Some Simple Advice

  • If you have not done it already, talk to a nutritionist about what you eat and how you can improve your nutrition

  • Begin a walking program at 10 minutes a day with a goal of having a total walking time of greater then 30 minutes of a brisk walk and build on it by increasing exercise tolerance


First thing to do is to Increase physical activity

Goal of 150 minutes per week of moderate-to-vigorous intensity activity, spread over at least 3 days per week, with no more than 2 consecutive days without exercise.

Intensity (How hard to work?) : Moderate intensity means working at 40-59% of heart rate reserve, while vigorous intensity is at or above 60%. Perceived exertion (e.g., being able to talk but not sing during moderate exercise) can also be used.

Duration (How long to go?): Bouts of at least 10 minutes are recommended, but even shorter bouts can be beneficial if accumulated throughout the day.

Examples: Brisk walking, jogging, cycling, swimming, dancing.

Simple Nutrition Recommendations

Aim to eat healthy protein such as lean meal, fish, tofu. Recommend healthy fats including avocado, nuts. Half of your plate should be vegetables. Avoid processed carbohydrates, sugary meals. Recommend brown over white rice, whole rather than bleached/ white pasta. Recommend grain such as quinoa, barley, bulgar, buckwheat as a good source of fiber and complex carbohydrates.

 

What to do if you have a low blood sugar:

  • If you suspect a low blood sugar, test your blood sugar (symptoms include shakiness, dizziness, extreme hunger, extreme thirst, fatigue, blurred vision)

  • If the number is <70, treat!

  • Ingest 15g of a simple carb (simple sugar) Example: 4 oz of juice (not diet), 4 oz of soda (not diet), spoonful of sugar/syrup/honey, 4 glucose tabs, 1 tube glucose gel, package of fruit snacks, 5 lifesavers, small piece of fruit.

  • Wait 15 minutes (your body needs 15 minutes to process the simple sugar).

  • Recheck your BG after 15 minutes. If going up, proceed to step 6. If not going up, repeat step 3.

  • Once your glucose is back above 70 mg/dl eat a meal if it's time for a meal, or a snack, to prevent the low from coming back.

  • Please inform me if you are having frequently low glucose levels or levels <70mg/dl. We may need to adjust your diabetes medications.

Principles of dietary management for diabetes:

  •  Breakfast/morning as time of day of highest insulin resistance due to peak of counter-regulatory hormones like cortisol- this is time of day to limit carbohydrates

  • Choosing carbohydrates that have higher fiber/protein content, avoiding "simple" carbohydrates. Choose carbs that are higher in color versus "white" and those that take longer to cook i.e ancient grains such as faro/quinoa or brown over white rice; sweet over white potatoes; steel-cut vs. instant oatmeal

  • Always pair carbs with healthy fat and a protein: eat that portion of meal first to induce satiety and limit carb portion

  • Avoid sweetened beverages- beverages should have O calories (with the exception of milk in moderation)

  • Discussed exercise/walking after large carb intake as a way to also reduce blood sugar.

What is a Diabetic Emergency?

  • If you are having an episode where your blood glucose is greater >250 or <70 consistently to contact the the clinical expert who helps you manage your diabetes.

  • If vomiting, feeling unwell, changes in mental status to go to the emergency department.