Diet and Nutrition

Checking your blood glucose

BMJ Group, Diabetes Information, Diabetes, type 2, Diet and Nutrition, Editorial, Health & wellbeing, Health and Fitness News No Responses »

May 312010

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To control your diabetes, you need to get a good balance among the treatments you take (insulin, tablets or both), the food you eat and your physical activity.

Your doctor may suggest you check your blood glucose regularly, to see if it’s in the right range. Regular checks will also tell you if your blood glucose is dropping too low (hypoglycaemia or hypo) or climbing too high (hyperglycaemia). Both of these can be dangerous.

For example, if you’re about to do some exercise and you find that your blood glucose level is quite low, you need to eat something before you exercise. If you don’t eat anything, exercising could lower your blood glucose level even more. You could have a hypo.

Testing your blood glucose is most important if you use insulin. People with type 2 diabetes who use insulin need to be sure that they don’t have a dangerous hypo. But we don’t know whether testing your blood glucose yourself is helpful if you have type 2 diabetes but don’t use insulin.

Testing kits

There are kits to help you test your blood glucose. The kits make testing simple. Here’s what you do. You can test your own blood glucose level regularly using a simple kit.

First, take some of your blood, usually one or two drops from your finger or your forearm. To get blood for the test, most people use a special needle that springs out when they press a button. You put this needle on your finger. When you press the button, the needle makes a prick that gives you exactly the right amount of blood.
When you have a drop of blood on your finger, you touch the drop to a test strip. The test strip is usually held in place on a meter.
There are many types of meters. But they all do the same thing. The meter analyses your blood. Then it tells you how much glucose is in it. The number usually shows on a little screen on the meter.

Your doctor will help you decide how often to test your blood. You also need to decide when you will do the test. Some people need just one test a day. Others need to do it before they take their insulin therapy (three or four times a day).

You also need to get used to adjusting your insulin dose or your activities based on what you find in your test. You will get used to this over time. But if you’re not sure what to do, ask your diabetes nurse or your doctor for advice.

If you are having a treatment called peritoneal dialysis because your kidneys aren’t working or if you are getting injections called immune globulin to boost your immune system, check with your doctor. Some blood glucose meters might not give you a reliable reading. Your blood glucose might read high when it isn’t. It is very important to have a reliable reading to avoid getting low blood glucose.[2]

It’s a good idea to keep track of your blood glucose level over a period of time. This will help your doctor see how you’re controlling your diabetes. You can carry a notebook with you to write this down. Or you can plot your blood glucose levels right onto a graph. This will help you see how your levels change.

Also, most modern meters have an internal memory. This means that you don’t have to keep a record yourself. You can simply show the meter to your doctor.

Keeping a record of your blood glucose level helps your doctor decide if you need to change your treatment, change to a different kind of insulin or change when you give yourself insulin (this is called your dosing schedule). For example, when you go to bed, you might find that your blood glucose is always a little bit higher than it should be. If this happens, your doctor may advise you to take more insulin before your evening meal.[1]

Haemoglobin A1c test

Another test you’ll get used to is the test for haemoglobin A1c (HbA1c for short). Haemoglobin A1c is a chemical found in your blood. You might hear it called glycated haemoglobin, glycosylated haemoglobin or glycohaemoglobin.

Your haemoglobin A1c level gives your doctor an idea of what your glucose level has been over time. It is kind of an average of your blood glucose level over the previous weeks. If your blood glucose level is often higher than normal, you will also have a high haemoglobin A1c level. So this test is useful for seeing how well you’re keeping your diabetes under control. Most people with diabetes should have their haemoglobin A1c checked every three months to six months.

The result of this test is given as a percentage. A good result is 7 percent. Your ideal result depends on your own situation, but it should usually be between 6.5 percent and 7.5 percent.[3] The higher the number, the greater your chance of getting complications from your diabetes. But most likely it would have to stay high for many years before you got problems.

Driving

If you take insulin, you must inform the Driver and Vehicle Licensing Agency (DVLA) about your diabetes. You must also tell the DVLA if you control your diabetes with tablets or diet and you have a complication that could affect your driving, such as a problem with your eyes.

