Diet

• According to the Malaysian Diabetes Clinical Practice Guidelines, medical nutritional therapy (MNT) encompasses an important aspect in preventing diabetes, managing an existing disease and delaying complications. The goals of MNT is to ensure a near normal glucose, blood pressure and lipid levels.
• Patients are encouraged to consume food with high-fibre, low-glycaemic-index carbohydrates such as fruits, vegetables, whole grains and legumes; including low-fat dairy products and control the intake of saturated and trans fatty acid foods.

Exercise

• For patients who are obese and overweight, a weight loss of 5-10% of initial body weight over the period of 6 months is recommended to prevent diabetes.
• If you have a pre-existing diabetes, patients are recommended to exercise at least 30minutes, five times a week (150minutes/week) of moderate intensity with not more than two consecutive days without physical inactivity.
• If patients are both obese/overweight and has diabetes, they are recommended to exercise at least 60-90minutes per day for long term weight loss.

Medical Checkups/Compliance

Patients are encouraged to follow-up regularly with their doctors to ensure their glycaemic control is well-maintained. If they are on medications, compliance is of utmost importance to ensure that the progress of the disease is halted.

Smoking/Alcohol

• Patients with diabetes are at an increased risk developing heart disease, eye disease, stroke, kidney disease etc. Smoking increases their chances of getting these diseases ten-fold. Smoking also makes exercising harder as there is a decreased lung compliance. Talk with your doctor about ways to quit.
• It is easier to manage glycaemic levels if patients chooses to not drink, however so, that is not the case in most. If a patient chooses to drink, make sure they are educated to not overdo it. The American Diabetes Association recommends not more than one drink a day for women and not more than two for men.

Stress

Stress can increase the cortisol levels in the body which directly increase the glucose levels. Therefore, patients should be taught on how to manage stress. When you are stressed, you might forget to exercise, eat a balanced meal or take your medication. Ensure that you manage your stress in a healthy way. Find a doctor, if you need help.

Sleep

Lack of sleep has been postulated to increase the chances of a pre-diabetic state. Therefore, ensure that you have at least 6-8 hours of sleep daily. A proper sleep hygiene does not only help with preventing and controlling diabetes, it helps with an overall improvement of day to day life.

References

1. Clinical Practice Guidelines, Management of Type 2 Diabetes Mellitus. 5th ed. Kuala Lumpur: Kementerian Kesihatan Malaysia; 2015.
2. Cold F, Health E, Disease H, Management P, Conditions S, Problems S et al. Sleep-Diabetes Connection [Internet]. WebMD. 2017 [cited 20 July 2017]. Available from: http://www.webmd.com/sleep-disorders/features/diabetes-lack-of-sleep
3. Type 2 diabetes in adults: management | Guidance and guidelines | NICE [Internet]. Nice.org.uk. 2017 [cited 20 July 2017]. Available from: https://www.nice.org.uk/guidance/ng28/chapter/1-Recommendations

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