Seeing the Big Picture

To insure good health: Eat lightly, breathe deeply, live moderately, cultivate cheerfulness, and maintain an interest in life.

— William Londen

Achieving any big goal usually involves taking many small steps. Certainly that is true when your goal is to maintain good health with a chronic illness such as diabetes. The routine tasks that you carry out daily, weekly, or in some cases less frequently to keep your blood glucose in target range all contribute toward your goal of good health with diabetes.

But sometimes it’s important to take a step back from the actions you’re taking to reach your goal and take a look at the goal itself: Is the goal still a reasonable one for you? Do you still feel motivated to work toward it? Or might you need to redefine what you’re aiming for?

It’s also important to assess the effectiveness of the steps you’ve been taking to reach your goal: Are they having the desired effect? Can you fit them into your life reasonably well, or are you struggling to carry them out?

If you feel motivated to care for your diabetes most of the time, and the actions you take to care for your diabetes seem to work well in the majority of situations, you probably have a good plan in place that doesn’t need any major changes. On the other hand, if good health seems like an impossible goal, and you’re struggling to carry out the tasks your diabetes care providers have recommended, your plan isn’t working and needs to be revised so you can feel that your efforts are doable and worth doing.

This article presents some of the basic elements for staying healthy with diabetes (see “Take-Away Tips“). As you read, think about how best to fit them into your life, what you can do on your own, and where you might need some help from your diabetes care team or from the other people in your life.

Eat lightly
People with diabetes have two good reasons to eat lightly: weight control, and blood glucose control. Overweight — particularly excess fat in the midsection of the body — contributes to insulin resistance, which makes it harder to keep blood glucose levels in target range. While most people with Type 2 diabetes have some degree of insulin resistance, it can also occur in people with Type 1, particularly if they become overweight.

Even with good reasons to eat lightly, however, doing so can be difficult in today’s food-centric society: Large portions have become the norm at most restaurants, and many events and celebrations are centered on eating. For people with diabetes, it’s also easy to get caught up in the details of eating — such as the proportions of carbohydrate, fat, and protein in each meal — and to lose sight of the overall importance of choosing healthful foods and eating enough but not too much of them.

If you’re gaining weight or having high blood glucose levels after meals, take a look at how much you’re eating. The average American adult eats 2700 to 3700 calories per day, which is two to three times what he actually needs. By simply trimming your portions, you are likely to slow your weight gain and lower your after-meal blood glucose levels. (However, if you match your premeal insulin doses to the carbohydrate in your meal, you will need to count the carbohydrate. Also, if you continue to have high blood glucose levels after meals even after cutting your portions, you may need to check in with your diabetes care team to discuss an alternative treatment plan adjustment.)