WHAT ARE LIFESTYLE MEASURES FOR TYPE 1 DIABETES?

Diet and Diabetes

The current state of the diabetic diet is in flux, and at this time, there is no single diet that meets all the needs of everyone with diabetes. Patients should meet with a professional dietitian to plan an individualized diet that takes into consideration all health needs. There are some constants, however:

• Limit fats (particularly saturated fats and trans-fatty acids).

• Limit dietary cholesterol.

• Consume plenty of fiber-rich foods in the form of whole grains and fresh fruits and vegetables.

• Limit protein.

• Reduce salt.

[For detailed information, see the Well-Connected Report #42, Diabetes Diet .]

Healthy Weight Control

Weight gain is a potential side effect of intense diabetic control with insulin. Being overweight can increase the risk for health problems. On the other hand, studies suggest that more than one-third of diabetic women omit or underuse insulin in order to lose weight. Eating disorders have become a serious problem within the general population and are especially dangerous in diabetics. Some evidence suggests that they contribute to about 20% of cases of recurrent ketoacidosis in young women. Ketoacidosis is significant complication of insulin depletion and can be life-threatening.

Exercise

Aerobic exercise is proving to have significant and particular benefits for people with type 1 diabetes. It increases sensitivity to insulin, lowers blood pressure, improves cholesterol levels, and decreases body fat.

Because glucose levels swing dramatically during workouts, people with diabetes need to take certain precautions:

• They should monitor glucose levels carefully before, during, and after workouts.

• Patients should probably avoid exercise if glucose levels are above 300 mg/dl or under 100 mg/dl.

• To avoid hypoglycemia, diabetics should inject insulin in sites away from the muscles they use the most during exercise.

• Before exercising, they should also avoid alcohol and if possible certain drugs, including beta-blockers, which increase the risk of hypoglycemia.

• Insulin-dependent athletes may need to decrease insulin doses or take in more carbohydrates, especially in the form of pre-exercise snacks (skim milk is particularly helpful). They should also drink plenty of fluids.

Resistance or high impact exercises should be avoided. They can strain weakened blood vessels in the eyes of patients with retinopathy. High-impact exercise may also injure blood vessels in the feet. Because diabetics may have silent heart disease, they should always check with their physicians before undertaking vigorous exercise.