1: Plan your meals – Most poor diet choices are made due to lack of planning.

Meal planning really applies to anyone living with or without diabetes. Most poor diet choices are made due to lack of planning. Creating a routine with meals and having a general idea of what you will be eating for the day is key to success. If you have to eat out, familiarize yourself with the restaurant’s menus, and select a few go-to meals. The best options would be grilled chicken tenderloin plate, grilled sirloin plate, or the grilled chicken salad. Avoid dishes that are fried. Make sure to incorporate a green vegetable or salad with your entree. Don’t assume that if it looks healthy then it is healthy. Did you know at Arby’s restaurant the Market Fresh Roasted Turkey Breast Bacon ranch sandwich has 800 calories and 76 g or carbohydrates. While the Beef and Cheddar Classic has 450 calories and 45 g of carbohydrates.

2. Stop Smoking – Did you know that smokers are 30-40% more likely to develop type 2 diabetes?

Once diagnosed with diabetes, no matter which type, smoking can cause difficulty with controlling blood glucose levels. Exposure to nicotine can cause insulin resistance in the body which can cause difficulty with regulating medications often requiring higher doses of oral medications and insulin therapy. Smoker with diabetes also have increased health risks, such as heart disease, decreased circulation and vascular disease which could increase potential amputation, retinopathy (eye disease), and neuropathy (loss of feeling and sensation in limbs). Smoking can often lead to gum disease and gum disease itself also increases the risk of diabetes so be sure to continue routine checkups.

3. Know your numbers – Let’s be honest checking your blood sugar is never fun, but it is really helpful. Ignorance is never bliss in this situation.

Patients will often say “I know when my blood sugar is high or low based on symptoms.” Did you know that your body can regulate symptoms when exposed to higher glucose levels for long periods of time? This means that even though your blood glucose reading are running high, you may no longer experience the obvious symptoms of uncontrolled glucose levels. Symptoms of hyperglycemia includes increased hunger, increased thirst, increased urination throughout the day and night, unexplained weight loss, blurred vision, fatigue, increased sweating, irritability and mood changes, and in severe cases coma or death. The reverse side of that is hypoglycemia, or low blood glucose levels. Symptoms of hypoglycemia include feeling shaky, increased sweating, confusion, increased hunger, irritability, and in severe cases loss of consciousness or death. We don’t need to encounter any of those symptoms while over the road. Also, you don’t need to be surprised at your doctor’s office when your Hemoglobin A1c (lab value that is a three month average of blood glucose levels used to evaluate the control of your diabetes.) is too high, and you are in jeopardy of losing your medical card. In patients with diabetes a goal A1C is 6.5-7%. What that means is if you monitor your blood glucose levels fasting and 2 hours after meals, your readings should range from about 90-150 mg/dL. Luckily, we now have devices available that do not require finger sticks.

5. Water, Water, Water – Drink plenty of water throughout the day. And when I say plenty of water, I’m talking about 2 liters per day.

Staying well hydrated is obviously beneficial for everyone to maintain, but it is especially beneficial for patients with diabetes. Water is the healthiest option as it contains no calories or carbohydrates. With hyperglycemia, your kidneys will attempt to excrete the excess glucose through your urine. Ensuring that you drink plenty of water ensure that your kidneys stay healthy and hydrated. Patients with diabetes have increased risks of dehydration due to hyperglycemia. When the body is dehydrated the kidneys will hold onto fluids and certain hormones will rise. Subsequently, the hormones can causes the liver to produce additional glucose. Maintaining adequate hydration also has added benefits such as improving bowel movements, aids in blood pressure, and can also promote weight loss. Patients also confuse thirst for hunger. If you get a hunger pain, drink 8 oz of water to see if your body responds to the water instead of filling up with extra calories. It is also beneficial to remember that diet drinks contain a lot of sodium which can cause hypertension and fluid retention. Caffeine is also considered to have a mild diuretic effect, so make sure to replace each cup of coffee or tea with water to ensure that you are staying hydrated. In addition, water is also much kinder to your teeth and gums than sugary alternatives and can help to promote better oral health. Just remember to attend frequent checkups with a dentist in your area to make sure your teeth and gums are healthy.

