15
LIVING
help you decide your target range
for blood sugar levels. Keeping them
stable is important in preventing
small blood vessel damage and
ensuring you stay as free as possible
of complications, such as eye, kidney
and nerve disease.
Generally, if you're an adult with
type 1, before breakfast your reading
should be between 5 and 7 mmol/l
(between 4 and 7 before eating at
other times), and between 5 and
9 at least an hour and a half after
eating. If you have type 2, it's 4 to 7
before meals and below 8.5 two hours
after eating.
If you're driving for longer than
two hours, your blood glucose needs
to be at least 5 within two hours of
setting off.
Time in Range (TIR)
At least 70%
Since the advent of CGM and pump
technology, TIR has become a handy
alternative to HbA1c for measuring
safe blood sugar levels. Using HbA1c
and TIR together enables you and
your healthcare team to manage your
diabetes in order to minimise your
risk of complications.
TIR refers to the percentage of
time your blood glucose levels should
be within the range agreed with your
healthcare team. You should also
aim to spend no more than 4% of
your time below range. If you use a
CGM or flash sensor, TIR should be
calculated automatically.
BMI
Under 25
Your body mass index (BMI) gauges
if you are a healthy weight. For most
adults, 18.5 to 24.9 is considered a
healthy BMI; over that is deemed to
be overweight and 30 is obese. Being
overweight is a risk factor for type 2
diabetes. If you already have diabetes,
a healthy BMI is important in keeping
your blood pressure and cholesterol
down, and reducing your risk of
serious complications.
BMI is worked out by dividing your
weight in kilograms by your height in
metres squared. The NHS website has
a handy tool for calculating your BMI
Waist size
94 cm (men)
80 cm (women)
Waist circumference (measured
midway between the bottom of
your ribcage and your hip bone)
is important because it's a good
indicator of your risk of type 2
diabetes. This is because extra weight
around your middle suggests a buildup of
fat around your vital organs,
such as your liver and pancreas,
which can cause insulin resistance.
This means insulin struggles to get
through the fat, increasing your
chances of developing high blood
sugar. Even if your BMI is low, having
a bulky waist can still mean you
are at risk of type 2 diabetes. South
Asian men, whose risk is higher,
should have a waist measurement
below 90 cm.
Fruit and vegetables
5 a day (or more)
Everyone should be eating at least
five portions of fruit or vegetables
a day to stay healthy and cut their
chances of developing heart disease
and certain cancers.
What's a portion? A medium-sized
fruit like an apple or banana counts
as one portion, while you'll need two
small fruit like a kiwi or satsuma. Half
a grapefruit or one slice of melon
constitutes a portion of a large fruit.
Fruit juices should preferably not be
counted in your five a day as they
have less fibre than whole fruits
and it's very easy to down extra
calories and carbs without realising
it. Examples of vegetable portions
are one bowl of salad, three broccoli
florets or three heaped tablespoons
of peas.
Exercise
150 minutes a week
Being physically active is important
whatever type of diabetes you have.
It helps insulin work better in your
body. Exercise can reduce insulin
resistance and help you keep within
your blood glucose target range.
Everyone under 65 should aim
for 150 minutes of moderate exercise
a week. This includes fast walking,
cycling and dancing. Alternatively, 75
minutes of high-intensity exercise,
such as swimming, running, football
or skipping, will do the trick. You
should also build in some musclestrengthening
exercises, which could
be yoga, lifting weights or digging.
Alcohol
14 units a week
The government's guidelines for
drinking are the same for people with
diabetes as for those without. But
bear in mind that drinking can mess
with your diabetes - you are more
likely to have a hypo and it can make
you put on weight. A unit is less than
you might think: a single measure
of spirits counts as one unit, a small
125 ml glass of wine is one and a half,
and a pint of lower-strength lager is 2
units, but many wines and beers are
stronger than they used to be.
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Other numbers worth knowing if
you're having a blood test include
levels of Vitamin B12 if you're on
metformin (you're more likely to be
deficient), Vitamin D (healthy levels
may improve sensitivity to insulin)
and iron (anaemia is common if you
have diabetes, increasing your risk
of complications).
The numbers here may vary
depending on your age, gender,
ethnicity, specific health needs
and if you are pregnant or trying
for a baby. In every case, if in
doubt, consult your GP or diabetes
healthcare professional.