You need to be especially careful about checking your blood glucose level when you’re driving. If it drops too low when you’re at the wheel, you could have a hypo and black out. To reduce your chances of getting hypo while driving, check your blood glucose level just before you get into the car.[4] If it is low, have a snack and check again before you set off. Try to always have some sugary drinks or sweets in the car. If you feel you’re going into a hypo, you can stop and have a drink or sweet, to boost your blood glucose.

If you feel you’re going into a hypo while you’re driving:[4]

Stop the vehicle in a safe place
Switch off the engine
Have a sweet drink or snack, such as a sweet or glucose tablet. Wait until you feel better before setting off. This can take 15 minutes
It’s a good idea to check your blood again before driving.

References

Williams G, Pickup JC. Handbook of Diabetes. Blackwell Science, Oxford, UK; 1992.

U.S. Food and Drug Administration. 2005 safety alerts for drugs, biologics, medical devices, and dietary supplements: parenteral maltose/parenteral galactose/oral xylose-containing products. November 2005. Available at http://www.fda.gov (accessed on 18 November 2009).

National Institute for Clinical Excellence. NICE issues national guidelines for the management of blood glucose levels in people with type 2 diabetes. September 2002. Available at http://www.nice.org.uk/36734 (accessed on 18 November 2009).

British National Formulary. Insulins. Section 6.1.1. British Medical Association and Royal Pharmaceutical Society of Great Britain. Also available at http://bnf.org (accessed on 18 November 2009).

Glossary

kidney

Your kidneys are organs that filter your blood to make urine. You have two kidneys, on either side of your body. They are underneath your ribcage, near your back.

immune system

Your immune system is made up of the parts of your body that fight infection. When bacteria or viruses get into your body, it’s your immune system that kills them. Antibodies and white blood cells are part of your immune system. They travel in your blood and attack bacteria, viruses and other things that could damage your body.

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Losing Weight and Gaining Life

Athletics and Sports, Diet and Nutrition, Health Coaching, Loosing Weight 1 Response »

May 262010

Walking to a first place win

This month has been a new milestone for me. I have won two first place awards in sporting events in one month. Now for many of you that would seem like old hat. I knew your types and their abilities my whole life. I just was never on a first place team or came in first on any sporting event in my life. This month I received a first place ribbon in a 5k walk for my age bracket and our volleyball team won the university staff tournament for staff appreciation week.

Now for you folks that have been good at sports getting 2 first place awards in a month might seem small. Stop for a moment and imagine being in your 50’s and never having taken first place before. Twice in one month seems like a life changing event. In fact it was due to a lifestyle change that it came about.

I now know why people who are good at sports seem to walk a little taller. It feels good to compete honestly and win. Win with humility and not in their face but win none the less. Imagine a whole lifetime of never winning and you understand why someone might give up the idea of ever winning at anything. I have lived my life thinking I would never win. It did keep me from trying until the last couple of years.

Rick Dorey Great Idaho Potato Marathon 2010

Still moving at the end

After I lost my weight someone suggested trying for a 5k run. My first one I did some training and came in better than some but didn’t place at all. The great thing was it keep me focused in trying to improve. I found I could get faster. I found I could run longer. I found that I could train for a purpose that was as much about me as it was the people I was working with to improve their health and fitness.

The results are, it continues to motivate family and friends to do more for their health. They remember when they couldn’t get me off the couch, or to garden, heck even sometimes to just go visit somewhere. I was too tired. I was too sick. It gives them hope. I get the benefit of enjoying more life. I believe because of my choices to lose weight that people in my life and those yet to come along will live longer, more enjoyable lives. And that my friends is a prize worth winning.

Tobey and April not far behind

I say if I can do it I can help someone else do it. What say you? Your comments are welcome!

Weight Loss – You can’t afford not to.

Diet and Nutrition, Health and Fitness News, Loosing Weight 2 Responses »

May 032010

Many of you interested in health and fitness probably follow TV shows like “The Biggest Loser” and the new one with Jamie Oliver’s “Food Revolution”. What you don’t probably see is what is going on in the background. Obesity and the costs of it are becoming more and more talked about. Our policy makers, you know the guys and gals that just got you “free” medical insurance, are looking at the costs of a society that continues to struggle with weight issues.

