High blood sugar
High blood sugar is the third high of chronic disease. The three highs together with overweight and obesity form the deadly quartet. This deadly quartet of high weight, high blood pressure, high cholesterol, and high blood sugar damage us. The result is premature death, and often times with increased number of years lived with disability.
Normal and abnormal blood sugars
The normal blood sugar levels in each of us are defined by the following numbers:
- Fasting blood sugar — This is the reading from a blood sample taken after an overnight fast e.g. from 10 pm the night before till morning. The normal values are 3.0 to 6.0 mmol/l
- HbA1c — This measures the average blood sugar level over 3 months — 4.5 to 6.4 = ideal; 6.5 to 7.0 = optimal; 7.1 to 8.0 = suboptimal; More than 8 = unacceptable i.e., poor control.
Different underlying causes for diabetes mellitus
- Type 2 — adult onset diabetes — this is the most common and accounts for 90% of cases. The underlying cause is overweight and obesity. The treatment is to lose weight and aided by medications.
- Type 1 — insulin depended diabetes — this is due to damage to the pancreas, the cause of which is not clearly known.
- Pancreatic disease — this can sometimes be the cause of diabetes mellitus.
Therapeutic lifestyle change
This negative scenario of premature death and disability is not inevitable. With the will to introduce a therapeutic lifestyle change, you can reduce the high blood sugar in you. The changes to make can be remembered as DEW:
- D = Diet. Change to a healthy plate concept for each meal. This is the half-quarter-quarter food plate meaning — half plateful of vegetables, one quarter plate of protein, and one quarter plate of carbohydrates or starchy food like rice, kuay-teow, beehoon, bread, wheat, cheppati, or maize. Remember also that the entitlement for a sedentary person for carbohydrate is only two tablespoons of rice or equivalent. Start with halving your carbohydrate intake per meal.
- E = Exercise. The easiest is to walk reqularly 5 days a week. Begin with 30 minutes a day. You can walk anytime of the day. Walking 20 minutes after food is said to be most effective in using up the carbohydrates taken in your meals.
- W = Weight control. Keep an eye on the weight. The idea is to lose 10% of your weight in 6 months. So for a 80 kg man, you can plan to lose 8 kg divided by 6 which is 1 1/3 kg a month.
Can all these work?
Yes. if you have the belief. All these three actions work together to make you have a better blood sugar. Diet control without exercise and attention to your weight will not be successful. There is an end in mind — which is to achieve a good BMI (Body mass index). BMI can be calculated using the following equation
BMI = Weight (in kg) divided by (Height (in m) X Height (in m). The ideal is around 20 to 22.
Take home messages
Therapeutic lifestyle change works. The secret is to keep the body weight to a BMI of around 20 to 22. You can do it. Start on DEW today.
Dr LG Goh
Dr GOH Lee Gan is a retired Associate Professor in the Department of Family Medicine, National University Health System. He has an interest in learning and teaching how we can age well everyday (AWE).
