We left off looking at Dr. Hite’s 5 M’s of diabetic self care, I’m sure that there are many that don’t start with M though but he does have 5 here and they do, and the first one we looked at is monitoring.
Monitoring is something we need to pay attention to on both a short and long term basis, and diabetics tend to look at the short term results, the last few readings, pretty much exclusively. Meters do generally track averages though, for instance weekly, monthly, 90 day averages and I would say that these are even more important.
We’re using our meters as a tool to manage our day to day activities, and we want to be using representative samples here, and averages achieve this so much better, whereby with a reading or two there are so many factors involved and so much going on below the surface that we usually need a bunch of readings to get a better picture of all of this.
How much testing one does really depends on the situation. Newer diabetics will generally need to test more often than diabetics who have been testing for a long time, because there is more to learn when you are new.
The second M is meals, and Dr. Hite simply recommends that we eat healthy and nutritious meals. A healthy meal for a diabetic and a non diabetic aren’t going to be the same kind of meal, as we are handicapped so to speak and have a condition that makes meal selection very important indeed.
It is nowhere near good enough to just say eat healthy and nutritious, and as we’ll see later when Dr. Hite speaks more about diet later, he doesn’t really get this. There isn’t anything that even comes close to the importance of proper dietary management with type 2 diabetes in fact, and getting this right is not optional at all, and if we don’t, we are simply screwed no matter what else we do, and our disease will just get worse and worse over time no matter what else we do.
I will say more about this later when he starts making more specific recommendations, not too specific mind you but he does show his hand and sadly enough it’s one based upon confusion, but that’s the case with the medical profession anyway, doctors, nurses, dietitians, nutritionists, diabetes educators, etc., as they just haven’t been given the right information.
While their advice tends to be off base generally, it really is when it comes to recommending diets for type 2 diabetics, and while these people are generally over preoccupied with blood sugar, blood sugar takes a back seat to some of the general dietary myths out there, such as we need to get a large amount of carbohydrate to maintain our energy levels, or that fat is somehow worse for diabetics than carbohydrates, or only sugar intake really matters and we can eat all sorts of starches without worrying too much, and so on.
The next M is motion, and getting a healthy amount of exercise is healthy, although this is definitely overrated with both diabetes and weight management. It doesn’t really make much difference at all long term with weight management actually, for reasons we won’t be going into here, but weight management is really all about insulin levels, and the body adjusts its metabolism according to levels of activity so that doesn’t help much, although it may a little, as in 346 pounds instead of 350 and that sort of thing, not a meaningful difference really.
With diabetes, well it’s more complicated than this, and while exercise does increase glucose uptake, depending on where we’re at and the particular type of exercise, it can actually raise our blood sugar instead of lowering it. This is because, as we mentioned earlier, that the problem is with excess glucose being put into our blood, and exercise tends to both remove and add glucose.
In a non diabetic, this tends to balance out well, they don’t have high levels of insulin resistance though, so with diabetics, at least in terms of peak performance, less is taken in than normal perhaps, although not to the extent you would think, and more is definitely put in, although this varies by the amount of “liver dumping” you have, the tendency for the liver to dump excessive amounts of glucose into our blood, over and above what is needed to prevent our blood sugar from going too low.
So this doesn’t mean you shouldn’t be moving around, but the more intense the exercise, the more likely that the stress this places upon the body will raise our adrenal hormones to the point where this elevation may raise us up. So this bears monitoring at the very least, and then one can choose a balance between physical fitness and not causing one to have higher blood sugar than one may desire.
I would say that everyone should engage in a good amount of light exercise, and then as far as more intense exercise goes, one can judge what they feel may be best for them based upon a number of factors, which include the effects that this all may have on their blood sugar.
By the way, there’s a lot more going on here than just not wanting to go up higher than you want to for a time, as the stress of the exercise itself does matter, as this can elevate cortisol levels and cortisol’s main role is to elevate glucose, and too much cortisol elevates it too much.
So this is why managing stress is so important with diabetes, and you want to manage both excessive mental and physical stress both, if you do hard labor for instance and have a lot of aches and pains from it, well that’s going to make your diabetes worse for sure.
The next M is medication, and if we view medication in the broader sense, meaning not just prescription medication from a doctor, this one I strongly agree with, that we need to be aware of the medications out there and how they may help us and play an active role in this, instead of just putting all of this off on others and just taking what we’re given.
I definitely agree with the remark about minimizing the side effects, which actually points us toward natural medicines, although I’m sure that’s not what our friend means here. However, that’s an important point, we need to maximize the benefits while minimizing the side effects to be sure.
Finally, we have the last M, motivation, and this one is super important, and what diabetics generally need help with the most. Managing diabetes properly does take a lot of motivation, especially given that if you do this right you are going to be avoiding foods that you may have enjoyed in the past but cannot tolerate without making yourself sicker.
He speaks in particular about avoiding depression and that’s certainly a good idea.
We’ll move on to look at the next question in Part 7.