Diabetes - Mind and Body

Diabetes is a complex disease in that it can affect many parts of your body as well as your mind. Knowledge of how to look after yourself to minimize or even prevent complications is an important first step.

Diabetes and Your Heart

Diabetes puts you at risk of heart disease (even if you have ‘normal’ looking cholesterol and no symptoms). Diabetes can change the chemical makeup of some of the substances found in the blood and this can cause blood vessels to narrow or to clog up completely.

Maintaining fitness with regular physical activity combined with some weight loss can help reduce high blood pressure. Blood pressure lowering medications, often in combination, are often required.

Detecting Heart Disease

Often people do not know they have heart disease until they develop symptoms like chest pain, shortness of breath, dizziness or excessive fatigue when walking or exercising. It is important to note that symptoms may be mild to severe and sometimes there may be none at all.

Examples of some other warning symptoms may be:

• Arm or jaw discomfort
• Indigestion
• Weakness
• Nausea

Reducing the Risk of Heart Disease

One of the most important things to do to reduce the risk of heart disease is to meet with your doctor and/or Credentialed Diabetes Educator to discuss your individual risk factors and how to reduce them. In general terms you can reduce the risk by:

• Being physically active
• Losing weight if you are overweight
• Not smoking
• Managing blood fats
• Managing high blood pressure
• Taking medication as prescribed.

Be Physically Active

Regular physical activity combined with a healthy diet and achieving/maintaining a healthy weight can help to reduce the risk of a heart attack and stroke. Any type of physical activity– whether sports, household work, gardening or work-related physical activity – will help.

Aim to do at least 30 minutes of moderate intensity physical activity on most, if not all, days of the week. Moderate intensity is when your breathing increases noticeably – a ‘little bit of puff’. Check with your doctor before beginning a physical activity program.

Lose Weight

Being overweight, especially around waist is a major risk factor for heart disease. Even a 10% weight loss (e.g. a loss of 10 kgs in a 100 kg person) reduces the risk of heart disease.

Don’t Smoke

Smoking is a very important risk factor for heart disease compared with non-smokers. Stopping smoking at any age can significantly improve health, including reduced risk of heart diseases.

Take Medications as Prescribed

As cardiovascular disease is the leading cause of death in people with diabetes, statins (medicines that reduce cholesterol) are usually required to manage cholesterol levels to reduce risk. The most recent research indicates that statins should be considered for all adults with diabetes, even those without any signs of heart disease. Medication, referred to as ‘blood pressure lowering agents’ can also help lower high blood pressure. You may require more than one agent.

Ask your doctor about aspirin to help reduce the risk of heart attack. Aspirin in low doses is sometimes recommended for people at risk of heart attacks as it makes the blood thinner and less likely to clog blood vessels.

Always take your medication as prescribed by your doctor. If you have any concerns then discuss them with doctor, do not alter your medication yourself. 

Your pharmacist and Credentialed Diabetes Educator can also answer questions or concerns that you may have.

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Diabetes and Exercise - Keeping Active

Everybody benefits from regular exercise. If you have diabetes, or are at risk of diabetes it plays an important role in keeping you healthy. 

Regular exercise is an important part of your diabetes management. If you are on insulin, it will help your insulin to work more efficiently and assist with your blood glucose control. However, if your diabetes is poorly controlled (i.e. fasting blood glucose levels greater than 14 mmol/L and urinary ketones) then it is best to avoid exercise until your blood glucose has settled. Exercise in these circumstances can actually elevate blood glucose and increase ketone production.

For a person with diabetes exercise helps:

• Insulin to work better, which will improve your diabetes management
• You control your weight
• Lower your blood pressure
• Reduce your risk of heart disease
• Reduce stress.

You are discouraged from strenuous physical activity if you are feeling unwell or have ketones present in your blood or urine.

