Diabetes - Diet & Exercise

The Diabetes Forum Logo depicts the dragon
of this disease we must battle each day,
and includes the forum motto:
"Educate" - make yourself aware of what research
and treatments are available,
"Motivate" - chronic diseases often produce denial
and depression, keep on fighting your disease every day, and
"Activate" - we are a worldwide community of
mostly invisible members, this disease kills slowly,
and often through its complications, making others
believe that it isn't really serious; we must join
together to make others aware of this disease,
which in the US affects one in twenty.

Join the Gray Ribbon campaign to spread awareness of diabetes and to press for a cure. The Gray Ribbon campaign was kicked off in December of 1996. Check out these sites for more information on how the Gray Ribbon Campaign got started, how to make your own gray ribbons, and the answer to the question "Why Gray?"
Arlene Shapiro's Diabetes Miscellany page
Curtise McKenzie's old page and new page
Diabetes Cure Now!
The Insulin Dependent Diabetes Trust (IDDT) from the UK
Dr.Joe's (our resident DDS) Gray Ribbon page
and Children with Diabetes

The Diabetes and Hypoglycemia forum on CompuServe (CSi) has 23 topical areas (sections) for leaving messages, each with a related library, so that members may check in (from all over the world) at anytime of day and ask or answer questions, relate experiences, and give support. Check out our new web site! There are approximately 1900 files in the library sections, which include text, graphics, and programs. Examples of forum messages and library files are given below.

In section 7 (diet and exercise) we talk about meal planning, weight loss, exercise, and we exchange recipes. The messages follow "threads" based on the message title, with people jumping in as they get the inclination, while many others just "lurk" in the ether, listening in to what may be happening. For an extract from one of these threads <press here>. We have a library with about 300 files in it, some of which contain multiple recipes, many of which were contributed by members during some message thread as shown <here>. We also have a weekly COnference for *SLIMMERS*, our online healthy lifestyles club, where we meet real time at 7 PM PST, 10 PM EST, in meeting room 7. These meetings range from lectures, to question and answer sessions, to free form exchanges on any topic, and kudos for your latest achievement in fitness or weight loss. A short extract of a COnference is included <here>. For more info about the Diabetes Forum on CompuServe click here.

Diabetics need a balance of diet and exercise in their lives, whether they are Type I or Type II, for improved BG (blood glucose=blood sugar) control, and general well being. One of the serious complications of DM (diabetes mellitus) is cardiovascular disease (CVD), and a well balanced meal plan and regular exercise helps reduce the risk of CVD. About 80% of Type IIs are insulin resistant; this means their insulin can't be used well, rather than they are not producing enough insulin (in fact many have excess insulin floating around in their bloodstream). Regular exercise helps improve insulin utilization, and that, along with a controlled diet and a loss of weight, may allow some people to be able to get off drugs. It worked for MarC - who was as high as 20 mg of micronase (glyburide) a day at one point, but now takes no drugs to control BG. Why don't doctors push the diet and exercise regimen more? The biggest reason is because they know the statistics on how few people can stick with the change of lifestyle it requires. Let's be honest here - this is not easy for obese people - if it were, there would be a lot less of us (hmmm, I think that should have been a lot fewer of us, but there would be less of us too <G>). For more info on how diet and exercise can help the Type II DM, see the NIDDK article about Non-Insulin dependent DM

A good diabetic meal plan is really a balanced meal plan, and the USDA pyramid is a good starting point for any diet. Use fats and sweets sparingly, have 2-3 servings of dairy products, 2-3 servings of protein sources (meat, fish, beans, etc..), 3-5 servings of vegetables, 2-4 servings of fruit, and 6-11 servings of starches (breads, pasta, etc...). The new FDA Nutrition Labels on U.S. foods have made it easier to develop a diabetic meal plan. Fiber content, as well as others, influences the rate at which BGs rise and this can be important to many, especially those with reactive hypoglycemia. A list of glycemic indexes provides the relative ranking of foods to how they raise BGs. Many thanks to Rick Mendoza for this link - be sure and check out his outstanding page of Diabetes related links.

Most Type Is will probably look for a 30% or more fat content meal plan, where most Type IIs (who are typically obese) will be better off with a 20% fat or less meal plan. Remember, these are percentages of fat by CALORIES - not weight. Each gram of fat supplies 9 calories, while proteins and carbohydrates (CHO) provide only 4 calories per gram. Need to lose some weight? Just cut some of the fat out of your diet.. Many ethnic foods tend to be high in fat, and the problem is that some ethnic groups have a higher probability of getting diabetes. Check out these hints on how to improve your favorite Hispanic or African American recipes. The latter is a multimedia page, but a plain text version is available as well. One of the sources of that fat comes from meat and there is no reason why someone with DM can't be on a vegetarian diet. Actually, there are thousands of low fat vegetarian recipes available online. CompuServers might want to check out the Vegetarian Forum.

Don't try to lose that weight all at once. One to two pounds a week is a lot easier to handle with regard to feeling satiated and without getting your body to rebel against being starved. If you do this for a year you could then lose 50-100 pounds! To lose a pound a week, you typically need to have a deficit of 500 calories a day. If you weigh 100kg (220 lbs) you need 2800-3300 calories/day to maintain body weight, depending on activity level. That means you could lose weight on something in the way of 2300-2800 calories. Here is a sample 2500 calorie diet for a comparison. For more information, you may want to check out the NIDDK page on weight loss. Still confused about meal planning? Then try calling the American Dietetic Association hotline at 1-800-366-1655 where you can talk to an online dietician or find a Registered Dietician (RD) in your area. The ADA also has a number of nutrition fact sheets available online.

And now for that "X" word, X-er-cise. The other way to increase that caloric deficit is to have a regular exercise program. If you have been a practicing couch potato, check with your doctor first before starting any exercise program. What exercise to do and how often? Well, the answer is something you enjoy - so you'll stick with it - and 3-5 days a week of 20-30 minutes/day of aerobic exercise. The simplest form of exercise is walking - the only thing you need is a good pair of shoes - and make sure they fit well; diabetic foot neuropathy and reduced circulation can mean blisters, ulcers, or infection if you don't care for your feet. The long strungout winter cuts down on opportunities for walking, but you can always take your workout indoors. There is a group of lunchtime walkers who cruise the halls of MarC's office, getting their daily exercise in. Over 2300 malls nationwide let walkers in before shopping hours to exercise, quite often as organized groups. To find out if there are programs near you write: The National Organization of Mall Walkers, PO Box 191, Hermann, MO 65041. Once the weather warms up, you might consider looking into a walking club to have someone to keep you company. MarC prefers cycling but for running and hiking and other sports, maybe you want to check out the Health and Fitness Forum on CIS. Remember, any change in activity is liable to affect your BGs - your medication or eating patterns may have to be adjusted to normalize your BGs - so test often to begin with, and keep a source of quick sugar on hand in case you go low. If you are going to be out exercising for an extended period of time, like MarC did on his first century ride, you'll need to keep your CHO intake up to maintain BGs. You may want to look into using a sports drink or making your own, or taking along some energy bars.

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