Diabetes Weight Loss: Week by Week. Jill Weisenberger

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СКАЧАТЬ best results. For more information, check out this website: www.cdc.gov/physicalactivity/everyone/measuring/exertion.html.

      Avoid Low Blood Glucose During and After Exercise

      Both losing weight and becoming more active improve insulin action. If you use insulin or any of the pills that sometimes cause low blood glucose, exercising puts you at risk for hypoglycemia both during the activity and for as long as a full day later. To avoid exercise-induced hypoglycemia, follow these guidelines.

      • Measure your blood glucose before starting to exercise. If it’s below 100 mg/dl AND if you take medications that can cause low blood glucose, you will need a snack of about 15 grams of carbohydrate or whatever amount is necessary to raise your blood glucose to 100 mg/dl. A small piece of fruit will usually do. If you take no diabetes medications, it is unlikely that you need a snack.

      • If you are exercising at a very high intensity, doing interval training, or doing intense weight training, you may need a carbohydrate-containing snack both during and after exercise to help prevent hypoglycemia some hours later.

      • Measure your blood glucose frequently before, during, and after exercise to learn how different activities uniquely affect you. Check whenever you feel like your blood glucose is low.

      • Always carry a source of carbohydrate in case you experience hypoglycemia. Follow the Rule of 15 if your blood glucose ever drops below 70 mg/dl.

      — If you have your blood glucose meter, use it. If your blood glucose is less than 70 mg/dl, or if you don’t have your meter but believe your blood glucose is low, consume 15 grams of carbohydrate. It’s best to use pure glucose in the form of tablets, gel, or liquid because it works quickly and contains a minimum of calories. Some good choices include:

      2–5 glucose tablets (check the label for the proper dosage)

      1 tube of glucose gel

      2 tablespoons of raisins

      4 ounces of regular soda or fruit juice

      1 tablespoon of sugar or honey

      1 cup of nonfat or low-fat milk

      Do not use candy bars and desserts because they add calories, saturated fats, and work slowly. If that is all you have, however, use it.

      — The second half of the Rule of 15 is to wait 15 minutes after treating before eating anything else or resuming activity. Measure your blood glucose again. If it’s still low, consume another 15 grams of carbohydrate.

      — Recheck your blood glucose in another 15 minutes. Continue to treat with 15 grams of carbohydrate and recheck in 15 minutes until your blood glucose is back to normal.

      — If your next meal is hours away, you may need a snack.

      More from Bill K

       Exercise is a big part of my diabetes management and weight-loss plan. Sometimes when I’d exercise, though, my blood glucose would go too low, which forced me to take in extra carbs to push it back into my target range. Weight loss is difficult under any circumstances, but being forced to eat to keep my blood glucose up was making it a lot harder. I worked with a certified diabetes educator, who is also a registered dietitian, to help adjust my insulin dose, so my blood glucose wouldn’t go too low. That did the trick. By reducing my insulin, I was able to eat less, which reduced my calorie intake. Weight loss is definitely achievable with persistence.

Reflect on Your Food Record

      You’ve kept your food record for at least two weeks by now. Take some time to look at it carefully. What patterns do you see? Perhaps you’ve noticed that you eat mindlessly in front of the television or feel the need for sweets in the afternoon. Maybe you tend to take second and third helpings, even though you’ve had enough to eat. Do you eat too fast, without fully tasting your food? By monitoring your own behaviors and progress, you can identify problem areas and take note of the strategies that work for you and those that do not. Some people like to review their food record daily and to write notes about things they did well or not so well. Then, they set a goal for the next day. Other people prefer to reflect on their food records weekly. Do what you prefer and what works for you and put those SMART goal practices into action.

      Frank P’s Story

       I keep a food record with a computer program that calculates my intake of calories, fat, protein, and carbohydrates. This helps me see if I’m on track or falling away from my goals, and it helps me feel like I have some control. For example, if I see that I’m going to go over my calorie budget for the day, I can choose what to do. I can choose to eat different foods or eat less or hit the gym a bit harder to balance things out.

      I’ve had a few AHA! moments. Sometimes I feel as if I haven’t eaten very much during the day, but then I see that the calories, fats, or carbohydrates were significantly higher than I thought they were. Usually in those situations, I realized I gave myself excuses for eating something earlier and only fooled myself. Keeping records helps me see what I’m really doing and guides me to make good choices.

      WEEK 3 ACTION STEPS

      Continue your current goals or rewrite them if necessary. Additionally, select from the following goals or steps, modify them, or create your own. Choose goals from the previous weeks if applicable. This week I will:

       Continue the following goals: ___________________________________________________________ __________________________________________________________________ __________________________________________________________________

       Record and reflect on my food intake daily.

       Not skip any meals.

       Keep the following foods on hand to make eating breakfast easier:___________________________________________________________ __________________________________________________________________.

       Use a smaller plate for dinner and small dishes at other times.

       Add 1,000 steps to my daily step goal.

       Wake up 20 minutes earlier to fit in a few minutes of physical activity.

       Pull out my old exercise DVDs.

       Check my blood glucose before, during, СКАЧАТЬ