6.Get some rest – Ok, you may have a good laugh at that one, but it is true. Sleep is important for our body’s overall health and gives us the daily recharge that we desperately need.

Now, you may be asking how sleep can help with diabetes. Often times when we are tired we eat in attempts to stay awake. This excessive snacking can cause weight gain due to increased caloric intake. Fatigue causes stress on the body and when we our bodies are under stress that in turn can cause hyperglycemia. You should aim for 7-9 hours of restful sleep per night. Tips for better sleep include: turning off all electronic devices prior to sleep, use a sound machine to reduce any outside noise, use a sleep mask to reduce any excessive light, and stay cool. Even changing the mattress could help improve the quality of sleep. According to research, investing in a new mattress can help with health and overall wellbeing.

Adequate sleeping temperatures are 60-67 degrees Fahrenheit. Achieving better control of your blood sugars will help reduce symptoms of fatigue. If you still can’t get the rest that you need, speak with your healthcare provider as you may benefit from further medical evaluation.

7. Get your steps – We all know that we should be more active. When you are in a profession that requires you to sit for the majority of the day, finding the time to be active is even more critical.

Exercising doesn’t have to happen in the gym. When at a rest stop, walk a few laps around the parking lot. Be creative and try to incorporate a routine with different exercises that you can do right outside of your truck. An example of a routine includes doing 20 leg squats, 20 jumping jacks, 20 lunges, running in place for 30 seconds, and holding in plank position for 30 seconds. Repeat this set 3 times with a 1-2 minute rest between each set.

8. Let go of the stress – As mentioned previously, stress on the body can cause high blood glucose levels from the release of the body’s stress hormones.

This reaction is shown for mental and physical stress. Simply put, if you have physical pain such as a back strain or even a severe headache, you may notice elevated glucose levels. Mental stress may be due to your job, marriage, and even horrible traffic. Often times we make poor decisions when under increased stress, such as eating too much, alcohol use, tobacco use, or even not eating at all. Increased stress can also lead to poor sleep. Maintaining stress and anxiety can be difficult, but that is why it is important to incorporate healthy techniques throughout the day. Try to take 10 minutes a day to clear your mind. This can improve mental focus and clarity. If you find that you have a lot on your mind, try writing it all down. Staying organized can reduce anxiety and stress throughout the day. Try refocusing your thoughts by listen to calming music, recorded comedy routines or audio books. Exercising is not only beneficial for glucose control, it is also shown to aid in stress relief. If you notice that you still have trouble maintaining your anxiety and stress, try to talk with someone that has more tools available to find the right technique for you.

9. Routine is the way to go – Establish a daily routine.

I don’t mean you have to be so strict that you schedule a time each day to use the bathroom, but carve out a general idea of how your day is going to go. For example plan your meals, when you will exercise, and when are you going to bed. While your schedule may change from day to day depending upon your route, having a general idea of what you will accomplish will help ensure that you make the best decisions each day.

10. Interdependence is greater than independence – Understand that you do not have to do this alone. Find a health care provider that you are comfortable with and understands your lifestyle.

Ensure that your health care provider knows the guidelines for maintaining your medical certificate. Make sure that you follow up on a routine basis to review medications and your glucose logs. Routine follow up is also important so you do not run out of prescription refills. Talk with your partner or friend to help with accountability. This may be with your diet, activity, or taking your medications. Diabetes can be very frustrating, so If you don’t understand why something is going on, then ask for help. If you know someone with diabetes and notice odd or different behavior, such as extreme changes in diet or avoidance of diabetes-related checkups, they could be suffering from Diabulimia. This is when someone suffering from Type 1 diabetes restricts the amount of insulin they need. Alarmingly, 30-40% of adolescents with diabetes will suffer from an eating disorder at some point, which puts diabulimia as a more common eating disorder than thought by many. It’s important that as a loved one, you help them access help. Look for diabetes support groups online or encourage talking about it.

by Helen Belcher, Ediabetes Care Clinic