Behavior and Lifestyle

Diabetes and Alcohol

If your blood glucose is in good control, you could safely drink alcohol in moderation. First, discuss this with your doctor to consider all of your health issues. Moderate alcohol intake defined by the Dietary Guidelines is one drink a day or less for women and two drinks a day or less for men. A serving of alcohol is defined as 12 oz. beer, 5 oz. wine or 1.5 oz. of distilled spirits.

You should not drink alcohol if you have a history of alcohol abuse, are pregnant or breast feeding, planning on becoming pregnant, have pancreatitis, or have very high triglyceride levels.

What effect does alcohol have on blood glucose? Your biggest risk is hypoglycemia – straight alcohol lowers your blood sugar. If you are taking blood glucose medications, it will exacerbate the effect of your medicine, causing even more risk of low blood sugar. Alcohol will reduce the normal rise of your blood glucose in the early-morning hours. Alcohol will also slow impair your mental and physical abilities, and you may not be aware of hypoglycemia symptoms.

If you eat when you are consuming alcohol, which mostly will contain carbohydrates, your blood glucose will rise. You may have a sudden drop at a later time. So, never drink on an empty stomach, and consume some food if you do have a drink. It would not be wise to drink and exercise, because both have blood glucose lowering effects.

If your doctors allows, your dietitian can fit alcohol calories into your meal plan. Research has found some health benefit to moderate alcohol intake for the heart and blood vessels. Talk with your doctor about what benefits alcohol may have for you.

Diabetes Changes & Goals

The reality is that you are in charge of your diabetes. Your health care support team keeps you educated about what to do to take care of yourself, but you are the center of the team. A proactive attitude on your part will keep you healthy.

Changing behavior to improve your health is the subject of much study. But first, do you need to change, and what needs to be changed? Do you need to lose weight? What types of eating habits do you have? Is your diet balanced and healthy? Are you in control of your carbohydrate intake? Do you exercise for 30 minutes four times a week or more? Are you keeping your doctor’s appointments? Do you need to stop smoking? Are you testing your blood glucose as instructed-and treating the information accordingly?

Ready to Change

There is a lot to do to take care of yourself. Are you ready to make changes? Have you ever taken on a big goal only to miss your mark completely? Maybe you were not properly ready, and the goal was not a good choice.

Behavioral researchers use the Readiness to Change Model to help us define if and how ready we are to make changes.

Stage 1: Pre-contemplation – You are not aware that the behavior is a problem. You have no intention of changing the behavior.
Stage 2: Contemplation – You are aware that the behavior is a problem, but you are on the fence about doing anything about it. You are ambivalent—the risks do not outweigh the benefits.
Stage 3: Preparation – You accept the need to change and start planning how and when you will conduct this change.
Stage 4: Action – You put your plan into action and keep a check on how you are doing.
Stage 5: Maintenance – As time passes, your change is working and you are feeling the benefits.

Choosing a Goal

What stage are you in? Since you are educating yourself on this website at the moment, you are probably contemplating some change. When you are ready to set a goal, it is important to set yourself up for success by following the SMART rules for goal setting. A goal should be:

SPECIFIC: Bring your goal to a specific task—I will walk 10 minutes at lunch three days a week, rather than I will try to walk more.
MEASURABLE: Keep track of your progress with your goal by tracking and measuring it. Mark your walk and the length of time on your calendar.
ATTAINABLE: Can you really accomplish this goal? How realistic would it be to set a goal of running one hour a day every day when you are really a couch potato?
REALISTIC: Can you do this goal realistically with your lifestyle and resources? Do you have good walking shoes? Is there a place to walk at lunch, and do you have the time in your workday? Would it be better to walk before work?
TIME: Define a time frame you will do this—give yourself a time goal—I will do this walking schedule for the next month.

Write down your goal, think about what steps you’ll need to take to accomplish it, and make a plan. Perhaps you want to share your intentions with others by being a part of DiabetesCare.net’s forums community and write about your goals and progress.

Managing Diabetes Through Behavior Modification

Managing diabetes requires lifestyle changes. You need to pay close attention to your diet and your physical activity. You should probably monitor your calories in (diet) and your calories burned (exercise). Modifying your behavior might prove challenging, but it is the only sure way to achieve control. A large part of this process involves addressing the beliefs that keep you from living a healthier lifestyle and replacing problem behaviors with healthy behaviors. Setting goals, keeping records, and evaluating your progress also play an important role.

To jumpstart the behavior modification process, follow these tips:

Develop a Positive Attitude

While assessing your habits and learning to control them might seem difficult at first, the rewards of accepting personal responsibility are worth the effort. Concentrate on developing a positive attitude.

