Lifestyle Changes: The ideal prescription for controlling diabetes
The statistics are not encouraging — 16 million people in the United States have diabetes, a chronic — today uncurable — disease. Yet there are relatively simple ways to live with diabetes while avoiding major complications and preventing the disease's progression.
At the heart of the solution is changing one's lifestyle: watching what you eat, exercising, not smoking, drinking alcohol only in moderation, controlling stress and becoming educated about the disease.
“A healthy lifestyle can almost reverse diabetes,” says Cindy Rudolph, R.N., a certified diabetes educator.
Mills-Peninsula takes the prescription for a healthier lifestyle seriously by offering a monthly, eight-hour group class over three days. It focuses on medications, psychosocial issues (such as stress), maintaining targeted blood sugar levels, nutrition and exercise. Rudolph and a dietitian meet with each participant before the program begins.
The majority of people with diabetes have Type 2, in which the body is unable to efficiently use insulin that helps carry sugar from the blood into the cells for energy. In Type 1 diabetes, which affects mostly children and young adults, the pancreas does not produce any insulin. Gestational diabetes is another form of the disease; the risk of getting it is aggravated by excessive weight gain. Although the diabetes disappears after the baby is born, women with this type are more prone to developing Type 2 diabetes later. The risk for diabetes increases with age, obesity, heredity and for certain racial groups.
What bothers Rudolph is the prevalence of the disease and the growing rate of children who are getting Type 2 diabetes, which in the past affected mostly older adults. To Rudolph, who teaches the Mills-Peninsula class, diabetes management starts with education — making sure that those with the disease fully understand how to control it and prevent complications.
“There is a lot of folklore out there about what people should or should not eat,” she says. “Many people with diabetes are obese, and we have found that losing 10 to 20 pounds can dramatically lower blood sugar,” Rudolph says. “The more muscle mass a person has, the better able they are to metabolize their glucose. That is why both proper diet and exercise play such critical roles.”
The mantra for healthy eating is well-balanced, low-fat meals, which help prevent heart disease, and the recipe is no different for those with diabetes. Rudolph recommends cutting down on carbohydrates, eating smaller portions more often rather than too much at one sitting and reducing fat and sugar intake.
Taking control through exercise Bonnie DeLeuw, R.N., a certified diabetes educator at Mills-Peninsula, tuned into the disease when her daughter developed diabetes 12 years ago. She works with those who have a history of diabetes and individuals recently diagnosed, and puts together a personalized exercise and educational program. “Exercise makes insulin more sensitive, lowers blood sugar, develops cardiovascular conditioning and builds self-esteem,” DeLeuw says. She recommends exercising three times a week for at least 12 weeks to see any positive changes.
The program's primary goals are improving blood sugar control, developing cardiovascular conditioning and improving the knowledge and care of diabetes. It starts with a group warm-up, followed by exercise designed to meet each participant's needs as determined in a one-to-one orientation by DeLeuw. The fitness center houses stationary, arm and aerodyne bikes; tread mills; rowing machines; wall pulleys; free weights; and other equipment. The class ends with a group free weight session and a cool down period.
DeLeuw monitors blood sugar, hoping to keep hemoglobin A1c under seven percent to significantly diminish the risk of complications of diabetes. Heart rate and blood pressure are monitored before, during and after exercise to meet heart rate targets.
“We look at the whole person — checking blood sugar, blood pressure and lipids — since diabetes has so many complications,” DeLeuw says. “Our exercise program helps people maintain a high level of health and well-being on their own. I tell patients that they can let diabetes control them or they can control the disease.”
For more information about the diabetes class, call Rudolph at 800-654-9966. To register for DeLeuw's fitness class, call her at 650-696-5824.