We all feel fatigued at times; it may be due to working long hours, looking after family or, just because we are growing older!  Energy resources are doubly challenged when you have diabetes.  Changes in blood glucose levels have a significant effect on our vitality.  Our body runs low on energy and then our blood sugar levels are either too high or too low.  Fluctuations occur for several reasons:

\r\n
• physical activity is a major cause of  hypoglycemia in people using insulin or oral diabetes medications

\r\n

• not eating enough carbohydrates to balance your medication resulting in fatigue and severe headaches

\r\n

• long term insulin users can develop “hypoglycemic unawareness”.  They experience none of the usual signs of sweating, racing heart, anxiety or trembling.  This makes it more difficult to take early action to avoid the effects of low levels.

\r\n

• stress will increase your blood levels

\r\n

\r
Beware of tiredness creeping up in such a way you may not register how much your energy levels have fallen.  

How can you energize yourself?

1.  Don’t Forget to Drink Fluids.  It is important to keep up your fluid intake as even mild dehydration can cause fatigue.  Dehydration can also lead to an increase in blood sugar.  Calming herbal teas are more beneficial than caffeine based drinks.  Caffeine:  

\r\n
• small amounts may affect your brain in such a way you are not aware you are fatigued

\r\n

• drinking too many cups of tea, coffee or soft drinks, leads to restlessness and interferes with sleep

\r\n

• if you are dependent on caffeine reduce your intake gradually to avoid withdrawal symptoms

\r\n

\r
2. Master your Moods.  Calm down, relax and take it easy.  Research is now beginning to reveal just how important stress management is when it comes to diabetes.  Overwork and pushing yourself too hard are common causes of fatigue.  These stress relieving techniques could help:  

\r\n
• being clear when it is appropriate to say no to unreasonable demands

\r\n

• learning to breathe more evenly, deeply and slowly.  This can help turn off the body’s stress switch and reduce blood sugar levels

\r\n

• taking regular breaks from a sedentary job.  Walk around the room or take a walk outside the building during your lunch break.

\r\n

• soaking in the bath

\r\n

• sitting quietly and listening to  music, or reading a book

\r\n

• meditating is another way to help you relax

\r\n

• taking up a hobby, something you really enjoy

\r\n

\r
3. Sleep Soundly.  A basic way to feel less stressed during the day is to get enough sleep at night.  Research shows that not having enough sleep may contribute to insulin resistance.  One reason is that poor sleepers often experience sleep apnea; this is a condition that interferes with normal breathing and has been linked to diabetes.

\r\n
• don’t sleep in on weekends as this could throw your body out of rhythm and make it difficult to get to sleep at night

\r\n

• reserve the bedroom for sleep, make sure it’s a peaceful environment

\r\n

• if you don’t fall asleep within 30 minutes, get out of bed and read a boring book

\r\n

• if you wake up during the night stay in bed as you will have a better chance of getting back to sleep.  At least your body will be resting.

\r\n

\r
The good news is if you take action you can reverse the symptoms of fatigue.

Is the widely held view that diabetes sufferers should have a special diet that avoids certain foods and which includes specially formulated diabetic foods a fact or a fiction?

Diabetics do need to pay close attention to their dietary habits to ensure they have a healthy balanced diet. So, what things should a diabetic include in their diet and what things should be eschewed? Here are my ten tips:

# 1. Avoid highly processed foods and foods that are high in fat, particularly saturated fats and trans fats.

# 2. Include a wide range of fruits and vegetables in your diet. Try to eat at least five portions of different fruits and vegetables each day.

# 3. Choose whole grain foods such as brown rice and whole wheat pasta.

# 4. Have two portions of fish per week. One portion should be oily fish, such as carp, mackerel, salmon or fresh tuna; the other portion should be white fish, such as cod, lemon sole, skate or sea bass. The fish should be steamed, baked or grilled but not fried.

# 5. Choose lean cuts of meat and remove any excess fat. Remove the skin from poultry before serving. Avoid frying when cooking meat.

# 6. Choose low fat or fat free dairy products in preference to full fat products.

# 7. Avoid high calorie sweetened drinks and carbonated drinks. In preference drink water or natural fruit juices.

# 8. Go easy on the desserts. Many of these, such as cakes and ice cream, have a high fat and sugar content. That does not mean to say a diabetes sufferer cannot have these desserts, but they should be looked on as a treat not an every day food item.

