Diabetes is a common metabolic problem seen very often in South Asia. India has at least 80 million individuals suffering from it and numbers are steadily increasing. Around 9% of population of Jammu and Kashmir have diabetes as per the survey conducted by the Union Ministry of Health. The underlying problem in diabetics is high blood sugar levels due to either reduced production of insulin or the inability of the body to utilize insulin (insulin resistance). In spite of our improved knowledge and better treatment the problem and its complications like heart attacks, strokes, heart failure and diabetic kidney disease are increasing steadily.
Winter is a bad news for most diabetics especially in places experiencing severe cold from December to March every year. The sugar control gets erratic very often. It is because of multiple factors which include reduced physical activities and increased intake of food. This leads to increase in glycosylated Hb (a marker of diabetes control). It is important to know that even a little activity can help in increasing the insulin sensitivity.
The immune system in winters is not at its best and people get more prone to get infections like influenza, pneumonias and exacerbations of bronchitis especially in smokers. This results in the body producing more cortisol, glucagon and catecholamines which lead to release of glucose in the blood from the liver. Dietary indiscretions add to this problem. The other problem is that people feel low because of the preference to stay indoors. This often leads to mood swings and a feeling of depression. This again triggers the hormonal pathway increasing the ugar levels. Spending more time with friends and family with active engagement and discussing pleasant things helps.
Home blood sugar testing especially for people on Insulin injections often becomes in frequent because of difficulty or reluctance in pricking finger because it is difficult for blood to come out. It is always advisable to warm the hand by keeping on a hot tea mug or rubbing the hands close to a heater or washing with hot water.
Long standing diabetics often have numb feet and sensations are blunted because of peripheral neuropathy and reduced blood supply due to small vessel disease. This can lead to injuries without recognising them. It is therefore imperative to check for any ulcers or skin abrasions. Keeping feet moisturised with inner fingers and feet clean and without any open wounds is important. In case of a wound or injury seeing your doctor is very important before it gets complicated into a “diabetic foot”.
Tips for good health during winters
Physical activity:
Even a modest physical activity is useful by keeping the body warm, increasing insulin sensitivity and keeping a healthy mind. You do not have to do a lot of it necessarily. The good effects do not last only during the period you do activities, like walking, climbing stairs up and down, doing household work like cleaning and tidying things. The bottom line is that your limb muscles need to be working. Activity also rejuvenates the mind and brings in positivity which helps managing diabetes better.
Watch what you eat:
In order to maintain the skin warm enough, more calories are needed as a fuel hence more food. However, it should be the right kind of food which should be balanced. Plenty of fruits, vegetables, salads, broccoli, carrots, almonds and walnut are highly recommended. Warm beverages like green tea, soups are soothing . Fish, lean meat and paneer are good sources of proteins. Take only small servings of rice and breads because if taken in excess these increase the sugar levels and triglycerides beyond the thresholds. Butter, ghee and egg yolk again are sources of saturated fats which increase the bad cholesterol (LDLc) levels and should be restricted. Blood cholesterol and triglycerides in diabetics are often high.
Prevent illnesses and be cheerful:
Getting vaccinated in time before the onset of winter against influenza in particular and ensuring that a pneumonia shot had been taken in the stipulated period of the last 4 years is always important. Take care of your feet and toes especially if sensations are blunted. Avoid going out in very smoggy and bad quality air atmosphere.
Spending at least one hour for relaxing the mind in the form of listening to music you like, watching a movie or reading something which keeps you in good cheer is helpful in preventing the surge of bad hormones and thus preventing spikes of very high sugar.
Needless to say, taking the prescribed medicines in time and appropriate doses goes a long way to prevent the complications of diabetes. Very erratic levels demand seeing or informing your treating physician.
Take home message:
Winter period is likely to upset the blood sugar control because of reduced physical activities, unhealthy eating habits and behavioural issues. All this leads to upsetting the hormonal balance. It is therefore important to take important measures like continuing indoor physical activities even for shorter periods. Watching your calorie intake and taking good number of fruits, vegetables, nuts and avoiding junk and calorie dense food. Keeping yourself in good humour in these monotonous months is equally important. Finally, keep a track of your blood sugar levels.
Prof U Kaul, Founder Director, Gauri Kaul Foundation, recipient of Padma Shri and Dr B C Roy Award.
DISCLAIMER: The views and opinions expressed in this article are the personal opinions of the author.
The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.