Getting Started

Before commencing a regular exercise program see your doctor for a full medical examination. There are also two things you have to be careful of:

Take it slow: You don’t want to start off too hard because if you are not used to the exercise you will be sore the next day and this will not make the exercise experience an enjoyable one! Always increase the intensity of the exercise very slowly.

Get checked out. If you have any health problems such as diabetes complications like retinopathy, nephropathy, you should talk to your doctor or an accredited exercise physiologist before you start increasing the intensity of your exercise.

Suitable Types of Exercise

Suitable types of exercise depend on the individual. Here are some suggestions for you to discuss with your doctor:

• Walking
• Swimming
• Dancing
• Water aerobics
• Gardening
• Golfing
• Cycling
• Exercise bike
• Walking machine.

Increasing your general physical activity is also helpful, e.g. taking the stairs instead of the lift, getting up to change the TV station instead of using the remote control, housework, and gardening.

Amount of Exercise

Ideally, you should be doing about 30 minutes of exercise every day. If this is not possible, then this time can be divided in 3 x 10 minutes sessions. 

Intensity of Exercise

You do not need to puff to gain the benefits of exercise. Aim for moderate intensity. This means you should still be able to talk as you exercise without becoming breathless. 

Exercise Tips

• Drink extra fluid before, during (only if prolonged exercise) and after exercise to avoid dehydration. The fluid may be water or a sweetened drink if extra carbohydrate is required. 250 ml every 15 minutes or one litre of fluid per hour is recommended. 
• Take care of your feet when exercising.
• Wear comfortable and well-fitting shoes. 
• Always inspect your feet before and after exercise. 
• Ulcers or other lesions on the feet are a serious danger for people with diabetes. It is important to avoid foot damage especially for middle-aged and elderly people
• It is wise to avoid exercise that causes stress to the feet (e.g. running). Exercise which poses minimal weight or stress on the feet is ideal such as riding an exercise bike or brisk walking in good footwear.
• Take extra carbohydrate before and during exercise to prevent hypoglycaemia. Extra carbohydrate is often needed after exercise. Discuss adjusting carbohydrate intake with your doctor or dietitian.
• Monitor your blood glucose levels before, if possible during (at least initially), and after exercise to assess your requirements for extra food. 
• It may be necessary to reduce your insulin dose prior to exercise. Insulin adjustment varies with each individual. Discuss appropriate adjustments to suit your exercise schedule with your doctor or Credentialed Diabetes Educator.
• Wear sun block when exercising outdoors.

People with diabetes are generally discouraged from strenuous physical activity if they feel unwell or have ketones present in their blood or urine.

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Eating Well with Diabetes

Choosing healthy foods and being active will help manage your blood glucose levels and your body weight. Healthy eating for people with diabetes is similar to recommendations for everyone so there is no need to prepare separate meals or buy special foods. Healthy eating can be enjoyed by the whole family.

All people with diabetes are advised to have a healthy eating plan, however, to control blood glucose levels in people with type 1 diabetes requires further consideration.

Managing blood glucose levels for a person with type 1 diabetes requires matching the amount of insulin to the carbohydrate in the foods eaten. There are different types of insulin and various regimes. It is possible to be flexible about the time of meals and the amount of carbohydrate in meals and snacks. Individuals with type 1 diabetes need to know how to plan their food, insulin and activity to best manage their blood glucose levels. It is advisable that all people with type 1 diabetes attend a dietitian experienced in working with people with type 1 diabetes to help them develop their own suitable meal plan.

What Should I Eat?

To help manage your diabetes, your meals need to be:

• Regular and spread evenly throughout the day
• Lower in fat, particularly saturated fat
• Based on high fibre carbohydrate foods such as wholegrain breads and cereals, beans, lentils, vegetables and fruits.

Matching the amount of food you eat with the amount you burn up each day is important. Not putting too much fuel in your body (keeping food intake to moderate serves) is vital to getting the right balance.

Along with healthy eating, regular physical activity can help you to manage your blood glucose levels, reduce your blood fats (cholesterol and triglycerides) and maintain a healthy weight.

