Pictured recipe: Colorful Roasted Sheet-Pan Veggies
Managing diabetes is a big task, but breaking it down into small daily actions can make it more manageable. We asked the experts for seven ways to refine your everyday routine.
Some changes may speak to you more than others. "It's not going to be easy to make all these changes and it's harder to make all the changes at once. So pick a couple that you really want to work on first and then make those changes," says David K. Miller, M.S.Ed., RN, CDE, a certified diabetes educator and care coordinator at Community Health Network in Indiana.
When you plan ahead, you're more prepared. And this can make it more likely that you'll stick with your healthy behaviors, says Cara Schrager, M.P.H., CDE, RD, a dietitian and certified diabetes educator at Joslin Diabetes Center in Boston.
At the start of each week, carve out time to look at your calendar. Consider when you'll eat at home and when you'll eat out, and aim for regular mealtimes. Look at which days you'll have more time for longer exercise sessions and which days you'll need to fit in shorter bursts of activity
Select a few recipes, make a list of ingredients, and shop for the whole week at once. "I think making a list and sticking to it helps you save money and focus on what you really need," says Schrager. Stock up on snacks as well as ingredients for meals. "If you already have healthy snacks lined up, you're less likely to stop at a vending machine," she says.
Schedule exercise in 10- or 15-minute chunks on busier days, and aim for longer sessions when you have more time. And plan around your energy levels. If you're typically too tired in the afternoons, plan to exercise in the morning or walk at lunch. No time to get to the gym? Plan for an at-home exercise session a few days a week.
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You've heard it before: Exercising more often, even for just 30 minutes a day, can improve your health, says Elizabeth A. Walker, Ph.D., RN, CDE, professor of medicine and of epidemiology and population health at Albert Einstein College of Medicine in the Bronx, New York. Those benefits include improving blood glucose, lowering your risk of heart attack and stroke, helping you shed pounds, and helping improve your mood.
Finding activities that you enjoy is key, says Schrager. Like to socialize? Try starting or joining a walking group that texts or calls to remind each other to get moving, says Walker. This can be great if you live or work in an area where you might not feel safe walking alone. Hate the gym (or can't afford it)? Try online exercise classes. The key is to find an activity you enjoy—that you look forward to, even.
Another key to staying active? Motivation. Schrager suggests using a pedometer, even the one built into your phone, which can track your steps to keep you motivated. Set a steps goal and reward yourself when you meet it each week.
Having support from others living with diabetes can be particularly helpful in managing a long-term chronic condition. "Knowing that someone else is going through the same thing mentally helps you get through what you're doing," says Schrager.
Find others with diabetes through local classes or online groups. You might find a buddy in a diabetes education class with whom you can compare notes, stay in touch, and offer support even after the class is finished, Miller says. Online, Twitter has become a resource for diabetes support, with hashtags like #DSMA (diabetes social media advocacy) and #DOC (diabetes online community), says Jill Weisenberger, M.S., RD, CDE, CHWC, FAND, author of Prediabetes: A Complete Guide.
Thinking about which friends or family members can support you can be helpful too, says Schrager. For example, you might want to bring a family member or friend with you to your doctor's appointments, to help you take notes or remember changes to your plan. Weisenberger suggests being direct when asking family members for support: "Will you clear the dinner dishes so I can spend a few minutes on the treadmill?"
Pictured recipe: Basic Quinoa
Making batches of food can save time and money during the week, and can make it easier to eat more meals at home. It can also help you choose lower-calorie meal options, and help you be more in control of what the ingredients are and how the food is prepared, Schrager says. Having a pre-prepped meal can be a lifesaver during busy weeks when you're swamped with work or entertaining family.
Make large batches of one-pot recipes, such as soups, stews, and chilis, says Schrager. You can reheat individual servings throughout the week for lunches and dinners. Or cook a pot of whole grains that you can use as the foundation for meals, or prep snacks like hard-boiled eggs or sliced vegetables.
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Sharing your concerns and asking questions about your diabetes-management plan can help you adn your provider find solutions together. For example, if you are having trouble remembering to take your medicine, or if you are struggling to afford a prescription, telling your provider can let them know you need a change in your plan. Your provider may be able to change the time of day you take your medicine or help you find a more affordable option.
Take notes between visits so you remember what you want to talk with your provider about. Journaling can help you pinpoint areas that are and aren't working. For example, write down the times when you forget to take your medication, notice side effects, or struggle with your food plan.
Then, during your visits, share your notes with your provider. "Don't be afraid to ask: Is there something that I should be doing that I'm not? Is there something I should know that I don't?" says Miller. Be honest about your health beliefs, including whether you intend to follow a provider's advice, Walker says. Talking to your provider may spark practical, realistic conversations that could have a big impact.
When you have diabetes, both the quality and quantity of your sleep matters, says Vsevolod Y. Polotsky, M.D., Ph.D., professor of medicine at Johns Hopkins School of Medicine in Baltimore. Not getting enough quality sleep can affect blood glucose. It can also lead to food cravings, which can increase when you don't get enough sleep. And many diabetes complications can affect sleep, including sleep apnea, neuropathy, and nocturnal hypoglycemia.
There are many small changes you can make to help you practice good sleep habits. Get up at the same time each day to help train your body to a regular sleep schedule, says Polotsky. Avoid daytime naps if you have trouble sleeping at night. Abstain from caffeine-containing drinks after lunch. Try not to use electronic devices like cell phones or watch television in bed before falling asleep, says Polotsky. Aim for at least seven hours of sleep per night, which is the amount recommended by the American Academy of Sleep Medicine.
Talk with your doctor if you notice these signs of sleep apnea: snoring, frequent awakenings, and feeling tired during the day despite seeming to get enough sleep. Your provider may refer you to a sleep specialist for treatment. If neuropathy is keeping you awake at night, talk to your doctor as well: treating the nerve pain could help improve your sleep. Signs of nocturnal hypoglycemia include nightmares, restless sleep, and waking up with a headache or drenched from sweat. Talk with your doctor if you notice these as you may need a change of medication or insulin dosing.
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Caring for diabetes is hard work. Acknowledging that you are at the center of your care—and that you are the one doing this work—is important. Listening to yourself can help you be realistic about what you have the energy to do and can help you prioritize based on what is most important to you. Valuing yourself can help you take the time and energy you need to take care of you, says Martha Funnell, M.S., RN, CDE, an emeritus research scientist in the learning health sciences department at the University of Michigan Medical School in Ann Arbor.
Think about what is important to you and inspiring to you. Consider your goals, not necessarily the goals from doctors or your health care team. Weisenberger suggests creating a "personal wellness vision" to help you set your goals, which is a short statement about how you will feel and act when you are at your healthiest. This vision of what you are working toward can help you stay motivated.
Funnell recommends asking these questions: What am I good at, in terms of caring for my diabetes? What am I struggling with? What is important for me? Reflect on strategies that have worked in the past, and incorporate those in your daily life. You can do this on your own or work with others, such as a diabetes support group, your family or friends, or a certified diabetes educator.
Working with a CDE can help you pinpoint your beliefs, concerns, and goals, says Funnell. Part of an educator's job is to listen. An educator can also help you gain the information, skills, and support you need to make better decisions about your care.