# 9. Reduce the amount of added salt in your diet. Look for foods that have reduced salt content or are low in salt. Many processed foods and snack foods are not only high in fat content, but they also contain large amounts of salt.

# 10. Introduce the principles of food combining into your dietary habits. Many diabetes sufferers have reported good results when they have used food combining in conjunction with the previous nine tips.

If you are thinking that these ten tips sound like normal dietary advice and that there is nothing specifically for diabetes sufferers, you are correct. The widely held view that diabetes sufferers should have a special diet is a fiction. A normal healthy balanced diet is an effective way to help control your diabetes. 

If you have diabetes, then you know how important it is to have your glucose monitor close by at all times. Your glucose monitoring system is the number one way you stay on top of your diabetes. The numbers on your blood sugar monitoring system determine the course of your treatment in both the short term and the long term. A blood sugar reading that is too high or too low will determine things for you on a daily basis - whether you need something to eat, whether you need to abstain from eating, how much insulin you need, or whether you should drive your car. In the long term, the trends displayed on your glucose monitor tell you whether or not your treatment plan is working. Numbers that are too high or too low for a sustain period may mean you need a new dose of insulin, a new brand of insulin, or a new diet and exercise regime.

Since your blood sugar monitor is so important, you have to find one that fits your lifestyle. Here are the things you should consider before you choose your ideal glucose meter:

First of all, price is a driving factor for everyone. Meters range in cost anywhere from a few hundred dollars to a few thousand. The good news is that most manufacturers have free meter promotions regularly and will work with people with low incomes at other times. You can also find cheap glucose meters by shopping sales at drug stores or by joining a diabetic care type club. Your insurance company will also offer free or cheap glucose monitors to their policy holders in order to promote a specific type of test strip.

Size is another factor. Your meter has to be portable, and if you travel often, a smaller meter may more convenient. Beyond these basics, there are things like color and style options to help you find the perfect meter for you.

Knowing you have diabetes is a first step. The next step, as you have probably already been told by your doctor and nutritionist, is to modify your diet to control your diabetes. There are great recipes for diabetics and you can create your own diabetic diet plan with your favorite foods if you know the basics.

First, start with the foundation of giving your body what it needs. Diabetic research shows that keeping the carbohydrate content of your meals to 45-60 grams at each meal is effective in controlling blood sugars.. Fibers show the best benefit of keeping your blood sugar level so plan to get the recommended amounts of fiber every day. Split your meals into 5- 6 smaller meals each day and divide your daily caloric intake among them. Breakfast is my biggest meal of the day so I spend my greatest amount of calories there. Each meal should be about 3-4 hours apart. Whole foods that are unprocessed are the best so I recommend you emphasize these in your plan.

So what are some creative ways to plan what you want into your diet? If it’s a food you love that costs too much in terms of carbohydrates, try substituting with a food that is a better fit for your diabetic diet plan. Example: if you like orange juice, try one of the new lower sugar brands on the market and plan it into a meal. Another way to be creative is to prepare foods in a way where they are just as tasty but fit into your plan. You can also include some the specialty foods such as shakes bars and frozen foods that are commercially prepared just for diabetics.

Desserts and treats are one category of food that can be difficult to deal with at times. When possible, try to get the low or no sugar equivalent of these so it doesn’t send your blood sugar rushing to the sky. Russell Stover sugar free candies are my life saver when I have a chocolate craving that just won’t quit. You can also find dessert recipes for diabetics online. Splenda and Stevia are the two most used artificial sweeteners right now and you can find a wide range of products that use these two that will help to take the edge off of your sweet tooth.

The next thing you will want to do is to keep track of what you eat in conjunction with the readings you get from your blood glucose meter. The point of keeping these records is to identify what foods spike your blood sugar and how much. Usually foods like fruit juices and milk tend to spike blood sugars for me and I have learned to measure how much of these I take in at a meal. If you keep to measuring carbs at each meal, the process of limiting problem foods will be made easier and you can fine tune the whole process. Recipes for diabetics often have the information for carbs included with the recipe itself.