Fat

Fats have the highest energy (kilo joule or calorie) content of all foods. Eating too much fat can make you put on weight, which may make it more difficult to manage blood glucose levels. While it is important to try and reduce fat in your diet, especially if you are trying to lose weight, some fat is good for health.

Saturated Fat

It is important to limit saturated fat because it raises your LDL (‘bad’) cholesterol levels. Saturated fat is found in animal foods like fatty meat, milk, butter and cheese. Vegetable fats that are saturated include palm oil (found in solid cooking fats, snack foods or convenience foods) and coconut products such as copha, coconut milk or cream.

To reduce saturated fat:

• Choose reduced or low-fat milk, yoghurt, ice-cream and custard.
• Choose lean meat and trim any fat off before cooking.
• Remove the skin from chicken (where possible, before cooking).
• Avoid using butter, lard, dripping, cream, sour cream, copha, coconut milk, coconut cream and hard cooking margarines.
• Limit the amount of cheese you eat and try reduced-fat and low-fat varieties.
• Limit pastries, cakes, puddings, chocolate and cream biscuits to special occasions.
• Limit pre-packaged biscuits, savoury packet snacks, cakes, frozen and convenience meals.
• Limit the use of processed deli meats (devon/polony/fritz/luncheon meat, chicken loaf, salami etc) and sausages.
• Avoid fried takeaway foods such as chips, fried chicken and battered fish and choose BBQ chicken (without the skin) and grilled fish instead.
• Avoid pies, sausage rolls and pastries.
• Rather than creamy sauces or dressings, choose those that are based on tomato, soy or other low fat ingredients. As some tomato and soy sauces can be high in salt, choose low-salt varieties or make them yourself without any added salt.
• Limit creamy style soups.

Polyunsaturated & Monounsaturated Fats

Eating small amounts of polyunsaturated and monounsaturated fats can help ensure you get the essential fatty acids and vitamins your body needs.

Polyunsaturated fats include:

• Polyunsaturated margarines (check the label for the word ‘polyunsaturated’)
• Sunflower, safflower, soybean, corn, cottonseed, grapeseed and sesame oils
• The fat found in oily fish such as herring, mackerel, sardine, salmon and tuna.

Monounsaturated fats include:

• Canola® and olive oils
• Some margarines
• Avocado.

Seeds, nuts, nut spreads and peanut oil contain a combination of polyunsaturated and monounsaturated fat.

Ideas for Enjoying Healthy Fats

• Stir-fry meat and vegetables in a little canola® oil (or oil spray) with garlic or chilli.
• Dress a salad or steamed vegetables with a little olive oil and lemon juice or vinegar.
• Sprinkle sesame seeds on steamed vegetables.
• Use linseed bread and spread a little canola margarine.
• Snack on a handful of unsalted nuts, or add some to a stir-fry or salad.
• Spread avocado on sandwiches and toast, or add to a salad.
• Eat more fish (at least three times a week) because it contains a special type of fat (omega-3) that is good for your heart.
• Do more dry roasting, grilling, microwaving and stir-frying in a non-stick pan.
• Avoid deep fried, battered and crumbed foods

Carbohydrate

Carbohydrate foods are the best energy source for your body. When they are digested they break down to form glucose in the bloodstream. Insulin takes the glucose out of the blood and deposits it into the muscles, liver and other cells in the body where it is used to provide energy. A regular carbohydrate intake is required to provide our body and brain with instant energy. Most foods contain carbohydrate and also provide us with fibre, vitamins and minerals. Very low carbohydrate diets are not recommended for people with diabetes.

 If you eat regular meals and spread your carbohydrate foods evenly throughout the day, you will help maintain your energy levels without causing large rises in your blood glucose levels. If you take insulin or diabetes tablets, you may need to have between meal snacks. Discuss this with your doctor, dietitian or Credentialled Diabetes Educator.

