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Scott Webb (Host):  Welcome to Hally Healthcast, the monthly wellness podcast from Hally Health – your partner in helping you live your healthiest life. Visit www.hally.com for health and wellness resources, information, tips and much more. Every month in our podcast, we address a new topic important to your health, brining in expert doctors, therapists and specialists who offer advice and answer your most pressing questions. November is National Diabetes Month, so we’re talking about this all too common disease that affects millions worldwide. Specifically, we will walk you through five helpful tips for managing your diabetes, all of which can be done at home. I’m Scott Webb and here with us is Jean Land, a Registered Dietician and Certified Diabetes Care and Education Specialist for Carle’s Diabetes Education Services. So, Jean, thanks so much for joining me to. We’re talking about diabetes and how to manage it at home. And we want to go through the five tips for people. So, tip number one may be the most important one. We need to know which type of diabetes we have, right?

Jean Land, MS, RDN, LDN, CDE (Guest):  Right. There are three main types of diabetes plus several others. But type 1 diabetes is an autoimmune disease where the pancreas actually ceases to make insulin so, people with type 1 diabetes require insulin injections. Type 2 diabetes is actually a disease of insulin resistance. It’s the most common type of diabetes. It can be controlled with lifestyle modification, diet and exercise, oral medication and in some instances, a person may need insulin with type 2 diabetes as well. And then also gestational diabetes is fairly common and it’s a type of diabetes that develops in pregnancy related to some of the hormones. Usually it goes away when the baby is born. So, it occurs during pregnancy. People who have gestational diabetes are at risk for developing type 2 diabetes in the future. But typically it is gone after the baby is here.

Host:  So, as we move on here, we go to tip number two, we want people with diabetes to check their blood sugars regularly, right? Multiple times a day.

Jean:  Yes and now. It depends on their treatments. If they have type 2 diabetes and they’re either lifestyle modifications controlled or maybe on an oral medication; if their hemoglobin A1C is less than 8%, they may only need to test their blood sugar once a day. Usually at varying times of the day. If their control is not real good, if their A1C is above 8%, we recommend that they test their blood sugar fasting first thing in the morning and then maybe two hours after a meal so we can kind of see a big picture of what their blood sugar is doing throughout the day and then the doctors can adjust their medications better that way.

If a person is taking insulin, then they typically test their blood sugar four or more times a day.

Host:  Okay and as we move on here now to tip number three, this tip of course would be good for anybody, anytime, eating healthy, balancing meals and snacks, but especially for people with diabetes, right?

Jean:  Right. People with diabetes should see a registered dietician to work together, develop a healthy meal plan based around carbohydrates. Of course that’s the nutrient in food that affects blood sugar. It doesn’t mean that a person has to cut out all the carbohydrate from their diet but we want to educate them on which foods contain carbohydrates and how to spread those out throughout the day, how much carbohydrate they should have at meals and snacks and so on. So, we really individualize it so there’s not one meal plan that works for every person.

Host:  That’s good to know and I think maybe that would be the perception that there’s sort of a standard, well if you have type 2 diabetes, here’s your meal plan and your snack plan. I definitely know during COVID-19, during the lockdown, that I was treating myself to more comfort foods and I’ve noticed that my entire family has just been snacking more because I’m the one who does the grocery shopping, so I know how often I’m buying snacks and is that an issue also for people with diabetes, just too much snacking?

Jean:  It can be. We talk about some good choices for snacks and things that are lower in carbohydrates, maybe with more protein, snacks that will sustain them a little more and hopefully make them not as hungry. And also, all foods can fit into a diabetes meal plan. So, if they do eat sweets occasionally, we teach them how they can work their favorite occasional ice cream or birthday cake or whatever the occasion may be.

Host:  That’s great. Yeah, we were talking before we started today, and my grandfather had diabetes and he was very careful about it and we knew a lot less than we do now of course about diabetes, but he had is little bowl of candy and he would have candy in moderation, but it was like the thing he looked forward to most during the day. Finally, I can have that piece of candy, right?

Jean:  Some people keep candy on hand if they tend to have a low blood sugar occasionally. So, there’s different treatments for different aspects of diabetes and times that that candy can be okay, whether they are low or not. As long as they do it in moderation.

Host:  Yeah, that’s definitely key, moderation and maybe when we talk about tip number four, about getting moving and exercising, maybe that’s also a good word for that. Moderation, especially if it’s not something people are used to but nevertheless, we really want people with diabetes and perhaps everybody else. Get moving, right?

Jean:  Physical activity is definitely an important part of managing diabetes. Physical activity actually lowers insulin resistance so it can make your insulin that’s produced in the body to work more efficiently or even if a person is taking insulin injections, or oral medications. It just overall can help improve the blood sugars by lower insulin resistance. Of course, if a person has not been doing any type of exercise or physical activity, we recommend that they start gradually and then eventually, build to 30 minutes a day is a typical recommendation. Yeah, you don’t have to go to a gym to get physical activity. You can certainly walk outside in nice weather. Of course, now it’s good to get outside since we don’t want to be spending a lot of time inside or with other people but there’s just ways you can get physical activity into your every day routine as well. For people who are working in an office building, if they have breaks throughout the day; it’s good to get up and walk for ten minutes if you have that opportunity. Or for people who do go to the grocery store and shop, I might suggest to them take an extra lap around the inside of the store before you start putting groceries in your cart. Just anyway that you can get some extra steps in.

Host:  So, as we wrap up here today Jean, we want to talk tip number five, and this would be key I’m sure for people with diabetes. But it is taking their medication and taking it properly.

Jean:  Whether the medication is prescribed once a day, twice a day, three times a day; it’s important to talk with your doctor about what time you should be taking that medication. Whether it needs to be taken before a meal or spaced twelve hours apart. Our diabetes educators, we review that with patients as well. Because it can be a problem. Sometimes I’ll have someone who used to take a medication twice a day, they take the first dose in the morning, but they wait until bedtime to take the second dose. Well some of the medications are meant to be taken before a meal. So, if they take it at bedtime, it’s possible that it could cause a low blood sugar later in the middle of the night. And we don’t want that. We want them to be safe. Timing is very important and understanding how the medications work because each one works to control blood sugar in a different way.

Host:  Yeah, it sounds like it and what I really like about your approach is that it – there’s no one size fits all and everything is customized and personalized and really working with people with diabetes to make sure that they are on the right medications, that they know when to take them, how to take them and all of that. Really useful, helpful advice and thank you Jean for all that you do in your work as a Registered Dietician and Certified Diabetes Educator at Carle.

And that’s it for today’s Hally Healthcast. Tune in next month when we’ll bust five scary myths about aging. We’ll tell you why you don’t need to fret as you reach your golden years. and remember Hally Health is your partner in helping you live your healthiest life. Visit www.hally.com for resources, information, tips and much more. Let us help keep you and your family healthy and well. Thanks for listening and we hope you tune in again next month.