Putting together your own diabetic diet plan is easy when you know the basics. Diabetic research shows that keeping the carbohydrate content at each meal to 45-60 grams is effective in controlling blood sugars. When planning your own diet, you can include your favorite foods by substituting lower sugar foods, preparing foods so they are more diabetic friendly or by using foods prepared commercially just for diabetics. Keep up with what foods affect blood sugars so you can limit these in your diet. Planning a diet when you are a diabetic can be easy when you know the rules.

I was 12. Not fat, tubby, plump, portly or any other word you want to use. Nor did I have any immediate family with the condition. I ate well and life was easy. So very very easy. But it was all about to change.

It was Monday 18th November 1996

One minute I was sleeping, the next I was running to the bathroom. I needed water and quickly. I felt like I could drink the tap dry. I looked at the clock. It was 2.13am. I went back to sleep. It must have been something I’d eaten, a one off.

The next night the same thing happened only this time it was worse. If I didn’t make it to the sink I felt my mouth would close up and stop any oxygen from reaching my lungs. It was 2.17am. It couldn’t be blamed on what I’d eaten for a second consecutive night, could it? Something was wrong.

I told my mother the following day and a trip to the doctor followed. This was met with the usual jubilation that a 12 year old has when they’re told they have a day off school. It was all a bit of a game. A morning off school, sympathy and lots and lots of attention. Where was the problem?

“Mrs Paget, after some initial tests, it looks like your son may have diabetes”. Well, to a 12 year old you may as well have said that NASA has just opened up a canteen on Mars. I didn’t have a clue what the doctor was on about.

It wasn’t until my father met us at the hospital and the nice nurse sat me down I realised things weren’t perhaps worth missing school for. Then I was being asked to hold out my finger so the nice nurse could test my blood sugars. This seemed like a fairly straight forward thing to do.

I passed out. The next thing I knew I was on the bed, surrounded by worried faces.

“Its not good news. Your son must go straight away to Worcester hospital for further tests; we’re 99% sure he’s diabetic”.

Things started moving at a million miles an hour, tests, consultants, more tests and more consultants. I would end up being in hospital for 5 days. But the one thing that stays with me from that torrid day was the realisation that something had gone wrong with my body. Now I would need artificially made insulin to keep my blood sugars controlled stopping my organs from drowning in sugar or passing into a coma induced sleep as my body ran out of it.

It’s a weird sensation for a 12 year old. Suddenly taken out of school and told to live the biology lesson my teacher would be giving my class. It all seemed so…unimportant.

Then came the needle and the orange. By this point I knew things were seriously wrong. I understood I was very unwell. I’d lost weight. I’d begun to drink like a fish and suddenly didn’t seem that interested in that commodity every 12 year old can’t get enough of; food.

I remember my father practicing on the orange, then my mother and then me. It was a strange sensation. No one really knowing what to say and everyone in disbelief that this injecting lark would be happening between 2 and 6 times a day for the rest of my life.

The doses of human mixtard 70/30 varied, as did the frequency of trips to the toilet. Family visited and even the local press wanted to talk to me. On day 3 I was allowed to go for a walk to the other end of the hospital and buy a magazine, closely chaperoned by my mother of course.

Day 4 and my father came with good news. He was taking me out for the afternoon to watch Kidderminster Harriers play football. What a treat. I needed it. Even for a positive, happy 12 year old I was becoming depressed in the hospital. Boy was it a breathe of fresh air. Life could go on. I would still enjoy everything I’d enjoyed before. It would just be with a few major changes.

I left the hospital on day 5 and went back to school. What a week!

It’s easy to now look back on this time and review what happened but it’s only now that I reflect back and think of what was going on. My parents, who were strong throughout, must have had a far worse time than me. They got the serious talks from the doctors. They were told their son would now have a lower life expectancy. That diabetes could cause blindness, organ complications, circulatory problems, increased risk of stroke. They heard about the issues I would face later in life in reference to tolerance to alcohol, sex life, obtaining a driving licence and flying on airplanes with needles.

They understood the seriousness from Day 1. They were unable to control what was happening and could only sit and watch as it rapidly changed the life of their only son. Many parents have been, are going through and will go through the same situation and feelings of helplessness.

It is my hope that articles such as this help more people to understand this dangerous condition and raise the awareness of Diabetes and its management.