Dr Louise Johnson offers hacks for healthy winter living for people with diabetes.
Professor Elliot Joslin was the first doctor specialising in diabetes in the United States. He was involved in diabetes for seven decades (June 6, 1869 – January 28, 1962) and first recognised the management of diabetes as the management of diet, exercise and correct medication to prevent complications. He coined it the “three wild horses of diabetes running each in its own direction.” To live healthy, it’s important to get the balance between diet, exercise and the correct medication. Either too little or an excess of any of the three can throw the scales over and cause havoc.
A well-balanced diabetes diet that has adequate portions of starch, lean protein, vegetable, fruit and fat in the form of nuts and avocado is important.
Note, it’s vital to take in all your vitamins, especially in winter or during stress and illness when the immune system is down. Oral supplementation may be necessary. In winter and during stress and illness there is a need for more vitamin C, zinc and vitamin D.
- Vitamin C in dosage of 500 to 1000 mg per day improve the immune system.
- Zinc is a nutrient that is important in the body for a healthy immune system, good wound healing and prevention of age-related macular degeneration. It’s found in chicken, red meat and fortified breakfast cereals. It’s good to supplement in winter: a dosage of 8 mg for women and 11 mg for men.
- Vitamin D is more important in winter since we get less sun exposure.
- Adequate calcium (600mg/d) is also important for good bone health throughout life in both men and women. Osteoporosis is four times more prominent in people with diabetes and can be prevented by calcium supplementation, sunlight and exercise.
- During winter or sometimes watching TV, snacking is a problem amongst many people. Try to minimise this or do healthy snacking with cucumber or popcorn.
- Water is always important. The calculated amount of water is your weight without the naught. For example: 60 kg person will need six glasses of water per day. This can be divided between tea, juice and water. Remember that coffee doesn’t hydrate. To get access to healthy water, use a water filter or boiled and cooled down water.
- Don’t forget your probiotics for a healthy gut. The best form is in the form of yoghurt. Should you not get enough yoghurt, a supplement can also help but natural is always better.
The importance of aerobic exercise can’t be overstated. This increases insulin sensitivity and helps you use less insulin more effectively, burn fat and prevent osteoporosis. Any form of aerobic exercise (walk, swim, run or cycle) for 30 minutes per day is recommended.
- Exercise in the morning is better for glucose control since insulin resistance is at its highest value then. Be careful of hypoglycaemia after exercise, especially if you do it in the evening.
- Anaerobic exercises (weightlifting) can push up glucose due to the stress response of the body. It’s wise to do a combination of aerobic and anaerobic exercises dependent on the glucose level to help with control. For example, if glucose is above 10 mmol before exercise start with aerobic training (walking or running) and end with squats and weights. The reverse works well too when glucose is between five and 10 mmol to start with weights and end with aerobic exercise.
- Always have a sugar snack handy and remember to hydrate well. Drink enough water and stretch well before and after exercises.
- Proper shoes are important for people with diabetes, especially if you already have nerve damage with loss of sensation and burning feet. Don’t forget proper socks are as just important as shoes.
To control the three wild horses, the correct medication is important. Remember that medication changes continually and better medication become available as well as devices (insulin pumps and glucose sensors). Visit your diabetes specialist regularly for an evaluation.
Other general hacks
It’s important for good control of glucose and a healthy immune system to sleep at least six hours per night uninterrupted. If you have trouble sleeping talk to your doctor. Avoid caffeine (coffee) before bedtime. Daytime sleepiness can be a sign of sleep apnoea and can be diagnosed with a sleep apnoea test and managed with sleeping with a special mask. This will also improve glucose control and weight issues.
Seasonal affective disorder
Many people suffer from seasonal affective disorder (SAD) when the weather changes to cold. Symptoms include feeling tired, depressed, down or lethargic. Care for your mental health. Depression is 50% more common in people with diabetes and if symptoms persist despite healthy living, seek professional help.
Reduce shower/bath time
There is nothing better than a long hot shower or bath especially during winter times. You shouldn’t exceed this time with 10 minutes since all the healthy oils of the skin can be washed away. This can increase weakness and peeling of nails.
When we are stressed out, our immune system is compromised, and this can give viruses and bacteria space to cause problems. To help prevent this, spent time meditating daily in whatever form relaxes you. Reading, listening to music, drawing, sitting and reflecting.
The more constant we keep our body temperature, the easier it will be to fight of infections. Remember a scarf. Cold viruses spread in the cold. Your nose is the highway to your lungs. Keep it warm.
Remember to wash your hands
This is now second nature to us in the COVID era but don’t forget when inside and touching your face, wash your hands regularly. Travel with wet wipes when touching all those surfaces that are unavoidable and full of germs.
Gargle regularly with warm water and a teaspoon of salt. This is anti-inflammatory and good for teeth and throat health. Gargle and spit with warm water until the salty taste is gone.
I can’t think of a better stress reducer than laughing. Watch your favourite movie and start laughing.
In the Middle Ages, it was tied around the neck to ward off evil. It still helps with those evil viruses by boosting your immune system. Be sure to crush whole garlic to get all the goodness that comes from its health-giving compound: allicin. Add it to your soups and stews for a healthy winter.
It’s good practice for people older than 50 years of age and those living with diabetes to be up to date with vaccines. Don’t forget the annual flu vaccine that is very effective against flu.
Do everything in moderation from diet, exercise to taking supplements. Remember too much is just as harmful as too little.
MEET THE EXPERT
Dr Louise Johnson is a specialist physician passionate about diabetes and endocrinology. She enjoys helping people with diabetes live a full life with optimal quality. She is based in Pretoria in private practice.
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