.
While this is a deeply personal topic, I wanted to open up about my experience living with and managing this complex condition. I hope that I can help others who are in the same situation, or those with loved ones who suffer from diabetes. Please bear in mind that people are different and I have experience only with Type 2 diabetes, so this information is no substitute for seeing a doctor if you think you might have diabetes or would like to control your condition better.
Since this is a very broad subject, I will divide it into a series of posts. In this post, I will describe what diabetes is and how it can be managed.
What is Type 2 diabetes?
Type 2 diabetes is a condition where your body cells are resistant to the action of insulin and/or your pancreas produces decreasing amounts of insulin.
Certain ethnic groups are predisposed to developing Type 2 diabetes. If you are of South Asian, African, Carribean, Maori or Polynesian descent, you are five times more likely to develop Type 2 diabetes than people of Caucasian origin. Being overweight also increases your risk of developing Type 2 diabetes.
Why is diabetes so serious?
If ignored or badly controlled, diabetes can have far-reaching consequences for your overall health including amputation, blindness and even death
How is it diagnosed?
You won’t feel well. Symptoms of Type 2 diabetes include fatigue, lack of energy, passing large amounts of urine, thirst and gradual weight loss.
If you’re in a high-risk category like me, your doctor might be keeping an eye on your HBA1C levels regularly.
Management of Type 2 diabetes
Type 2 diabetes can be controlled by (i) insulin (in serious cases); (ii) a drug such as metformin (and possibly insulin as well); or (iii) diet and exercise, like me.
The key is to keep your blood sugar levels stable throughout the day. Contrary to popular belief, you can’t reverse diabetes once you have it, but you can manage it.
When I was first diagnosed with diabetes in February 2016, my HbA1c level was 57. I was lucky that my GP gave me the chance to lower it to an acceptable range without meds. As I was able to bring it down to 50 after three months and 41 by the end of the year through diet and exercise and my HbA1c readings have been within the acceptable range since then, I have controlled my condition without meds for three years.
According to my dentist, controlling diabetes through diet and exercise rather than meds is preferable because the drug metformin can cause dry mouth and lead to gym disease.
Those of you who have been following my blog for awhile will probably know that I’m an avid runner. To read more about my passion for running, click here. I spent my 20s doing a lot of long distance running, including many half marathons and an entire marathon. When I turned 30, I discovered the 10k and have never looked back. Last summer, I made it my goal to compete in the YMCA 10k Summer Series in the Auckland Domain and managed to complete the first half of the races – a dozen – successfully, before I had a relapse and was unable to run anymore.
I have put together some tips for those of you who are looking to run your best 10k ever, and that means not just an improvement on speed but with strength and good form too, which are also important.
o When it comes to training, less is more. It’s the quality, not quantity of your training, that counts! Aim to run three times a week, no more than this. If you’re training for 10k events, then only one of your runs each week should be this distance. The other two runs should be shorter. You might do a 5k run as fast as you can and a tabata session for the other run. This was the advice given to me by a runner at the YMCA 10k Summer Series, which I followed. I found that I was able to improve my times more effectively than doing three 10k runs every week, which was wearing me out
o In saying that, I managed to lose a lot of weight by doing three 10k runs every week last winter, in order to prepare for the summer season. If you’re after weight loss and are not that concerned about improving your speed, longer runs may help with this
o To improve your speed, try doing a short run at the pace you want to achieve. If you get bored running by yourself, you might want to try the 5k event Park Run, which is held weekly around the world. It’s free and a great way to make training more fun. Park Run is very popular with runners at the YMCA. For those in South and East Auckland, there’s one held every Saturday at Barry Curtis Park at 8 am
o Another way to improve your speed is tabata. Try doing a 20 second sprint followed by 10 seconds of rest. Repeat 8 times. I found that tabata gave me the stamina to sprint towards the finish line in my 10k races, when you need that extra burst of speed
o To improve your speed, you could also try Fartlek training. This is basically interval training without a particular pattern
o You can do interval training both outdoors and on the treadmill, but it’s easier to monitor your speed when training indoors on the treadmill
o For 10ks, don’t run too fast in your first 5k. When I did the YMCA Summer Series at the Auckland Domain last summer, there was a very experienced runner who did this and inevitably ended up walking towards the end when I was able to sprint past her, thanks to the tabata training I had been doing (see above)
o A lot of people put trail and road running in separate boxes, but sometimes you need to think outside the box. Off-road running, which is generally much tougher, can help you improve your road running
o Having decent running gear always helps. Invest in a quality pair of running shoes and look for dri-fit clothing that absorbs moisture from sweat and rain
o Enter into a 10k event. Having a race to work towards gives you motivation
As I mentioned in a previous post, I have started incorporating swimming into my fitness programme because I hope to enter some swim and run events such as Stroke and Stride over the summer. I need to be able to swim between 500-1000m in the ocean, freestyle, non-stop. Improving on my stroke and speed now will mean that I’m not panicking later on. I thought it might be a good idea to put together a blog post outlining some of the benefits of swimming, as well as some tips for improvement.
