Strategies For Preventing Diabetes & More
More than 130 million American adults live with diabetes or prediabetes — and nurses help all those people prevent or manage diabetes. But knowing how to lower the risk of diabetes doesn’t necessarily mean you’re taking those actions yourself.
The occupational stress, disruptive work schedule, and long work hours many nurses endure can contribute to an unhealthy lifestyle — which may not include regular exercise, a restful sleep schedule, or healthy eating habits.
Findings from the HealthyNurse Survey in 2021 show that the average BMI of nurses and nursing students is 27.58, which is squarely in the overweight range and raises their risk for diabetes.
To help you guide your patients and lower your risk of diabetes, Carmina shares 5 recommendations for diabetes prevention.
Strategies for Preventing Diabetes
You don’t have to train for a marathon or give up all your favorite foods to prevent diabetes. Carmina recommends setting some basic rules you can incorporate yourself — and share with your patients.
1. Keep your diet simple and sustainable
You don’t need fad diets or fancy food to eat healthier. Instead, focus on the quality of the nutrient content of your food choices:
- Choose complex carbohydrates and minimally processed foods such as whole wheat, oats, and grains instead of cakes, chips, soda, or sweets.
- Incorporate fruits and colorful leafy vegetables in your daily diet to get essential vitamins and nutrients — the fiber also helps you feel full and eat less.
- Replace saturated fats with healthy fats, such as olive oil and omega fish oil, to reduce cardiovascular disease risk.
Carmina recommends including foods that meet your tastes and cultural preferences, so you’ll maintain the changes. “When it comes to a lifestyle intervention, you want to adopt healthy eating habits that are sustainable,” she says. “This is not a sprint. It’s a marathon. And you need to be able to live with this lifestyle for the long haul.”
2. Pay attention to portions
It’s common to have what Carmina calls “distortions in portions.” Consider measuring and weighing your food to see how much you really eat.
If measuring isn’t your thing, follow the MyPlate Plan created by the U.S. Department of Agriculture (USDA). It provides a simple and helpful strategy to keep food portions and food choices consistent with the recommended USDA dietary guidelines:
- Using a 9-inch plate, draw an imaginary line down the middle. Divide one of the sections in half.
- Fill the largest section (half the plate) with colorful, non-starchy vegetables such as broccoli, green beans, spinach, and carrots.
- In a quarter of the plate, add whole grains and starchy foods such as beans, whole-wheat bread, corn, brown rice, or quinoa.
- In the other quarter of the plate, add your lean protein such as chicken, fish, low-fat cheese, or tofu.
3. Find a form of exercise you enjoy
Exercise helps keep your heart and muscles healthy and strong. But it can also improve your sleep, stress, and eating choices.
Choose an activity you like — it will motivate you to get moving. Try to remove barriers to your exercise. If you joined a gym, but it’s inconvenient to get there, you might be better off lacing up your sneakers to walk around your neighborhood. Or find free workouts online if your neighborhood isn’t ideal for outdoor exercise.
The American Diabetes Association recommends 150 minutes or more of moderate-to-vigorous intensity aerobic activity per week. Spread your exercise over at least 3 days a week. Don’t go more than 2 days in a row without activity — regular exercise helps improve and maintain your body’s blood glucose levels.
4. Reduce stress
Reducing stress and managing your mental health is especially important for nurses, who often work in high-stress environments. Unmanaged stress can cause elevated blood sugar levels and make you more likely to engage in unhealthy behaviors (eating poorly, drinking alcohol, smoking).
To relieve your stress, incorporate relaxation exercises daily. Consider meditating or practicing yoga at home to unwind from your day.
Carmina also warns not to leave mental health issues untreated. “Mental health is a major issue in the nursing profession due to burnout and the moral injury we experienced during the pandemic and continue to experience in our profession. If you have symptoms of depression, you need to seek help.”
5. Get screened
As a nurse, it’s not always easy to practice what you preach. But getting screened for diabetes is essential for everyone, especially if you have risk factors for diabetes, including:
- Age 40 or above
- Ethnicity that includes African American, American Indian, Asian American, Hispanic/Latino, or Pacific Islander
- Family history of diabetes
- Overweight or obesity
- Personal history of gestational diabetes
- Physical inactivity
“We need to be screened so that early treatment and preventive measures can happen,” Carmina says. “Many people with diabetes had prediabetes for many years, but it wasn’t diagnosed or diagnosed too late.”
Helping Patients Prevent Diabetes
Nurses play a critical role in their patients’ diabetes prevention. “As nurses, we work closely with our patients, who see us as trusted messengers,” Carmina says.
Use your time with each patient to learn more about their medical history and the socioeconomic and cultural influences that can impact their health. It will help you tailor your guidance. Carmina recommends that you:
- Find your patient’s motivation: Pay attention during the initial patient assessment. Learn what motivates your patient and leverage that knowledge to help patients set meaningful and achievable health goals. For some, the goal for exercise might not be weight loss but increasing physical endurance — maybe they want to play with their kids or grandkids.
- Keep advice simple and positive: Talking about mortality and morbidity is not always effective or motivational when encouraging healthy lifestyle changes. Instead, focus on small, attainable goals — reaching those goals will keep patients on board and confident about targeting bigger changes.
- Consider each patient’s culture and living situation: Make sure your recommendations are culturally appropriate. Think about where your patient lives and works and whether they have access to healthy, nutritious food. Suggesting changes that fit their circumstances will help them stick with the plan.
Managing Diabetes After Diagnosis
If your patient is diagnosed with diabetes, they may need help managing it. Guide patients as they incorporate diabetes management into their lifestyle, and make sure they have the appropriate information and skill sets needed, including:
- Problem-solving strategies: People with diabetes face many daily challenges, especially during the holidays — travel and social gatherings can disrupt meal plans and exercise regimens. Help patients develop problem-solving strategies to manage those occasions. For instance, before going to a restaurant, they can look at the menu and nutritional information online to make more informed food choices. Or, during holiday meals like Thanksgiving, they might enjoy one favorite dish but make wise choices for the rest of the meal.
- An understanding of diabetes medications: Knowing how diabetes medication helps them can serve as motivation to take it. Reinforce the importance of consistently taking medication as prescribed to improve and maintain glucose control.
- Meal planning know-how: Outlining when to eat, which foods to include, and how much to eat can help patients get the nutrition they need while managing their blood sugar. For some patients on insulin, monitoring and counting carbohydrates to match their medication and activity level can significantly improve glucose control.
- An exercise and stress management plan: Make a clear, easy-to-understand, measurable, and achievable plan. Encourage patients to write it down. They should share their plan with a significant other and/or their diabetes management team, who can support and help the patient achieve their goal.
- Ongoing disease awareness: An important part of managing diabetes is knowing how it’s going. Go over when to monitor blood sugar, weight, cholesterol, and blood pressure. Remind patients that sticking with the plan and keeping up with routine health care appointments (like vision and dental checkups) reduces the chance of surprises. Staying in the know about your diabetes lowers the risk for complications such as stroke and heart attack, kidney failure, amputation, neuropathy, and blindness.
“We’re not just managing diabetes,” Carmina says. “Diabetes is not a disease that we can treat in isolation because it significantly increases the risk for cardiovascular complications. We are also trying to manage the patient’s cardiovascular risk factors to achieve optimum health outcomes.”
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What lifestyle choices do you make and share with your patients for diabetes prevention? We’d love to hear what worked for you. Share with us in our discussion.
Want to do more? Try our Leveling Your A1C challenge and learn more about the American Diabetes Association's Diabetes Hits Different campaign.
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