All carbohydrate foods are digested to produce glucose but they do so at different rates – some slow, some fast. The glycemic index or GI is a way of describing how a carbohydrate containing food affects blood glucose levels.

The type of carbohydrate you eat is very important as some can cause higher blood glucose after eating. The best combination is to eat moderate amounts of carbohydrate and include high fibre foods that also have a low GI.

Sugar

A healthy eating plan for diabetes can include some sugar. However, it is important to consider the nutritional value of the foods you eat. In general, foods with added sugars should be consumed sparingly (manufacturers sometimes use fruit juice or other sources of sugar to avoid using table sugar). In particular, high energy foods such as sweets, lollies and standard soft drinks should not be consumed on a regular basis.

Some sugar may also be used in cooking and many recipes can be modified to use less than the amount stated or substituted with an alternative sweetener. Select recipes that are low in fat (particularly saturated fat) and contain some fibre.

Alternative Sweeteners

The use of intense sweeteners by people with diabetes is preferable to use of natural sugars.

Protein

Choose protein foods that are also low in fat. This will help to reduce the amount of saturated fat you eat. Protein foods include lean meat, poultry without the skin, seafood, eggs (not fried), unsalted nuts, soy products such as tofu and pulses (dried beans and lentils).

Other Foods, Condiments & Drinks

You can use these following foods to add flavour and variety to your meals.

• Herbs, spices, garlic, chilli, lemon juice, vinegar and other seasonings.
• Products labelled ‘low joule’ (e.g. low joule/diet soft drinks, low joule jelly).
• Tea, coffee, herbal tea, water, soda water, plain mineral water.

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Gestational Diabetes

Gestational diabetes mellitus (GDM) is diagnosed when higher than normal blood glucose levels first appear during pregnancy. Between 3 and 8% of pregnant women will develop gestational diabetes around the 24th to 28th week of pregnancy, however, some may be earlier.

Pregnant women need two or three times more insulin than normal. If the body is unable to produce this much insulin, gestational diabetes develops.

If gestational diabetes is not well looked after it may result in problems such as a large baby, miscarriage and stillbirth.

Women who have had gestational diabetes are at an increased risk of developing

type 2 diabetes. 

Risk Factors

While there is no one reason for why women develop gestational diabetes, you are at a greater risk if you:

·         Are over 30 years of age
·         Have a family history of type 2 diabetes
·         Are overweight or obese
·         Are from an Indigenous Australian or Torres Strait Islander background
·         Are from a Vietnamese, Chinese, Middle Eastern, Polynesian or Melanesian background
·         Have previously had gestational diabetes
·         Have previously had Polycystic Ovary Syndrome
·         You have previously given birth to a large baby
·         Have a family history of gestational diabetes

Managing Gestational Diabetes

The management and treatment of gestational diabetes is a team effort, involving the woman with gestational diabetes, family, doctor and specialists, dietitian and Credentialed Diabetes Educator. There are three basic components in effectively managing gestational diabetes:

·         monitoring blood glucose levels 

·         adopting a healthy eating pattern

·         physical activity.

For some women insulin injections maybe required to help manage their gestational diabetes.

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Type 2 Diabetes

Type 2 is the most common form of diabetes, affecting 85-90% of all people with diabetes. While it usually affects older adults, more and more younger people, even children, are getting type 2 diabetes.

In type 2 diabetes, the pancreas makes some insulin but it is not produced in the amount your body needs and it does not work effectively.

Type 2 diabetes results from a combination of genetic and environmental factors. Although there is a strong genetic predisposition, the risk is greatly increased when associated with lifestyle factors such as high blood pressure, overweight or obesity, insufficient physical activity, poor diet and the classic ‘apple shape’ body where extra weight is carried around the waist.

Type 2 diabetes can often initially be managed with healthy eating and regular physical activity. However, over time most people with type 2 diabetes will also need tablets and many will also need insulin. It is important to note that this is just the natural progression of the disease, and taking tablets or insulin as soon as they are required can result in fewer complications in the long-term.