Benefits of swimming
o A great form of stress relief
o A good type of cardiovascular fitness activity
o A great way to lose weight, as it burns plenty of calories
o A good type of exercise to do if you’re large as you’re submersed in water. Jumping/high energy activities on land may be difficult if you’re carrying excess weight
o An excellent activity for women who are pregnant
o Swimming is low impact on joints, reducing the risk of injury or making it a suitable exercise for those in rehabilitation from injuries
o After awhile, you’ll see improved sleeping patterns
o It’s inexpensive. Some community pools in Auckland are free
o It’s refreshing. You can’t beat the feeling of being in the water
o It doesn’t matter if the weather is cold, wet and windy as you’ll be indoors
o In the heat of summer, there’s nothing nicer than swimming in an outdoor pool
o Swim T3 is the place to go for all your swimming needs. They stock an excellent range of swimsuits, wetsuits, caps and goggles
o If you’re after a heated 50m swimming pool to train in, you can’t go past the Newmarket Olympic Pools. I recently won a free one month’s membership and really enjoyed going there, but it’s a bit far so I’ll probably stick to training in a local community pool
o Work out when the pool isn’t busy and try to fit your swimming in then
o Take a bag to put your belongings in. Don’t forget to take a towel and a snack for after the swim. Sometimes I have a protein shake, other times I have a piece of fruit or a yoghurt
o It pays to invest in decent goggles. Until I did so, I found that my goggles always got foggy, the strap broke and they filled up with water, ruining my swim
o If you wear glasses, look for a pair of prescription goggles. Being able to actually see properly in the water makes swimming much more enjoyable
o Wear a swimming cap. It keeps your hair neatly in place, but you’ll find that you still have to wash it afterwards
o Swimming can be hard on your hair. If you swim most days like me, you’ll be washing your hair nearly every day. It pays to invest in a decent moisture repair shampoo and conditioner to prevent your hair from becoming dry
o Forget beach attire. Wear chlorine resistant swimming togs which are made for swimming. For ladies, I recommend a one-piece suit as they fit best when you’re doing lots of lane swimming
o Take a pair of jandals to wear in the changing rooms, so you avoid getting athlete’s foot
o After a long swim, treat yourself to a soak in the spa pool or head for the sauna
As I mentioned in a previous post, I recently had a relapse which meant that I put on quite a bit of weight, as I usually do when I’ve been sick. Notwithstanding this, I was determined to get back into it and continue with my weight loss journey. If you have suffered a set-back and are looking for some tips on how to get back on the horse again, you might want to read my previous blog post on this subject. Starting over is never easy but sometimes you just need to hang in there and ride out the rough patches. To start with, it helps if you can identify what you are particularly struggling with.
Here are some of the difficulties I have encountered thus far on my journey:
o Always feeling hungry
o Continually dreaming about foods that I shouldn’t be eating
o Looking at “forbidden foods” while shopping at the supermarket
o Finding it hard to stay within my daily allowance on My Fitness Pal, the app which I use to track my eating and exercise
o Not always weighing and measuring what I’m eating, making it hard to correctly gauge amounts and calories
After about a month, I have had a breakthrough. These are challenges I will always face but they are no longer such a struggle. There wasn’t anything in particular that I did to help with this; it just happened organically. What I have learnt is that sometimes your body just needs time to adjust to eating less food and of course eating different kinds of foods when you are watching your weight. I did reform my diet rather radically so it’s no wonder that my body was protesting so much!
Remember that this is a journey. There is no quick fix. To improve your health, lose weight and gain fitness you need to implement lifestyle changes gradually, which are on-going in nature. This means that there will be ups and downs. You just have to learn to accept the bad with the good and stick with your programme in the long term.
Here are some additional pointers:
o It might help if you re-define your fitness goals. Set some new and interesting challenges to work towards, such as entering an event
o Sometimes you can get stuck in an exercise rut. Try a new fitness activity. I have recently started incorporating swimming into my fitness regime and find that it’s great. It’s low impact, refreshing and helps me sleep well
o Revamp where and how you exercise. A change of scenery can be a good way to kick-start your fitness regime again. Try a new gym (even just for a session or two), set up a home gym which you can use occasionally (see my last post for advice on this subject) or try Les Mills on Demand, which gives you a huge range of workouts that you can do at home at your convenience
o Make eating interesting by trying a new recipe for variety, so you don’t end up eating the same foods again and again
o Layer up and head outdoors to exercise. In winter, we tend to hibernate but you’ll feel so much better getting some fresh air. I find being outdoors in winter really refreshing, especially in the early mornings when it isn’t usually windy
o Buy some new exercise gear – wearing something new can make you look forward to exercising and feel good while doing it. It can be tempting to wait until you lose weight before purchasing a new outfit but I’m a firm believer in celebrating the journey, not just the final destination
Over the years, I amassed a number of different pieces of gym equipment and set up a small home gym to use at times when I’ve been unwell enough to exercise at my regular gym. I have even tried to do away with my gym membership and exercise at home, but I always inevitably end up back at a gym. In other words, for me, a home gym is no substitute for a gym membership. Having said that, I do think that having a home gym can be very worthwhile and it is something that I use in conjunction with a gym membership. I thought it might be helpful to others if I set out the advantages and disadvantages to home gyms, as well as some tips for those who are considering setting one up.