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I came across this article Jamie Oliver Trims the Fiscal Fat that you might find a good read. It shows a growing trend (pun intended) that when it comes time to trim some budgets obesity will be one of the areas that is looked at very closely. The article in fact mentions that obesity related illness in this country costs us over 90 Billion a year. Now if you have been following the deficit numbers you will know that curbing that spending could easily become a priority.

Having felt the stigma of obesity I can tell you now is the time to rethink your comfort level with being overweight. You can look in the mirror all you want and be happy with yourself. I in fact hope that you are. The question is with all this information coming out about costs of obesity, will an employer looking at you, just be looking at your qualifications or will they take into consideration your health and costs to the company.

Another number included in the article was a estimate at what obesity costs an individual (that would be your costs) for obesity over a lifetime. It was $29,000 in added health care costs. So I ask you do you think it is time to take notice? Is it time to take this issue and do something about it? I have seen obesity when it was mostly a non-issue cost people their jobs as well as their health. I don’t think our planners that feel like they are responsible to “take care” of us will let this one slide much longer.

The Guardian’s health editor introduces our health factfile – and the full dataset behind it
• Get the data
• Tomorrow: politics

Health, as the work of Professor Sir Michael Marmot most recently eloquently demonstrated, is in no small part a function of where and to whom you were born. The most deprived communities, where jobs are low-paid if not scarce and those who make it to university are a talking point rather than the norm, are also those where cancer rates, heart disease and strokes are high. One government after another has been uncomfortably aware of this and made promises to do something about it. It has always defeated them.

But while the health inequality gap persists, the UK’s health overall has been getting better. Comprehensive childhood immunisation programmes have virtually wiped out some diseases. Smoking has become the number one public health target, and although we still struggle to get certain groups – young women and people in those deprived areas particularly – to quit, the public smoking ban, high taxes and campaigns have had an impact that must show up in lower rates of lung and other cancers and reduced heart disease. Diagnosis and treatment of cancer has improved – even if we still trail much of Europe in death rates. The politicians (and the drug companies) argue that is because we don’t buy the newest, most expensive cancer drugs. The cancer tsar, Professor Mike Richards, will tell you it is because we are slow to diagnose the disease, especially in those deprived areas (again) where men and women do not stride into the GP’s surgery demanding attention.

In recent years, the health gap has become visible, manifesting itself in obesity, which is often most rife among those with less money and less education, who are more likely to buy affordable and filling pie and chips than a smoked salmon bagel. Obesity puts people at risk of heart disease, diabetes and cancer – the big killers of our age.

To make a momentous improvement in the health of the nation today, those social inequalities have to be addressed. Yes – we are all living longer but, to misquote George Orwell, one of our greatest critics of social inequality, some of us are living longer than others.

Sarah Boseley

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Drinking water effects both exercise and weight loss

Diet and Nutrition, Exercise Help, Health and Fitness News, Loosing Weight 1 Response »

Apr 172010

When working with clients for weight loss I often hear: I can’t drink that much water!

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My advice to them is do drink half their body weight in ounces. So a 200 lb man would or should drink 100 ounces a day of water. Often they will argue with me and many won’t do it. However those that do often see faster and more consistent weight loss. take that for what is is worth, many experts agree that proper hydration not only helps in weight loss but also maintaining that weight loss.

Today I ran across this information on water and exercise that I thought might help a few of you as well:

Drinking plenty of water is important, particularly among people who exercise vigorously.

The American Council on Fitness offers these recommendations for how much to drink:

Two or three hours before you start to exercise, drink 17-to-20 ounces of water.

Twenty to 30 minutes prior to exercise, or while you’re warming up, drink another eight ounces.

While you’re exercising, drink seven-to-10 ounces every 10 minutes to 20 minutes.

Within 30 minutes of completing your workout, make sure you drink another eight ounces

So for a 60 minute workout you would drink somewhere around 66 ounces of water when combined with before and after workout. Now that 100 ounces doesn’t look like so much water when planed throughout the day.

Combining proper hydration with diet and exercise your body will be more ready to eliminate the toxins and wastes released into your system. It will also make it easier to break down the fat tissues and process them for energy. If you have difficulty drinking plain water then add some lemon juice or some sugar free water flavoring. I believe as you develop the habit of drinking water periodically every day you will find it gets easier. It will also help to relieve soreness after training and cut down on inflammation.

