Q: Good Morning Dr.
My problem and concerns are as follow
1) I’m a diabetic and eating right/losing weight is a major,major downfall 4 me.
2) I also have R/A causing my knees 2 ache on a daily basis which prevents me from doing a lot of normal life things.
3) Have developed Neuropathy from the diabetes and this is so painful.
So you see I have a lot of health issues. Where/What/When do I start to make a difference and begin to do something to if not get rid of, at least begin to live with all of these issues.

A: Thanks a lot for writing in and hey! It’s not as bad as it all seems. First, you’re alive. Then you do know that you have some issues that have to be dealt with and finally, you’re willing to put in the work. So, you’re halfway to victory already!

Now I will deal with the issues you have raised on Diabetes Mellitus and then deal with Rheumatoid Arthritis tomorrow.

What is Diabetes Mellitus (DM)? This is a disease in which there are high levels of sugar in the blood either due to a lack of insulin (Type 1) or a resistance to the effect of insulin. What is insulin and why is it so important? Every food we eat is ultimately converted to a form of sugar. Once this sugar gets into the blood, insulin is produced by the pancreas to help take the glucose into the cells where they are to be used. In Diabetes, the body does not make any or enough insulin to move the glucose into the cells or the cells become resistant to the effect of insulin such that there is excess glucose in the blood (hyperglycemia).

Peripheral neuropathy (PN) arises due to this excessive blood sugar that affects nerves that control involuntary body functions. PN can manifest in several ways like excessive sweating, reduced sensation in the hands and feet (such that these people can easily get injured without knowing and the reduced blood flow in the area, makes wound healing poor), constipation, bloating, reduced ability to identify the symptoms of full bladder (with resultant frequent urinary tract infections) and reduced ability to recognize even the symptoms of low blood sugar.

I know all of that sounds very scary…but good control of your blood glucose will help counteract the effects above. Your doctor may also prescribe medications with time. You need to work with your doctor to ensure that your blood glucose is kept normal.

How to tame your blood sugar? It’s a mix of two things: keep lean and keep active.
Keeping lean involves eating healthy, more veggies and fruits. Remember that because fruits are also high in natural sugars, they have to form part of your daily calorie amount. Be sure to check with your dietician who will give you a proper diet plan. Eat more complex carbs like beans, sweet potatoes, whole wheat cereals, oat meal etc. You’ve got to keep your weight within normal limits. The BMI is a good place to start. BMI is a simple calculation: weight in kg/height x height. Now, if math is not your favourite subject, you can simply go online and google ‘online bmi calculator’. There are lost of them and these calculators will do the work for you 😀 If your BMI is between 18.5 and 24.9, then you’re fine. If your BMI is 25 to 29.9, then you are overweight. Any BMI from 30 and above is obesity.

You can substitute some unhealthy foods with healthier versions. Please click on this link for more on these:
https://chatwithdrketch.com/2014/12/10/daily-health-tips-healthier-substitutes-for-foods-we-love/

https://chatwithdrketch.com/2014/11/27/daily-health-tips-weight-loss-revisited/

Keeping active refers to ensuring you have at least 150 minutes of exercise/activity weekly. For tips on how to incorporate activity into your day, please click on these:

https://chatwithdrketch.com/2013/12/09/daily-health-tips-fun-ways-to-exercise/

https://chatwithdrketch.com/2014/05/18/daily-health-tips-is-it-possible-to-actually-enjoy-exercise/

Have a super-fabulous weekend ahead 😀