There is currently no cure for type 2 diabetes.

Cause of Type 2 Diabetes

While there is no single cause of type 2 diabetes, there are well-established risk factors. Some of these can be changed and some cannot.

You are at a higher risk of getting type 2 diabetes if you:

• have a family history of diabetes
• are older (over 55 years of age ) - the risk increases as we age
• are over 45 years of age and are overweight
• are over 45 years of age and have high blood pressure
• are over 35 years of age and are from an Aboriginal or Torres Strait Islander background
• are over 35 years of age and are from Pacific Island, Indian subcontinent or Chinese cultural background
• are a woman who has given birth to a child over 4.5 kgs (9 lbs), or had gestational diabetes when pregnant, or had a condition known as Polycystic Ovarian Syndrome.

Symptoms of Type 2 Diabetes

In type 2 diabetes, many people have no symptoms at all, while other signs are dismissed as a part of ‘getting older’. By the time type 2 diabetes is diagnosed, the complications of diabetes may already be present. Symptoms include: 

• Being excessively thirsty
• Passing more urine
• Feeling tired and lethargic
• Always feeling hungry
• Having cuts that heal slowly
• Itching, skin infections
• Blurred vision
• Gradually putting on weight
• Mood swings
• Headaches
• Feeling dizzy
• Leg cramps.

Preventing Type 2 Diabetes

It is estimated that up to 60% of type 2 diabetes can be prevented. People at risk of type 2 diabetes can delay and even prevent this disease by following a healthy lifestyle. This includes:

• Maintaining a healthy weight
• Regular physical activity
• Making healthy food choices
• Managing blood pressure
• Managing cholesterol levels
• Not smoking.

Managing Type 2 Diabetes

Type 2 diabetes can sometimes initially be managed through lifestyle modification including a healthy diet and regular exercise. However, as the disease progresses, people with type 2 diabetes are often prescribed tablets to control their blood glucose levels. These tablets are intended to be used in conjunction with healthy eating and regular physical activity, not as a substitute. Diabetes tablets are not an oral form of insulin and they require insulin to be present in the body to be effective.

Eventually it may be necessary to start taking insulin to control blood glucose levels, when your body is no longer producing enough insulin of its own. Sometimes tablets may be continued in addition to insulin. 

The aim of diabetes management is to keep blood glucose levels as close to ‘normal' as possible, that is between 4 to 6 mmol/L (fasting), as this will help prevent both short-term and long-term complications.

Regular blood glucose monitoring is necessary to see if the treatment being followed is adequately controlling blood glucose levels.

No matter which medication or management plan your doctor prescribes, make sure you follow their instructions. The pattern and frequency will depend on the individual, the tables and your circumstances.

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What is Diabetes?

Diabetes is a chronic condition.  This means that it lasts for a long time, often for someone's whole life.

For our bodies to work properly we need to convert glucose (sugar) from food into energy. A hormone called insulin is essential for the conversion of glucose into energy.

In people with diabetes, insulin is no longer produced or not produced in sufficient amounts by the body.

So when people with diabetes eat glucose, which is in foods such as breads, cereals, fruit and starchy vegetables, legumes, milk, yoghurt and sweets, it can’t be converted into energy.  Instead of being turned into energy the glucose stays in the blood. This is why blood glucose levels are higher in people with diabetes.

Glucose is carried around your body in your blood. Your blood glucose level is called glycaemia.

Type 1 Diabetes

In type 1 diabetes the pancreas, a large gland behind the stomach, stops making insulin. Without insulin, the body’s cells cannot turn glucose (sugar), into energy. Without insulin the body burns its own fats as a substitute. Unless treated with daily injections of insulin, people with type 1 diabetes accumulate dangerous chemical substances in their blood from the burning of fat. This can cause a condition known as ketoacidosis. This condition is potentially life threatening if not treated.