Why Be a Health Coach – Part 3 Who to Coach

Athletics and Sports, Diet and Nutrition, Health and Fitness News, Inspiration, Loosing Weight No Responses »

Apr 142010

To continue the series I want to address the people who you will want to coach. If you are reading this series as a possible client you may see yourself in one of the categories mentioned.

First Timers

This is a group of folks that have decided for the first time in their life to really take on their health. They are ready to take an honest look or have been motivated recently to take care of themselves. Often one would associate this with age, but I see a trend that it is about awareness of their personal health condition. They may have recently visited their doctor, taken an honest look in the mirror, or even heard someone say something when they thought they weren’t listening. Something has them thinking about needing to make a change without any knowledge of how to get started, more or less to finish the journey successfully. They need someone with the expertise to do it right and teach them how to make it stick!

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Yo-Yo’s

I was one of these so I have particular affection for them. This person is someone that tries to lose weight, in fact often has tried many times. They may have had some measure of success. The hard thing for them is the ability to find it inside to try one more thing. Why would they think this diet would work for them, everything else failed at some point, why this one? They don’t understand why and they don’t know about metabolism and diet, they just know they have really tried and failed. They need someone that understands they are serious about it, they just struggle with something that keeps them from succeeding. Often they are the hardest to get to try again. They need an uplifting coach to believe in them and motivate them to give it effort and determination that this time they will succeed.

The Expert

SYDNEY, AUSTRALIA - FEBRUARY 04: A client str...

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This bunch is a hard bunch to even get to work with. They know it all. They have read every book. They have tried everything, and yet they have not reached optimal health. Another version of these wonderful people show up at trade fairs and run when they see a weight loss booth. They know nothing will work for them. I was also part of this group. I was convinced that nothing would ever work and that somehow I had messed up my body so bad that I would never be able to lose weight. I knew that there was no magic pill, no patch, no abs system, and it seemed like there was nothing that would work. If there was certainly I would have found it already, after all wasn’t I the real expert on what would work for me. This group has one question to ask them: Are you happy with the results you are getting now? If the answer is yes, they automatically become un-coachable. To be coach you have to be willing to admit you don’t have all the answers.

Why Be A Health Coach – Part 2 The Health Coaches Role

Athletics and Sports, Diet and Nutrition, Exercise Help, Loosing Weight No Responses »

Apr 092010

SYDNEY, AUSTRALIA - FEBRUARY 04: Clients work...

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It doesn’t matter if you are thinking of being a coach or a client of a coach it is helpful to understand the reason for the need of a coach. I hear it all the time. I can do weight loss and achieve health on my own. I have one honest answer to that. If you can then why aren’t you? When you look in the mirror are you happy with what you see? Why aren’t you at your optimal health then?

You see in today’s faced paced world many of us don’t have time to focus on all the education we need to optimize our health. I know personally I have worked on this journey for 20 years before I made the decision to focus all my spare time in that direction. Sure I had to give some things up. What I have gotten back was well worth the journey. Now it is a focus and one of my biggest purposes in life. Many of my clients simply can’t devote the time. Coaches are primarily self-made, self-developed. They work on themselves continually, learning, growing, and becoming more capable and competent over the years.

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People want results. They want the most effective use of their time and commitment to their health. A good coach can make all the difference if they are wasting their time or getting the most out of it. Why do you think when people yo-yo diet they often fail their attempts to lose weight and keep it off? It is because they don’t understand what is going on within their body when they diet.

Many give up even before they lose any amount of weight because they can’t figure out how to create a plan for themselves. They simply don’t have the time for it. But do they have time for the illness that will follow if they don’t do it? No, this is where you come in as a coach. You spend the time to sort through the noise of why they are where they are now and how to get to where they want to be. You help to create an individual plan for their success. You bring the panel of experts with you to make it all work.

After you get them going then your role shifts a bit. You still measure and adjust the plan, however your main role is to believe in them and inspire them to be accountable to their plan. Your goal is to get them to believe in themselves. It is important to work towards always raising that level of belief in themselves. This by the way is another area where many dieters have given up.

Look for the next in our Why Be a Health Coach – Part 3 Who to Coach.

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