Beyond What You Eat: How Lifestyle Habits Affect Diabetes

If you have diabetes or know someone who has it, you're well aware of how important diet is to managing the onset of symptoms. But you may be overlooking exercise and other lifestyle habits, such as foot and skin care, that are also important in helping manage this chronic disease.

If you don’t actively manage this common disease, which affects nearly 8 percent of the U.S. population, you could experience long-term complications such as heart attack, stroke, blindness, kidney failure, amputation, nerve damage or male impotence.

And if that doesn’t scare you enough, know this: Diabetes is on the rise, fueled largely by the current obesity epidemic, according to the National Institutes of Health. So learning how to prevent the onset of the condition in the first place, or how to manage your diabetes to avoid the onset of complications, can help save your sight, legs, kidney, relationship and life!

What is diabetes and who gets it?

There are two types of diabetes. Type 1 diabetes, formerly known as juvenile diabetes, affects mostly children and young adults. It results from the body’s failure to produce insulin, the hormone that enables the body to use glucose found in foods for energy, and accounts for about 5 to 10 percent of diagnosed cases.

Type 2 diabetes, formerly known as adult onset diabetes, makes up the majority of diabetes cases in the United States. It results when the body doesn’t produce enough insulin and/or is unable to use insulin properly (insulin resistance). This form of diabetes usually occurs in people who are over 40, have high cholesterol and/or blood pressure, are overweight, and have a family history of diabetes, although, sadly, today it is increasingly occurring in younger people, particularly adolescents. More than 80 percent of adults who have type 2 diabetes are overweight or obese.

Native Americans, African Americans, Hispanic Americans and Asian Americans/Pacific Islanders are more prone to diabetes. Also, people who develop diabetes while pregnant (a condition called gestational diabetes) are more likely to develop full-blown diabetes later in life.

Telltale symptoms of diabetes

According to Amy Jamieson-Petonic, a nutritionist, dietician and Director of Wellness Coaching at The Cleveland Clinic, the five most common symptoms include:

  • Increased thirst and frequent urination. “As excess sugar builds up in your bloodstream, fluid is pulled from your tissues. As a result you many drink — and urinate — more than usual.”
  • Extreme hunger. “Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger that may persist even after you eat.”
  • Weight loss. “Despite eating more than usual to relieve hunger, you may lose weight — sometimes rapidly, because without the energy that sugar supplies, your muscle tissues and fat stores may simply shrink.”
  • Fatigue.
  • Blurred vision. “If your blood sugar level is too high, fluid may be pulled from your tissues, including the lenses of your eyes.”

Lifestyle changes to help avoid or manage your diabetes

Since both types of diabetes are chronic diseases, it’s important to focus on healthy lifestyle changes to avoid getting type 2 diabetes in the first place, if you can, and to manage your glucose levels to avoid problems if you are already diagnosed. The good news is that studies show that small changes, such as losing a modest amount of weight (5-10 percent of body weight) and modest physical activity (just 30 minutes a day), can prevent or delay the onset of type 2 diabetes in adults who are at high risk of getting the disease.

For those already diagnosed with type 1 diabetes, and some with type 2, insulin injections will most likely be needed. Some people with type 2 diabetes may take medication to help them produce more insulin and/or use the insulin they are producing better. But enough can’t be said with regards to the importance of diet and exercise when it comes to keeping your glucose level under control.

In fact, a nationwide study completed over a 10-year period showed that if people keep their blood glucose as close to normal as possible, they can reduce their risk of developing complications by 50 percent or more.

“If you have diabetes, the most important thing you can do is control your blood sugar,” says Laurie R. Roust, M.D., a Mayo Clinic endocrinologist. “There is no cure for diabetes, but there are many things you can do to control the blood sugar to keep yourself healthy, to keep yourself energetic, and to prevent complications.”

Exercise

Exercise can do more than just help you lose weight — it can help the body use insulin better so it can convert glucose into energy for cells.

“Exercise is an important part of controlling diabetes,” says Larry Bergstrom, M.D., of Mayo Clinic. “Your skeletal muscle is an important area that uses blood sugar. So by using your muscles, it will take the blood sugar out of your blood to help you manage it.”

Bergstrom says that any sort of physical, regular aerobic exercise on a daily basis will help you — even just walking. “It's easy to do,” he says. “And it's something that can be done anywhere.”

Ilana Fishman, mother of 4-year-old twins, was diagnosed with type 1 diabetes when she was 11. In addition to using an insulin pump, she says she tries to exercise at least three to four times a week. “On the days I don’t exercise, I can feel the difference,” she says. “My blood sugar is higher and I feel tired and sluggish, and sometimes I feel like crap.”

But on the days she does exercise, she feels more energetic and better overall. “Exercising has a 24-hour effect, so if I do it one day it carries over into the next,” she says.

Jamieson-Petonic says that being active on most days, including getting both cardiovascular exercise as well as strength training, is very important to managing your glucose levels.

Managing stress

In people with diabetes, stress can alter blood glucose levels in a couple of ways. On the one hand, those under severe stress tend not to take good care of themselves and might resort to alcohol, unhealthy diets and skipping exercise. Second, stress hormones may also alter blood glucose levels directly.

“Stress management and treatment of anxiety or depression are all very important aspects of treatment of diabetes,” says Dr. Rouse. “Oftentimes they are overlooked because we focus so much on the food and the exercise and the medications. But, in the background, too much stress will tend to aggravate the blood sugars directly.”

To reduce or manage stress, Jamieson-Petonic suggests exercise, meditation, guided imagery biofeedback, reading a book or just listening to relaxing music.

The American Diabetic Association suggests that if having diabetes is one of the causes of your stress, you might consider joining a support group. Knowing other people in the same situation helps you feel less alone. Also, you can learn other people's hints for coping with problems. And lastly, making friends in a support group can lighten the burden of diabetes-related stresses.

Foot, skin, dental and eye care

It’s important to schedule regular eye and dental appointments and to check your feet and skin for diabetes-related issues such as sores or dryness. Why?

Diabetes affects the tiniest blood vessels in your body, explains Dr. Bergstrom, and they're most commonly seen in your eyes, your kidneys and your nerves. 

People with diabetes are at a greater risk than the general population for blindness, cataracts and glaucoma, but can minimize their risks by managing their glucose levels.

Additionally, early detection and treatment of eye problems can save your sight.

Diabetics are also at higher risk for gum problems, according to the American Diabetic Association, because poor blood glucose control makes gum problems more likely. Basic good dental hygiene, such as brushing twice daily, daily flossing and regular dental visits, will help stave off problems.

About half of all people with diabetes have some form of nerve damage, or neuropathy. Nerve damage can make you numb and, therefore, not notice pain or other issues, especially in your feet. “It's not as though your sensation goes away in your feet. But it's just less than it would be,” explains Dr. Bergstrom. “So a person can walk around with a sore on their foot for a long time, and that's what leads to the infections and the amputations.” Regular inspection of your feet will help.

Additionally, the nerves in the legs and feet may not get the message to sweat, which is necessary to keep skin soft and moist. Keeping your skin moisturized when you have diabetes is one of the easiest ways to prevent skin problems.

And, most importantly, be sure to find a good endocrinologist and primary care physician and schedule appointments twice a year.

Other important tips to manage your diabetes

  • Avoid alcohol.
  • Keep your vaccinations current.
  • Don’t smoke.
  • Take an aspirin daily.
  • Monitor your cholesterol.
  • Monitor your blood pressure.

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