• When it comes to diabetes care, it’s important to know what’s most essential to protecting your health.
• Certain tests are key! Be sure to have your A1C, blood pressure and cholesterol checked every three to six months or annually for cholesterol.
• Consider how you can make good nutrition and physical activity part of your daily self-care.

If you have diabetes, staying healthy is a top priority. With all the advice you hear, it can be hard to know how to look after yourself while avoiding serious illnesses like COVID-19. When it comes to protecting your health, what should come first in your diabetes care?

Diabetes is a complex condition, affected by how you eat, drink, and move. If you are unsure about what is most important, you’re not alone! You may be adjusting your day-to-day activities to help protect yourself from exposure to COVID-19, flu, and other transmissible diseases. These tips can help you to understand what’s essential in caring for your diabetes.

Begin with understanding yourself and where you are at with this condition. Having a starting point helps to plan toward goals. Remember that you can always reach out for advice from your health care team, including your pharmacy.

Tip 1: Know where you are with your diabetes care

If you have had an appointment with your health care provider postponed, you are not alone. Many Canadians have had medical appointments, tests and procedures delayed. While you may experience obstacles booking appointments, be sure to get the medical care you need.

• For someone with diabetes, this includes having the three “ABC” lab tests done, ideally every three to six months or annually.
  • A1C – your average blood glucose level for the past two to three months
  • Blood pressure
  • Cholesterol – LDL-C (“bad cholesterol”), HDL-C (“good cholesterol”) and triglycerides annually (more frequent testing may be necessary, always discuss your cholesterol results with your primary care provider or other members of your health-care team.)
• You can easily check on potential problem areas at home. Schedule a visit to a health care provider if you spot any issues.
• Examine your feet regularly. It is ideal to do this once a day, while thoroughly cleaning and drying your feet. If you notice any new or worsening cracks, growths, loss of sensation or other abnormalities, alert your physician or health care provider.
• Look closely at your injection sites to ensure there is no skin damage like bumps, bruises, or fat deposits.
• Vaccinations are important for those who have health conditions like diabetes and help provide effective protection against many infectious diseases.

Tip 2: Maintain a healthy diet

Eating meals at home can be a great way to care for your diabetes, since you are able to control exactly what goes into your food. If you cook more often than you once did, keep up the good work!

Homemade meals

When planning meals, be mindful of the recommendations from Canada’s Food Guide. To get a healthy balance of nutrients, keep an eye on the proportions of food types on your plate.

• Half of your plate should be vegetables and fruits.
• One quarter should be whole grains.
• One quarter should be protein foods. Consider having plant-based proteins, such as nuts, seeds, beans and soy products, more often.

Take out or order in

If you enjoy food from your favourite restaurants, these ideas from Canada’s Food Guide can help in making healthier choices.

• When looking at the online menu, check to see if nutrition information is included. This can help you to plan a healthier meal. If you do not see details there, ask the restaurant before ordering.
• Choose foods cooked in healthier ways – baked, grilled, or poached rather than fried.
• Substitute your sides for healthier choices. For instance, switch fries for a salad.
• For your carbohydrate, select a whole-grain option of pasta, bread, or rice.
• Ask for sauces or dressings to be served on the side. This allows you to control how much to include in your meal.

Getting groceries

People at high risk for serious illness may want to avoid crowds, especially during cold and flu season. If this is a concern for you, here’s a few ways to reduce contact with others.

• Try limiting the number of trips you make to the store. You can make the most of your trip by visiting your pharmacy as you shop for groceries. Save time by calling ahead or visiting the pharmacy before you begin shopping.
• You may be able to place your order online and use curbside pickup. A friend or family member might help by dropping your groceries off.

Tip 3: Stay active

Studies show over and over again that exercise, especially regular exercise, significantly benefits people who have type 1 or type 2 diabetes. Exercise improves A1C, blood pressure and cholesterol numbers. It has also been proven to reduce complications related to diabetes, and to increase life expectancy. According to Diabetes Canada guidelines, you should aim for:

• at least 150 minutes of moderate to vigorous aerobic exercise per week.
• two sessions of resistance exercise per week.

If you have not been as active recently, discuss your exercise plans with your primary care provider. Depending on your medical conditions, your primary care provider may recommend you have some tests, such as an ECG or an exercise stress test before you begin exercising.

Remember to stretch before you begin and when you finish. This will help prepare your muscles and prevent injuries.

Aerobic exercise

• Aerobic exercise does not necessarily mean running. It can be brisk walking, dancing, swimming, cycling, gardening, or doing domestic chores. Whatever you do, the goal is to elevate your heart rate through continued large muscle movements. Spending at least 10 minutes or longer exercising per session is recommended.
• Start small and do what you are likely to enjoy. For instance, try walking around your neighbourhood. Be cautious about ice and snow during wintry conditions.
• You can easily exercise at home, free of charge. Countless YouTube channels offer Zumba, dance, and home training videos that are easy to follow.
• Track exercise in a way that motivates you. For instance, use a phone app like Google Fit to count your steps and distance for each day and each week.

Resistance exercise

• Resistance exercise does not have to involve heavy and large dumbbells. You can do resistance exercises at home using your own body weight. As with aerobic exercise, you can find many free YouTube videos demonstrating activities.
• If you have limited space, resistance bands are a great idea. This inexpensive option can be used to exercise all the muscles in the body.
• Do three sets of eight to 12 repetitions of each exercise. If you cannot do eight repetitions, the weight is too heavy for you. If you can do more than 12 repetitions, the weight is too light.

Tip 4: Manage your weight

It is estimated that 80 to 90 percent of people with type 2 diabetes are either overweight or obese. (Diabetes Canada) Weight gain is also an increasing issue for people who have type 1 diabetes. If you are already living with diabetes, obesity can lead to many complications including heart disease and stroke.

Eating a healthy diet and staying physically active are key to managing weight. If you are carrying extra pounds, consider starting with the goal of losing five to 10 percent of your weight. This can improve those critical A1C, blood pressure and cholesterol levels, and reduce your risk of heart and blood vessel diseases.

Healthy weight by the numbers*

Body mass index: the healthy range is 18.5 to 24.9 kg/m2.

To find out your body mass index, use the Diabetes Canada BMI calculator:

Waist circumference:

Men: less than 40 inches (102 cm).
Women: less than 35 inches (88 cm).

*Note that these goals do not apply to women who are pregnant or breastfeeding, or very muscular or very lean adults. These goals can also vary depending on age, gender and ethnicity.

Tip 5: Ask for help

Reach out to your health care team to get the care you need. You can start by connecting with one of the diabetes educators or pharmacists at our pharmacy. These experienced health care providers can provide information and guidance over the phone, making it easier than ever to get advice.
So, what are the essentials of diabetes care? In addition to daily monitoring and medications, you can safeguard your health by:

• testing your A1C, blood pressure and cholesterol every three to six months or annually for cholesterol.
• making sure that what you are eating and drinking supports your health.
• getting the physical activity you need.
• and staying at a healthy weight.

Remember, your pharmacy team is always on hand to help.

WRITTEN BY: In Whang, RPh, CDE, APA, a pharmacist and diabetes educator at Safeway in Calgary, Alberta.