Controlling Diabetes - A Personal Story

The author was diagnosed with Type II Diabetes in 2004. The  Hemoglobin A1C (HgA1C) that this initial diagnoses was based on came out to 7.4 mg/l or 133 mmol/l.  As a guideline, a HgA1C result above 6.9 mg/l or 125 mmol/l indicates that a person is a Type II Diabetic.

After initial diagnosis, with prescription drugs in hand, the journey of keeping blood sugar under control began. An exercise program had already been started and was steadily increased and in less than a month, the medication was too powerful and resulted in low glucose readings. After consultation with the attending physician the medication was dropped and the diabetes was controlled strictly with diet and exercise.

Initially, exercise was the easy part, diet however was a mystery.  To start with, all carbohydrates were eliminated from the diet , which created problems with nutrition, although weight was lost rapidly. As a result blood sugar was under control, but the body was deficient of other needed nutrients.

It wasn’t until I attended a one day seminar on diabetes care, the mystery of diet was resolved. The bottom line is that a diabetic can eat almost everything within reason, as long as the portion size is monitored closely. The website www.eatracker.ca provides excellent tools to monitor ones food and nutrition intake. The activity and food intake tools provide the user with calorie intake and calculates your energy intake as a percentage of protein, fat and carbohydrates. Dieticians of Canada recommends 10 -35% for Protein, 20-35% for Fat and 40-65% of Carbohydrates in your complete diet.

One method taught during the seminar was the rating of a plate. ¼ of the plate should be meat, ¼ carbohydrates and half the plate should be vegetables. To my surprise it works.

Over several years my diabetes was easily controlled until I let down my guard. Over a period of a year, weight was gained, diet was disregarded and eventually it presented the inevitable results.

2010 was a particularly difficult year for me. I had to euthanize a dog that had been with me since he was a puppy, but at 12 years old he suddenly took ill. In November I was required to euthanize a 30 year old mare that had been part of my life for 21 years. I stopped exercising, overeating (comfort food) and lacked activity.

Although I was not feeling ill in a particular way, I knew that something was amiss. At the beginning of February I saw my physician and lo to my surprise my BP was dangerously high. It was high enough that the doctor decided that taking blood tests would not provide accurate results, since in his opinon they would give a distorted picture. He wanted to hospitalize me to stabilize the blood pressure. I talked him out of it, telling him that I had horses to feed.

He put me on a regime of cyversol plus and baby aspirin. For the first two weeks, other than feeding horses, there was no other physical activity. I reduced my diet intake and probably overdid it, feeling ill on most day. A week later I returned to the doctor’s office and my blood pressure had come down into the 150 range but it was still too erratic for blood tests. I kept on the same program, religiously checking my blood pressure and without any idea where my blood glucose was at.

During my visit to the doctor’s office after two weeks, the blood pressure had stabilized enough for blood tests and the doctor gave me go ahead to exercise as long as it wasn’t overdone. The bloodtests were less than charming. My nutrition levels were down, especially sodium and my HgA1C was at 8.1. Needless to say, none of this made me happy.

This sets the stage of where I started with a deliberate program to:

a. Reduce my Blood Pressure; and

b. Get blood glucose under control

In Part 2 of this series I will describe the action I took and how I approached diet and exercise along with the tangible results I achieved. Suffice to say, that both blood pressure and blood glucose can be controlled, with minimum use of medication as long as you are under the care of a physician.

What is diabetes?

There are two types of diabetes, Type I and Type II. Below are the simple definitions:

Type I Diabetes - This is a diabetes that can occur at any age, but is usually found in children and young adults. It is a condition where the pancreas produces little or no insulin and blood glucose levels must be controlled with insulin injections and the intake control of carbohydrates.

Type II Diabetes - This was formerly known as adult onset diabetes and as it indicates occurred with adults. An alarming number of children are now being diagnosed with this type of diabetes. Type II diabetes is often related to lifestyle, thus it is no surprise that in today's environment of computers and other digital devices, coupled with poor dietary habits, that this disease has reached epidemic proportions.

With Type II diabetes the pancreas still produces insulin, but is not efficient. Type II diabetes can be controlled with exercise and diet or a combination of exercise, diet and diabetes medication. From the author's point of view, when possible this disease should be controlled by lifestyle changes, including exercise and diet.

Disclaimer: All efforts of controlling diabetes (Type I or Type II) must be undertaken, while under the care of a medical professional.

One of the complications of Type II diabetes is also High Blood Pressure. Hypertension, especially if severe, will in all likelihood be treated with medication eventually, but under the care of a physician may be controlled with good lifestyle habits such as diet and exercise. Speak to your physician before making any changes to your medication or undertaking an exercise program.

Blood Glucose Levels - Blood Glucose levels for the average person should be in a range of 4.0 to 7.0 mmol/l (65 - 170 mg/dl). Type II Diabetes is normally diagnosed if the Hemglobin A1C1 ( reading exceeds 7.0 (170 mg/dl). My initial HgA1C reading on diagnoses was 7.4 (133) in 2006. I was able to get it to a respectable level with diet and exercise. One of my pitfalls was that I let down my guard, felt overconfident and took the eye of the ball. When retested in early 2011 my A1C1 had reached 8.4 (222). Uncontrolled this would have eventually crept up and cause complications.

