Ahad, 10 November 2013

The Star Online: Lifestyle: Health

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The Star Online: Lifestyle: Health

Be in sugar control


How daily life can affect blood sugar, and the steps you can take to manage this.

THE crux of diabetes (as well as pre-diabetes) management is blood sugar control. Once you achieve this, you reduce the risk of the myriad complications that can arise from diabetes.

Key to achieving this is knowing what situations result in fluctuating sugar levels. You may think you know what they are, but some of the things listed below might just surprise you.


This is a no-brainer. Eating healthily takes on enormous significance for diabetics, but it's not only what you eat that matters, but also how much and when you eat.

Well-balanced meals: Eat according to the guidelines provided by the Malaysian Food Pyramid. Include all the food groups in the relevant proportions.

For expert guidance, consult a dietitian about your meal plan.

Follow a schedule: Sugar levels are at their highest an hour or two after a meal. But making your mealtimes predictable allows you to control your sugar levels, especially when you're on medications.

You can prevent extreme blood sugar levels by eating several small meals a day. Another option is to eat healthy snacks at regular times between meals.

Control amounts: Do not binge! Remember the food guidelines: balance, moderation and variety.

Take your medication: Talk to your doctor to tailor a meal plan that will allow your medication to provide you the best benefits.


Stress has unfortunately become an unwelcome companion in the modern world. The hormones released during stress can adversely affect how insulin works.

In addition, stress can lead to you ignoring your routine, which is not good when it comes to controlling sugar levels.

Take control: Fight stress by learning relaxation techniques. Avoid getting stressed, and if all else fails, seek professional help. Learn meditation exercises, and new coping skills. Try rating your stress levels in order to fight back effectively.


Similar to what happens when you're stressed, illness can result in the production of stress-like hormones. This can affect blood sugar levels.

In addition, changes to appetite and activity levels when you're ill can also affect your blood sugar levels.

Plan of action: You should have a "sick-day" plan in order to cope with illness. This may include slight adjustments to your medications, and how frequently you monitor blood sugar levels.

It's important that you continue to take your diabetes medication. If you're nauseous or suffer from vomiting, contact your doctor.


Medications prescribed for diabetes have the primary aim of lowering blood sugar levels when lifestyle modifications are insufficient to manage them. Their effectiveness depends on the timing and size of the dose.

In addition, medications you take for other problems may affect how your diabetes drugs work.

Work with your doctor to ensure that the timing and dosage of the medications you take are effective.

If you're prescribed drugs for other illnesses, inform your doctor so that necessary adjustments can be made if required.

Stick to your medication routine, and if there are any changes, discuss them with your doctor.


Alcohol and diabetes are not a good mix. Alcohol can lead to low blood sugar after you drink, as well as aggravate diabetic complications. However, if your diabetes is under control and your doctor agrees, an occasional alcoholic drink with a meal is fine.


Regular exercise can improve your body's response to insulin. Hence, exercising regularly is good, not only for diabetics, but for everyone striving to improve their health.

Discuss with your doctor about an exercise plan, and how you can go about exercising safely, looking at things such as frequency, monitoring glucose levels before and after exercise, and so on.

Menstruation and menopause

The hormonal changes that occur with menstruation and menopause can affect sugar levels. Your diabetes plan needs to be adjusted accordingly, including meal plans, activity levels or even medications, during these phases.

Reference: Mayo Clinic 

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Here are five tips to help avoid losing your toes or feet to diabetes.

IT starts with a small puncture or wound in the sole of your foot. But you don't even notice it at first because it doesn't hurt, thanks to the damage to the nerves of your feet caused by the high sugar levels in your blood (i.e. diabetic neuropathy).

Perhaps you know you're diabetic, perhaps you don't.

After all, according to the 2011 National Health and Morbidity Survey (NHMS), 20% of Malaysians are diabetic, and about half of them are undiagnosed.

In addition, wound care specialist Dr Harikrishna KR Nair says that by the time of diagnosis, the majority of Malaysian diabetics would have already had at least five years of uncontrolled sugar levels, with some sort of complication already manifesting.

One of these complications is the diabetic foot.

According to Dr Harikrishna, who is Hospital Kuala Lumpur's Wound Care Unit head, around one-quarter of diabetics will develop foot-related complications.

Six percent of these will eventually have their foot amputated.

"Diabetics with poorly controlled sugar levels will experience a lot of changes.

"It's called the three '-pathies': sensory neuropathy, where you become very numb; autonomic neuropathy, where you have decreased moisture and decreased hair; and motor neuropathy, where the muscles of the foot shrink," he says.

Because of these changes, diabetics are more prone to injuring their feet without being aware of it.

And although the wound or ulcer may look small, the Malaysian Society of Wound Care Professionals president explains that once it gets infected, the infection can easily travel up the tendons and bones of the foot into the leg, potentially resulting in a below-knee amputation!

The tragedy is that about 85% of diabetic foot complications can be prevented, according to Dr Harikrishna.

All diabetics – and even non-diabetics, he adds – have to do are the following:

Control sugar levels

This one is a no-brainer. If your blood glucose levels are controlled, that means there is less chance of excess glucose floating around your bloodstream causing damage to your peripheral nerves.

Healthy nerves will help prevent the development of foot wounds or ulcers, and the infections that can come with them.

Regular foot assessment

Once every day – preferably at the same time, so that it is easier to remember – you need to check your feet for any redness, cuts, cracks, blisters, swelling, sores or other abnormalities.

Remember that you might not be able to feel it, so you need to see it.

If you have trouble looking at the bottom of your feet, use a mirror or ask someone to help check it for you.

Clean and trim

Another compulsory daily activity is to properly wash and dry your feet gently, especially between the toes.

Don't forget to apply moisturiser on the top and bottom of your feet, but not between the toes, which must be kept dry.

Trim your toenails regularly straight across, and file away any sharp edges,

Wear proper socks

Ensure that your socks can "breathe", i.e. absorb sweat and keep the moisture out. Cotton socks are usually the best.

Avoid nylon socks and those with tight elastic bands, as these can reduce your circulation.

Choose the right shoes

Buy shoes that are comfortable and provide proper support to the heels, arches and balls of your feet.

High heels and narrow shoes that squeeze your toes together should be avoided.

If your feet are of different sizes, buy the larger size.

Specially-designed orthopaedic shoes are also an option to consider.

It is advisable to avoid going barefooted at all, even around the house, so house slippers or shoes are recommended.

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IN conjunction with World Diabetes Day on Nov 14, The Star urges readers to join each other in pledging to reduce their daily sugar intake for a minimum of a week.

From Nov 10-21, The Star Online will be running a World Diabetes Day Reduce Sugar Pledge campaign to help raise awareness of the impact uncontrolled blood sugar levels can have on both pre-diabetics and diabetics.

Submit a pledge and participate in our interactive discussions on The Star Online's official Twitter (@staronline) and Facebook (The Star Online) pages with #ReduceSugar.

Also, look out for stories on various aspects of diabetes across the different print and digital sections of The Star throughout the campaign period.

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Be in sugar control

Kredit: www.thestar.com.my

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