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What not to do when you have diabetes

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cr_05_july31Confused as to what not to do when you have diabetes? Listed below are eight things you shouldn’t be doing (or should be doing in moderation) if you have diabetes. These are simple yet important “dont’s” to help diabetics lead a better and healthier lifestyle.

Don’t skip meals
Normally, if your sugar gets too low (hypoglycemia), you’ll have symptoms, like sweating and shakiness. If you have diabetic neuropathy, you may not get these warning signs, because the neuropathy can affect the nerves that control digestion. The best way to prevent hypoglycemia is to snack frequently and not skip meals. Also, check your blood sugar more often. If you are having trouble with low blood sugar, get help from your health care team.

Don’t overdo alcohol
Having diabetes doesn’t mean you can never imbibe. But you do have to take extra caution when you do. When you want to have a drink, the key is to do so in moderation: No more than one alcohol-containing beverage per day for women, and no more than two a day for men.

Alcohol can cause your blood sugar to drop immediately after you have a drink and to stay low for the next 24 hours. Check your blood glucose level before you have a drink to make sure it’s in a healthy range, and have something to eat either before or while you drink to minimize the effects of the alcohol. You will also want to check your blood glucose before you go to sleep; if the number is too low (below the 100 to 140 mg/dL range), eat something to bring it back up.

Remember, alcohol is toxic to nerves and can make neuropathy symptoms worse. Drinking too much can also lower your vitamin B12 level. Alcohol is bad for your blood sugar control because it’s all empty calories. On an empty stomach, alcohol can cause hypoglycemia, especially if you are taking insulin. If you drink, do so only in moderation, and always eat a snack while you’re drinking.

Don’t eat refined grains
Refined grains are in “white” products, like white rice, white bread, and white pasta. Refining whole grains removes their outer shell and, along with it, important B vitamins and fiber, essentials for your diet. Refined grains make it harder for you to regulate your blood sugar, which is bad for diabetic neuropathy. Try to replace refined grains with whole grains, including brown rice and whole wheat breads and pasta.

Don’t forget Omega-6 Fatty Acids
You might have heard about the health properties of omega-3 fatty acids, found in fatty fish, such as salmon and mackerel. Studies have also found that both omega-3s and omega-6 fatty acids together may help reduce diabetic nerve pain. Add to your diet vegetable oils high in omega-6, such as safflower, sunflower, and corn oils.

Don’t cut fruits and “starchy” vegetables from your diet
It’s true that some fruits and vegetables are higher in carbohydrate than others. But that doesn’t mean you should abandon them altogether. Potatoes, corn and peas are nutritious foods that can fit into a balanced diet; you just can’t eat them with abandon like you can non-starchy vegetables such as lettuce, cucumber and broccoli. The same goes for fruit. While it does contain natural sugar, it’s also loaded with fiber, vitamins and minerals, which make it a smart choice. Just be sure to favor fresh fruit over dried fruit or fruit juice, and be aware of portion sizes.

Don’t smoke
If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications, including heart attack, stroke, nerve damage and kidney disease. In fact, smokers who have diabetes are three times more likely to die of cardiovascular disease than are nonsmokers who have diabetes, according to the American Diabetes Association. Talk to your doctor about ways to stop smoking or to stop using other types of tobacco.

Don’t neglect vaccination; keep your vaccines up to date
High blood sugar can weaken your immune system, which makes routine vaccines more important than ever. Ask your doctor about:

  1. Flu vaccine: A yearly flu vaccine can help you stay healthy during flu season as well as prevent serious complications from the flu.
  2. Pneumonia vaccine: Sometimes the pneumonia vaccine requires only one shot. If you have diabetes complications or you’re age 65 or older, you may need a five-year booster shot.
  3. Hepatitis B vaccine: The Centers for Disease Control and Prevention (CDC) currently recommends hepatitis B vaccination if you haven’t previously been vaccinated against hepatitis B and you’re an adult aged 19 to 59 with type 1 or type 2 diabetes. The most recent CDC guidelines advise vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you’re age 60 or older and have diabetes and haven’t previously received the vaccine, talk to your doctor about the whether it’s right for you.
  4. Other vaccines: Stay up to date with your tetanus shot and its 10-year boosters. Depending on the circumstances, your doctor may recommend other vaccines as well.

Don’t neglect stress
If you’re stressed, it’s easy to neglect your usual diabetes care routine. The hormones your body may produce in response to prolonged stress may prevent insulin from working properly, which only makes matters worse. To take control, set limits. Prioritize your tasks. Learn relaxation techniques. Get plenty of sleep.

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Dr. Rajiv Kovil
Consultant Diabetologist, Dr. Kovil’s Diabetes Care Centre

Dr. Rajiv Kovil is a Consultant Diabetologist at Dr. Kovil’s Diabetes Care Centre, the first Preventive Diabetes Centre & Diabetic Foot Clinic in Mumbai, KLS Memorial Hospital and Holy Spirit Hospital among others. He is a founder member of United Diabetes Forum, a forum of practising diabetologists in India. He has also written various articles on diabetes for medical journals such as Asian Journal of Diabetology and Medical Image. His Preventive Diabetes Centre & Diabetic Foot Clinic is an initiative to provide preventive diabetic measures as well as to function as a specialized Foot Clinic for diabetic patients not only in terms of equipment but more importantly in terms of expertise.

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