My Program

As previously discussed, the shock came during a routine doctor's visit in early February. Hypertension was at what the doctor described as a stroke waiting to happen systolic reading in the doctors office was in excess of 200, while the diabolic was close to 100. Needless to say the doctor was concerned and wanted to hospitalize me, which I refused. That was probably not wise, but it is me.

The doctor prescribed Coversyl Plus HD at a strength of 8mg + 2.5 mg along with ASA (Baby Aspirin). I had to agree to make return visits weekly. I immediately started to take the prescribed medication and started watching my diet. As far as the diet went, I probably overdid it and almost starved myself. Despite having been a soldier and on forced diets, reduction of diet in this case was drastic and my body let me know. I deprived myself of nutrition and didn't follow the food group recommendations. This changed after my first return doctor's visit, when my family doctor enlightened me on the errors of my ways. In the introduction I mentioned eatracker.ca as a great tool to watch your diet.

After medication, diet was the next step to control hypertension. After week two the doctor gave me the go ahead to start a measured exercise program with the advice not to overdo it.

Exercise Program and Results - My exercise program was simple and measured. I started out with riding an exercise bike for 10 minutes once a day. Blood pressure, with medication had slowly stabilized and was now around 130/80. Each day I added 1 minute to my program until I reached 20 minutes, at which time I did five days at 20 minutes.

Weight loss, glucose control and Blood Pressure remained under control. My glucose reading moved from daily averages of 7+ to a range between 6 and 7. Blood Pressure was also improving.

Eventually I added a daily walk to my exercise program, which I started at 20 minutes and again adding a minute a day. By mid April my Blood pressure had become such that I reduced my blood pressure medication to half. My blood pressure readings had dropped to just 100 over 55-65.

My exercise program is now up to 55 minutes on my exercise bike and 50 minutes walking. Controlling diabetes takes determination and a good exercise program, suited to yourself.

Diet Considerations

Conventional wisdom has it that diet is a big part of any diabetes control. As previously stated carbohydrates are almost poison for Type I diabetes. For Type II diabetes, it is necessary to stay away from sugar loaded foods, found in a lot of cereals. It is best to start looking at the Nutrition Labels, which are mandatory in both Canada and the U.S.

Having initially left my doctors office, during my initial diagnosis in 2005, with little information on what to do and a prescription for a drug, I was left to my own devices to figure out how to deal with it.  Both the American and Canadian Diabetic Associations have excellent websites to look at food groups and what a diabetics meal should look like. Without advice of a dietician, it can be difficult to navigate your way through the jungle. I found out a shortly that after taking medication and depriving myself of certain foods, I ended up with glucose readings dropping to a dangerous level. After talking to my doctor I ceased taking it.

In Alberta's Capital Health Region ran a Diabetic Seminar.  It wasn't until a few months later that I discovered this.   In the morning a nurse, specializing in diabetes, had half a day, while a dietician had the other half. One of the most important things I learned about diet was that you rate your plate and balance your diet to include the requisite amount of servings. These can be found on the Diabetic Association website and the website of dieticians of Canada www.eatracker.ca . This website permits you to input your gender, age, weight and calculates your body mass index and the number of calories required to maintain your present weight. If you are trying to lose weight, dropping approximately 500 calories off your daily intake per day will let you lose about 2 lbs per week. This is healthy weight loss.

Rating your plate

Rating your plate is a good way to judge your intake and nutrition requirements. Your plate should contain one quarter meat products, one quarter carbohydrates and half the plate should be vegetables. Sound simple enough, right?

My daily intakes consists something similar to this and it has worked:

Breakfast - A whole grain bagel with cream cheese and a tomato, coffee

Lunch - I prefer rye bread, but any whole grain bread will do.

2 slices of rye bread

1 or two slices of light deli meat

mustard - about a teaspoon

a vegetable , tomato, carrots,

a pickle

1 cup of 1% milk

Dinner - almost any type of meal using the guidelines of a rated plate above. Meat should be about the size of the palm of your hand or a playing card

fresh or frozen veggies either boiled or pepared in the microwave. Should be about 2 cups

Carbohydrates (potato, spaghetti (whole grain), other whole grain noodles.)

As you can see from my typical meal, almost anything is possible and you can have variety. A key to healthy eating is the intake of fruit and vegetables. Having snacks at mid morning (either an apple or orange or other fruit) are great. Try to stay away from comfort food. My evening snack normally consists of a bowl of cereal (bran flakes, shredded wheat, special K, etc) Make sure you check the sugar content and stay away from cereal with too much sugar per serving.

The exercise program and diet will also put you down the road of success with your hypertension. While most of it sound relatively easy, it takes commitment to be successful. Feel free to ask me any questions on this subject.

Tools.

To properly control your glucose and blood pressure, it is essential that you have the proper tools.  Several pharmaceutical companies provide glucose monitors free of charge, at least in Canada, when you purchase the test strips.  In my case I use a Bayer Contour.  To maintain control and monitor you blood pressure the purchase of a blood pressure monitor is desireable.  I use an Omron Intellisense, which is a few years old.

Testing

I do Blood Glucose testing approximately four times a day, a fasting reading when I first get up, and then 1 or two hours after eating breakfast, lunch and dinner. 

I have found, when taking blood pressure readings, it is best to take it several times and get an average reading, i.e. take it five times in a row each time.  I normally check it before going on exercise and after exercise and again in the evening after dinner.  It is worthwhile to record those reading in order to discuss them at your next doctor's visit.