Beyond Diet and Exercise

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One thing writing this blog and reading comments for over three years has taught me: Living well with diabetes means much more than just diet, exercise, and medicines.

Here are six of the most valuable tips I’ve discovered.

1. Take care of your mouth.

Gum disease is related to serious conditions such as heart disease and kidney disease. It may as much as triple the death rate from diabetes! It does this by causing inflammation that can travel through your whole body.

Brush your teeth at least twice a day and floss at least once, preferably at bedtime. Use an antiseptic mouth rinse and keep it in your mouth for 1–2 minutes minimum. Have your teeth cleaned professionally once or twice a year if possible. Read more here.

2. Love your feet.

As you know, diabetes increases the risk of foot complications and can cause slow wound healing. Foot infections, in turn, can make diabetes control more difficult. Gently wash, dry, and moisturize your feet every day (however, do not apply moisturizer between the toes). Check for cuts, scrapes, blisters, and other injuries. Wear comfortable shoes and good socks. Don’t expose feet to sharp objects. Read more here or here or check out the Foot Care section of this Web site.

3. Get good sleep.

Your diabetes control and well-being will improve with decent sleep. If you have difficulty sleeping, learn about good “sleep hygiene (sleep habits),” and find ways to relax and unwind for bed. Make your room sleep-promoting — dark, quiet, and comfortable. Consider taking melatonin at dinner; it helps a lot of people. (Be sure to speak with your doctor first if you are considering using melatonin or another supplement to help you sleep.)

If you wake up during the night or feel tired in the morning, you might have sleep apnea. This is a serious condition and should be treated accordingly. Get it checked out. You might also have bladder problems or restless legs, both of which can be managed.

If you find yourself waking too early and can’t get back to sleep, you may have depression. Ask for help with this. There are many ways to self-manage depression, too.

4. Manage stress.

Stress is a huge contributor to diabetes and its complications. Stress can increase insulin resistance, blood glucose, and blood pressure. As much as possible, reduce stress or avoid it. If you can’t, learn better ways to cope with it.

Of course I know this is all much easier said than done, but some things do work. Meditate, pray, or relax every day. Some forms of exercise, like yoga and tai chi, can be relaxing as well as energizing.

5. Control blood pressure.

Blood pressure is nearly as important as blood glucose levels. I wrote about this last week, but it’s worth repeating. Several readers suggested taking magnesium for blood pressure, and the National Institutes of Health agree that magnesium “helps regulate blood sugars [and] promotes normal blood pressure.”

And while we’re on the topic of supplements, many readers wrote in about how much vinegar has helped them lower their blood glucose. I think this is one of the best things I’ve learned in this job. So simple, cheap, and effective! Thanks, guys.

6. Reduce inflammation.

Inflammation plays a role in the development of diabetes complications. High blood glucose levels cause inflammation, but so do a lot of other things. Certain foods promote inflammation; others, like most vegetables, reduce it. Read more here.

I would suggest taking an anti-inflammatory like aspirin or salsalate every day; take with food to protect your stomach. (The American Diabetes Association currently recommends that men under age 50 and women under age 60 who have diabetes but no other major risk factors for heart disease should probably not be on low-dose aspirin therapy due to certain risks, such as stomach bleeding. Speak with your doctor if you are considering starting an aspirin or salsalate regimen.)

7. Love yourself.

And if I might add a seventh point, diabetes self-management has nothing to do with denying yourself or abusing yourself. Those approaches don’t help in the long term. It’s important to love yourself, enjoy your life, and hopefully surround yourself with people who love you, too. Love is one of the most powerful medicines we have. Or is it a nutrient? Anyway, I wish you all more of it.

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