To stay alive, people with type 1 diabetes depend on up to four insulin injections every day of their lives. They must test their blood glucose levels several times daily. The onset of type 1 diabetes typically occurs in people under 30 years, but can occur at any age. About 10-15% of all cases of diabetes are type 1.

Cause of Type 1 Diabetes

The exact cause of type 1 diabetes is not yet known, but we do know it has a strong family link and cannot be prevented. We also know that it has nothing to do with lifestyle, although maintaining a healthy lifestyle is very important in helping to manage type 1 diabetes.

At this stage nothing can be done to prevent or cure type 1 diabetes.

Symptoms of Type 1 Diabetes

The following are symptoms of type 1 diabetes:

• Being excessively thirsty 
• Passing more urine
• Feeling tired and lethargic
• Always feeling hungry
• Having cuts that heal slowly 
• Itching, skin infections
• Blurred vision 
• Unexplained weight loss 
• Mood swings
• Headaches 
• Feeling dizzy
• Leg cramps.

These symptoms may occur suddenly. If they occur, see a doctor. Through a simple test, a doctor can find out if they’re the result of type 1 diabetes.

Managing Type 1 Diabetes

While there is currently no cure for type 1 diabetes, the disease can be managed through maintaining a healthy lifestyle, regular blood glucose testing and insulin.

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Unicity International

Unicity International was formed ten years ago when the idea of developing convenient, highly trusted, 100+ year old Rexall Drugstore franchises, was combined with the first company to successfully encapsulate and market herbal dietary supplements on a commercial basis – Enrich International – to form Unicity International.

Unicity stretches around the globe, embracing dozens of countries, a multitude of languages and all the possible colors of hair, skin, and eyes. Because our history is long and our experience deep, we’re able to draw on an expertise, a knowledge base, and a commitment level not available in any other direct sales company.

Across the globe, countless numbers of people have improved their health thanks to Unicity products – most experience a dramatic improvement in health.

Internationally, hundreds of thousands have gained confidence, poise, respect and satisfaction from the personal growth they’ve experienced through Unicity.

Thousands of Unicity Franchisees – regardless of previous business experience, previous income, or living condition – have become independent and wealthy business owners; dozens have become millionaires; some are now multi-millionaires.

Unicity International has been recognized as one of the Top 500 Privately-held Businesses in the United States – ranked 87th on the national level and number one in the state of Utah.

Unicity International’s roots go deeper than any other direct sales company in the world, formed by the merger of two successful direct sales companies.

After a hundred years of methodical and innovative product development and the creation of the most successful and rewarding home-based franchise model available, you can trust that we’re competent, solid, passionate, and committed to you.

1903 – A group of independent drugstores unite to form a cooperative – selling patented medicines manufactured by Rexall. The drugstore chain takes the Rexall name.

1958 – Rexall becomes the largest drugstore chain in the United States, with more than 11,000 stores across the country.

1985 – Sundown Vitamins, a world-class provider of nutritional supplements, acquires the Rexall brand and subsequently creates a network marketing division called Rexall Showcase International.

1987 – Enrich International is established in Orem, Utah. The company specializes in encapsulated herbal products, primarily weight loss oriented.

1992 – Enrich is recognized as one of the 500 fastest-growing companies by Inc. Magazine.

1999 – Enrich International is established in Japan, Europe, Thailand, Korea, and Hong Kong.

2001 – Royal Numico purchases and merges Rexall Showcase and Enrich International, forming Unicity International.

2003 – Royal Numico sells Unicity International.

2006 – Stewart Hughes, the company’s top Distributor, purchases Unicity International.

2008 – Unicity International is recognized as one of the Top 500 Privately – held Businesses in the United States – ranked 87th on the national level, and #1 in Utah.

2009 – Thailand hosts global convention to 30,000 Franchisees. Australia and New Zealand welcome Unicity International.

2011 – India welcomes Unicity International.

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