I’ve known for a while that diabetes was always a few steps behind lurking in the background. Eventually, it will catch up. Why? Family history. With five family members who have the disease, I understood a long time ago that membership in this club wouldn’t be optional. During my last physical, the doctor focused on abnormal lab values indicating diabetes could still be a reality. But of all the diseases I could end up with, diabetes is a disease that can be more or less of a burden based on the choices I make.
For most of my life, I did a decent job taking care of myself, but I also did two of the best things anyone can do for their health, quit smoking cigarettes and drinking alcohol. These habits in tandem make any effort toward a healthful lifestyle useless.
As a teen, taking up smoking was a window to the in-crowd and a way to rebel. What I felt was a symbol of freedom would’ve been a severe detriment to my health if I continued. Luckily, there were enough people around who reinforced the harmful effects of smoking. After a while, I stopped smoking altogether.
The best way to describe my alcohol intake was problematic binge drinking. Like many of us, having a few made socializing easier. I abstained from alcohol use during the week, but I wasn’t a person who could stop after having just one. Luckily again, someone close to me nudged me toward better health. I stopped drinking altogether.
Alcohol abuse puts patients at risk for diabetes. I’ve met patients in my practice with a history of alcohol use disorders and a prediabetes/diabetes diagnosis. Most of them were admitted with a metformin prescription and were confused as to why their bodies became insulin-resistant after they stopped drinking. One patient believed it was a punishment for their detrimental habits.
The World Health Organization published its views this year on the unhealthy effects of alcohol and the National Cancer Institute maintains ethanol and ethyl alcohol as carcinogens that contribute to many types of cancer. Click on the links above to read more.
Did alcohol use increase my risk? I don’t know for sure, but heredity on the other hand isn’t something I can change. My mother was diagnosed with diabetes over 10 years ago and her brother and sister also around the same period. My father died of complications related to the disease. In 2018, my brother lost his toes to gangrene from uncontrolled hyperglycemia.
Becoming a dietitian helped me support my mom in many ways and I learned more by observing her experiences. I remember going with her to her first appointment with the diabetes educator when she said, “I want to control my diabetes.” A phrase she kept true to this day by keeping her appointments and doing what her practitioners recommended. She’s been a positive role model for me as she rose to the challenge of necessary lifestyle changes. I’m proud of her for it.
There isn’t a clear path to heredity when it comes to diabetes, but does this mean I shouldn’t care for my health since I probably won’t prevent it? I can’t say what the future will bring if I become insulin-resistant enough to start treatment, but the life I’ve lived so far has put me ahead of the game. Diabetes complications can range from neuropathy, heart disease, renal disease, and gangrene, but this doesn’t have to be my story or anyone else’s.
Knowledge and insight are my best defense against this disease. As my journey unfolds my experience with diabetes will give me an edge to help patients who are motivated to maintain their health.
When to see your physician
Insulin resistance is when the body doesn’t digest glucose properly, it overstays its welcome in the blood. When the insulin in your body isn’t stimulating liver, muscle, and brain glucose metabolism to remove it from the blood, elevated blood glucose levels eventually affect the heart, blood vessels, and kidneys.
If you’re at risk of developing diabetes, there are a cluster of three symptoms to discuss with your doctor, like increased:
- HUNGER: when meals aren’t satisfying or there are perpetual cravings for sugary foods
- THIRST: unable to quench thirst even after drinking adequate amounts of fluid
- URINATION: are you always in the bathroom?
Other symptoms include fatigue, blurred vision, slow-healing wounds, and weight loss. Have you lost significant weight recently but are unsure why? Unexplained weight loss related to hyperglycemia isn’t healthy. Along with the other symptoms, it signals that your body isn’t producing enough insulin or metabolizing insulin appropriately.
If you have any combination of these symptoms, make an appointment with your doctor, don’t wait.
Counting Carbs
Since the 1920s, tracking carbohydrate intake with insulin or other diabetes medications has been the gold standard for managing hyperglycemia for patients with type 1 diabetes. However, researchers continue to explore the efficacy of tracking for T2DM. Recently the medical community has been moving away from it. The American Diabetes Association offers a diabetes plate approach similar to MyPlate. More recently patients informed me that their endocrinologists don’t emphasize medical nutrition therapy while using glucose meters and insulin pumps. My RD brain thinks they should’ve been referred to a registered dietitian diabetes educator. In my experience, MNT should be tailored to the individual. Some patients are more willing than others to utilize education, while others want to be told what to eat.
Avoiding carbs altogether is never the right way to go. Even with hyperglycemia the body still needs adequate carbohydrates. Your muscles and brain need them to function. Avoid listening to negative messages about carbs and learn why the body needs them. Arm yourself with education from trusted sources. Avoid Clickbait websites offering cures using vitamin supplements or other unproven remedies. There’s no cure for diabetes and spending too much time looking for one is a sure-fire way to miss out on healthy successful management.
Get enough fat in your diet
I’m old enough to remember the fat-free frenzy in the 80s and 90s and guilty as charged following it without questioning it. Society learned its lesson with a hungrier population that overconsumed carbs.
A balanced diet includes heart-healthy fats in avocados, nuts, seeds, and fatty fish. Fat adds flavor to food and helps us feel fuller longer. The jury is still out on whether saturated fat should be limited for heart health, but it’s important to remember your overall dietary intake and eating behaviors. Even so, to manage diabetes, I don’t recommend the Adkins or Carnivore diets.
Avoid high-protein fad diets
Fat-free mania gave way to the protein obsession that’s evident at every grocery store. Everywhere we’re told we don’t get enough of it, and of course, there’s a product to help with that. Healthy people on a regular diet, while not restricting their dietary intake, usually consume enough. Overconsumption leads to weight gain and is harmful to the kidneys, especially with the overuse of protein powders and supplements.
Get moving
Physical activity improves muscular, skeletal, and cardiovascular fitness while it improves glucose metabolism. If you are sedentary, look for opportunities to move more. I know it’s easier said than done, there are barriers to exercising and it’s never easy to start. How can you increase activity by making it part of something you enjoy? I like to hike in state parks to get fresh air while watching the butterflies and bees interact with the native plants. You don’t have to join a gym or jog on the side of the highway. Check with your doctor before starting any exercise program if you’re experiencing any health issues.
Take care of your mind
Receiving a diabetes diagnosis can be a slap in the face for some patients. It’s usually followed up by the overwhelming education from health practitioners which results in information overload. It’s understandable to feel a range of emotions after going through that. There’s nothing wrong with letting things settle and giving yourself time to process it all.
Even though I mostly accepted my situation, I can’t help but wonder if there’s something else, I can do to prevent a diagnosis. Deep down inside I hope for a cure. But then I think of the privileges I was fortunate to possess for maintaining my health and how my choices benefited me later in life. I also believe that if there is breath in your lungs and a beat in your heart, it’s never too late to keep learning and doing.
Plenty of research points to weight loss for diabetes management. Science continues to evolve and rarely considers a patient’s individuality and how they think and feel. I recommend staying focused on improving your body’s physical fitness and making necessary dietary changes. Your weight will trend accordingly because your body will respond to how you treat it. Steer away from black-and-white thinking: good foods vs bad foods or thinner bodies are healthier than larger ones to avoid increasing anxiety and allow for an open mind. Self-blame and unacceptance won’t move you forward. To reach your fullest potential, accept what nature gave you then maximize it.
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