STAYING HEALTHY

Living with diabetes during the COVID-19 pandemic

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By Kenneth K Chen, MD

If you have diabetes, you are not more likely to get COVID-19 compared with the general population. However, it has been shown that COVID-19 can cause more severe symptoms and complications in people who have diabetes. To this point, I would highly recommend that everyone who has diabetes obtain one of the COVID-19 vaccines which are currently available. All of the clinical vaccine trials had patients with diabetes and they were all deemed to be safe for them. There is also no advantage in getting one vaccine over another. It is important to stay hydrated and rest plenty after getting the vaccine. It is possible that glucose levels may become slightly more elevated for 24 to 48 hours following the injection but this is to be expected and not of any concern unless this persists. The vaccine has not been shown to interact with any of the diabetes medications including insulin. It is however recommended that insulin injections, glucose sensor applications or insulin pump infusion sets avoid the vaccine administration site for a number of days afterwards.

These are some general tips for managing diabetes during the pandemic. Please refer to the piece written by RD CDE Lauren Talbert below with regards to dietary tips. The other key things which I would like to recommend are staying relaxed and establishing an exercise routine at home. Because stress contributes to poor diabetes control, one way to minimize this is to incorporate regular breathing exercises as they have been shown to promote mental health, minimize anxiety, sharpen focus and improve sleep quality. Getting some fresh air in the garden or through an open window on a daily basis also helps to reduce stress greatly. An adequate amount of sleep each night is also important in maintaining a good immune system which is important during this pandemic.

Regular exercise has been shown to improve insulin sensitivity which means that your blood glucose can enter your muscle cells to provide energy instead of causing elevated blood glucose levels which tend to make you feel unwell and tired. Weight training at home has been shown to be extremely beneficial in building and maintaining muscle mass which in turn is helpful in improving insulin sensitivity. Examples of this include using dumb bells or even just water bottles. Gentle aerobic exercise in the form of walking up and down stairs is also extremely beneficial in preventing high glucose levels. Video instruction of yoga, Tai Chi, Pilates and Zumba can also be considered. Staying hydrated throughout any form of exercise is very important.

Lastly, it is important to maintain regular contact with friends and family virtually as social isolation can lead to depression and anxiety.

Kenneth K Chen, MD is Director of Endocrinology, Diabetes & Metabolism, CNE; Director of Obstetric & Consultative Medicine, WIH; Associate Professor of Medicine & Associate Professor of ObGyn, Clinician Educator, Alpert Medical School of Brown University; Co-chair of Health & Public Policy Committee, American College of Physicians, RI Chapter.

        

By Lauren Talbert RD, CSO, LDN, CDCES

When you have diabetes, figuring out what to eat or avoid can be confusing. During this pandemic, you may be motivated to make healthier choices with a goal to improve your overall health. With so many choices at the grocery store, deciding what to purchase can seem overwhelming. Registered dietitian and diabetes educator Lauren Talbert provides three simple tips to eating healthy with diabetes.

The first tip is to focus on fiber. Fiber is found in whole grains, legumes (beans, peas and lentils), fruits and nuts. Fiber slows the absorption of carbohydrates (sugar) and therefore helps to prevent spikes in blood sugar after eating. Fiber rich foods keep you feeling fuller longer helping to control hunger. To eat more fiber switch from processed grains like white bread or white rice to whole grains such as whole wheat bread, brown rice or quinoa. Also experiment with eating more legumes, add beans and lentils to salads or soups. If you haven’t yet tried legume pasta (made from chickpeas or lentils), pick a box up during your next grocery shop.

The second tip is to choose lean protein rich foods which include chicken, turkey, fish, eggs, low-fat dairy, legumes and nuts. Red and processed meats including beef, pork, lamb, sausage and deli meats are often high in unhealthy saturated fats. It is important to include protein at all meals and snacks to better manage post meal blood sugars as protein takes longer to digest and also helps to prevent spikes in blood sugars after eating. Since people with diabetes have an increased risk of heart disease choosing lean protein that is either naturally low in fat or contains healthy unsaturated fats is recommended. To eat more lean protein, consider swapping ground beef for ground turkey, or choose grilled chicken in place of roast beef for a sandwich.

The last tip for eating healthy with diabetes is to limit added sugars. Added sugars are found in several foods including sugary beverages such as soda and juice as well as desserts and snack foods like cereal bars or cookies. Foods with added sugars often are high in calories but low in nutrients like vitamins, fiber and lean protein. When you consume more added sugars you likely are missing out on important nutrients that help to support overall health. If you are wondering how much added sugar you consume, look at the food labels of what you eat. Added sugars can be found under total carbohydrates. About 4 grams of added sugars are equal to a teaspoon of table sugar. The American Heart Association recommends that women consume no more than 6 teaspoons and men limit to less than 9 teaspoons in a day. To cut back on added sugars, drink more water and less sugary beverages. Also, when choosing a snack, reach for a piece of fruit and a handful of nuts instead of a sugary bar or cookie. Not only will you limit the amount of added sugar, this snack will provide fiber and lean protein to keep your energy levels up.

The main message when it comes to nutrition is to keep it simple. When you plan your meals and snacks around fiber and lean protein rich foods the healthy benefits will follow.

Lauren Talbert RD, CSO, LDN, CDCES is a Certified Diabetes Care and Education Specialist; Board Certified Specialist in Oncology Nutrition; Registered Dietitian, Department of Medicine Women & Infants Hospital.

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