Close to 10 percent of the population has diabetes and the life threatening disease “is just too large for one quick fix,” UCF Health endocrinologist Dr. Rema A. Gupta told members of the community at a recent “Strategies for Successful Diabetes Management” talk. The free public event was part of the Kick-Start Your Healthy New Year series presented by UCF Health, the College of Medicine physician practice.
Managing diabetes is key to avoiding the disease’s potential complications – including kidney failure, heart disease and blindness. And Dr. Gupta recommends a three-prong approach of medication, physical activity and healthy eating.
There are many new – and frequently advertised – drugs for treating diabetes. However, “when it comes to medications, just because it’s new doesn’t mean it’s better,” Dr. Gupta said. She said insulin – taken through injections or an insulin pump — remains one of the best medications for Type 2 diabetes because it has been well studied and has fewer side effects than some other medications.
However, there are many medication options to discuss with your doctor, from sulfonylureas to GLP-1 receptor agonists, so it’s important to recognize that there’s never a static approach to medications. Blood glucose-lowering therapies must be individualized and will most likely change over time in response to factors like weight fluctuations, increased exercise and potential side effects. Dr. Gupta said she takes an aggressive approach to treatment, often starting with two to three medications.
The next line of defense in managing diabetes is exercise because it works to lower blood glucose, blood pressure and cholesterol, among other benefits. And especially important for people with diabetes, exercise helps insulin work more effectively.
“Whatever type of exercise you enjoy is the key to success,” Dr. Gupta stressed. Remain active throughout the day, she said, and include in your routine aerobic activities such as brisk walking, swimming or dancing along with strength training like lifting weights. While it’s best to exercise 30 minutes a day, five days a week and include strength training at least twice a week, patients can also break exercise into smaller intervals of time if that’s easier, she said.
If you find it difficult to fit exercise into your busy day, try making simple modifications to your routine, such as parking far from the door, taking the stairs instead of the elevator and finding a physical activity to do with your kids. Dr. Gupta even suggested joining organized walks like “Step Out Walk to Stop Diabetes,” sponsored by the American Diabetes Association. There’s no registration fee and the Orlando event is November 14.
Dietary changes can often be the most difficult part of diabetes management, so Dr. Gupta discussed two methods that can help simplify the process—the “plate method” and “carbohydrate counting.”
When using the plate method, fill your 9-inch plate half full of veggies; one-fourth full of breads, grains or starchy veggies; and one-fourth full of a protein. Be sure to include a small piece of fruit (about a half cup) and a cup of dairy (1% or skim) on the side.
When using the carb counting method, remember that major sources of carbohydrates include starches, fruits and milk. One carb choice equals 15 grams of carbohydrates. Most fresh vegetables are “free foods,” meaning you can eat as much as you like.
Start with three to four carbohydrate choices per meal and one carb choice for a snack. Healthy snacks with 15 to 20 grams of carbs include 2 small clementine oranges, half a banana, 17 small grapes or one cup of berries. Whole fruit gives you a bigger size snack than the same quantity of dried fruit. For example, a small box of raisins is about 100 calories, which is equal to 1 cup of grapes.
Managing diabetes also means teaming with your doctor to understand your risks and make lifestyle changes to improve your health, she said. So Dr. Gupta recommended keeping “A, B, Cs” in mind when visiting your doctor:
- A – Ask about your AIC, which is a blood test that estimates your average blood sugars over the last three months. As a general rule, your AIC should be around 7 percent.
- B – Make sure your blood pressure is within a healthy range for you
- C –Ensure you cholesterol is within a healthy range