Have You Ever Said…

“I have to entertain in my job” or “I am big-boned” or “I do not have time to exercise.” Blaming outside forces only delays your resolve.
“I do not have any willpower.” If you do not have control, who does? Willpower is not an inborn trait. You need to develop and practice this skill to get better at it. You can control your responses to foods; you have just convinced yourself you cannot.
“I simply cannot lose weight.” Translation: You think you are unworthy of trying again. Banish negative thoughts.

These rationalizations conveniently remove the responsibility from the individual. Accepting personal responsibility means recognizing that these statements impede success. Apply positive solutions to your problems and focus on what you can do to control your behavior.

Develop a Sense of Personal Responsibility

To take charge of your eating, follow these steps:

STOP. As soon as you feel the urge to eat something decadent, count to 20. This momentary pause allows you time to exercise your willpower.
THINK. Give your defenses a chance to kick-in.
LISTEN. To yourself, not the food. Talk yourself out of a temptation and the urge will pass. Determine whether the treat you crave is worth the consequences.
ESTABLISH SITUATIONAL CONTROLS. Remove the temptation before it grows too strong to resist. The best situational control? Do not keep your “weakness” in the house, be it ice cream, cookies or potato chips. Be good to yourself.

Assert Your Right to a Healthy Weight

When you watch what you eat to help manage your diabetes, you can help manage your weight as well. Identify “diet” saboteurs:

“Have some more lasagna…,” “Split a piece of pie with me….”

Sometimes the people around you seem like enemies when you try to change your eating habits. They might wonder if the new you will resemble the old friend. Do not be afraid to assert your right to make healthy food choices.

Ask for Help

Help those around you understand how their actions influence you, and give them suggestions for showing more support.

State the problem areas and situations in which you need help or support.
Explain how you feel about the problem and why you need help with its resolution.
Detail the action you wish your supporters to take.
Describe to them the results that you expect.

Work Toward a Healthy Lifestyle

Fill your evenings with people and activities. Do you eat out of boredom? Find something productive to do. Volunteer, ride an exercise bike while watching your favorite sitcom, visit a friend, take a night class.
Read food labels and become more aware of the calories in the choices you make. You can make a difference in controlling your blood sugar by keeping alert. When eating out, speak up. Ask for dressings on the side. Request small portions of lean meats. Ask for a doggie bag. If you can’t resist the rolls and butter, send them back to the kitchen.
Get out of the house and away from the fridge! Plan evening walks, bicycle rides, and other physical activities. Changing the focal point of your family time from eating to activity will help everyone rethink their habits and provide you with company as well.
Act positively. Moaning and groaning about saying no to chocolate cake will not elicit sympathy from your family. Let your family see a happier, healthier you and they’ll be more likely to support you and your new lifestyle.
Listen to your body. Spread your meals out throughout the day for better blood sugar control. Create a balanced meal plan with a dietitian that provides the calories you need based on your sex, age, weight, physical activity level, and lifestyle, and stick to it. When someone offers you food, do not feel pressured to eat.

Don’t Forget Exercise

You cannot achieve long-term weight loss by diet alone. To maintain a healthy diet, you should watch your calorie intake and increase activity.

Remind yourself about the benefits of exercise. Regular exercise reduces your risk of heart disease, lowers your cholesterol and blood pressure, and raises your metabolism. Not only do you burn calories during a workout, but you also use more calories all day long. Why? Because exercise builds muscle, and muscle uses more calories than fat.

Take a look at these exercise facts and fallacies.

No pain, no gain.
False. Exercising to the point of discomfort can signal bone, joint and muscle injury.
You can “sweat” the weight off.
False. Perspiration loss during exercise can account for some temporary weight loss. But, you will “regain” it with the first glass of water you drink!
Exercise makes you hungry.
False. Moderate activity will not increase your appetite. Exercising fuels feelings of control and accomplishment.
Spot reducing eliminates fat deposits in problem areas.
False. Spot reducing can tone and firm an area to make it look thinner, but if excess fat exists in the area, it will never look as firm as you want with spot exercises alone!
Cellulite is not the same as other fat.
False. Fat by any other name still equals fat! While some areas of the body resist fat loss more than others, no amount of creams or massages will reduce or eliminate the dimpled, fatty deposits known as cellulite. To shed these fat cells, you will need to use the same program of diet and exercise you’re using for generalized weight reduction.
Your scale is the best measure of your exercise program.
False. When you exercise, heavier, lean muscle tissue increases while lighter fat decreases. In fact, you might even gain a pound or two when you start to exercise. Instead of just checking the pounds, measure your success by evaluating the decrease in your body fat.