Still keen to set up a home gym? To give you an idea of what pieces of equipment may be helpful, here’s a list of what’s in mine:
You may also find the following equipment useful:
Have you ever experienced a set-back which puts you behind with your training? To read more about falling off the fitness wagon, click here. I recently had a relapse, which meant that the weight loss and fitness goals I worked towards in 2018 were nearly completely undone. While this was very upsetting and it was difficult to get on the horse again, I am determined to develop a positive mindset and continue with my fitness journey.
I have set myself some awesome new fitness goals to help me give me greater focus. Since we are nearly half way through 2019, this is a good opportunity to look back at the goals that I set myself for this year, re-evaluate and re-define them.
As I have mentioned in a previous post, PT has helped me tremendously during my weight loss journey. I see a lovely young girl called Alice Jackson at Les Mills in Howick for an hour every week. I was reluctant to retain a trainer as I’ve always preferred to train myself when I used to be in shape, but I was determined to lose a very large amount of weight and desperately needed support. As my weight crept up towards 100 kg, my diabetes was spiralling out of control and I was worried that I’d end up on insulin. I was – and still am – determined to control my condition without meds for the rest of my life which Stephen Farrell, the head coach of the North Harbour Triathlon Club, assured me was possible when he rang me to answer my questions about the Takapuna Beach Swim and Run event which I’d like to enter next week . Returning to the subject of PT, I also wanted to complete the YMCA 10k Summer Series, which started in October and you can read about in my earlier blog post. I was very lucky to do a couple of training sessions with Alice’s brother Dan Jackson, who is also a trainer at the same gym. Dan stepped in to train me while Alice was on holiday for three weeks in August last year. By complete fluke, he competed in the YMCA 10k Series while he was a student at the prestigious Auckland Grammar School, so he knew what was required to get me into shape so I would be ready to start the series at the beginning of October. Les mills isn’t just like a family. As I discovered, some of the staff members actually are family, like Alice and Dan. If you put a foot wrong, you’ll soon have to find yourself another gym.
Over the past six months, I lost a total of 25 kg and completed the first half of the YMCA 10k Series, which I wouldn’t have been able to achieve training on my own. I think of PT as the grease which makes my training flow. You can read the thank you letter I wrote Les Mills Howick here.
Benefits of personal training include:
If you’re thinking about hiring a trainer, here are some of my tips:
As I mentioned in a previous blog post, I have managed to make a lot of progress during my weight loss journey over the past six months, losing a total of 25 kg. I go to Les Mills in Howick and it’s a great gym. I simply love it there. I wanted to share the letter I recently wrote to the team, thanking them for all their support.
28 October 2018
To the team at Les Mills Howick,
A small gift from our garden – some plants and produce
I wanted to thank you all so much for helping me along my fitness journey. When I (re)joined the gym in July this year, I was 93.3 kg. Over the past four months, I have lost over 20 kg. My goal was to be able to participate in the YMCA 10k summer series in the Auckland Domain every Thursday, which I have achieved thanks to weekly PT sessions with Alice, as well as some training with Dan while Alice was away.
I have Type 2 diabetes, but with the support of this gym, I have been able to get my condition under control through diet and exercise. Losing weight has made it easier to manage my blood sugars. My GP didn’t recognise me when I saw him last Friday and was so happy with my progress.
A lot of people have asked how I managed to lose so much weight in a relatively short time frame. The truth is that there was no fad dieting or excessive exercise involved. I’m also carrying a few injuries, which restricts what I can do. There are a few revelations I have had that I would like to share, which might be useful to pass on to other gym members who are struggling to lose weight.
Everyone – the friendly reception staff, fitness instructors on the gym floor, group fitness instructors and personal trainers – have been absolutely fantastic. In particular, I’d like to say a special thank you to Autumn (who signed me up and continues to check in with me), Laura and Laetitia (who has since moved on) for helping me so much the first time I joined and who made me want to return so I could try again, Alice and Dan for motivating me through PT, Brandon for his support on the gym floor and Maureen, who has given me so much support in her classes and with my running. You’re all doing a wonderful job. Please keep it up! Thank you again. I look forward to getting to know even more of you over time.