2. Adopt a regular pre-sleep routine.
3. Create a comfortable sleep environment.
4. Allow for some time between consuming meals, caffeinated beverages, and/or alcohol and going to bed.
5. Steer clear of sleep disruptors, such as computer or TV screens, for at least thirty to sixty minutes before bedtime.
6. Turn off your cell phone and other noisemakers.
7. Read a book the old-fashioned way.
If you have difficulty falling asleep or staying asleep or suffer from a sleep disorder, seek the assistance of a sleep specialist.
A sleep study in a special laboratory may be advised so that the doctor can determine the cause of your sleep problems.
Whether the issue is your sleep environment, your bedtime routine, or a more troublesome issue, such as sleep apnea, the good news is that all of these can be improved upon or fixed.
Sleep apnea can often be overcome by achieving a healthy body weight.
It can also be managed with the use of a sleep apnea device; these have become much more comfortable and easier to use than earlier models.
Rest and renewal can be achieved with preparation and wise choices.
STRESS MANAGEMENT
S tress is the body’s way of managing changes that require a response.
The body reacts according to the form of stress and your state of health.
Generally, we’re well equipped to handle stress, as it’s a normal, healthy part of daily life.
Stress can be a motivator, pushing us to do our best.
However, excessive stress can take a physical, mental, and emotional toll, and that toll rises sharply for people with diabetes.
In addition to the standard laundry list of daily stressors, people with diabetes face the added pressure of managing and monitoring blood sugar, medications, meal planning, and often multiple complications associated with the disease.
When faced with challenges, your body sets in motion a series of responses geared toward survival. The brain sends out a distress signal, the nervous system is activated, and hormones that help kick your body into high gear are released. Adrenaline, the fight-or-flight hormone, is responsible for immediate reactions that affect your breathing, muscle tension, and sweat response. Norepinephrine is another immediate responder, increasing focus and awareness.
Cortisol, also known as the stress hormone, takes minutes rather than seconds to take effect.
It is responsible for helping to maintain blood pressure and fluid balance.
While cortisol is vital in times of danger, persistent stress can produce chronically elevated cortisol levels, suppressing the immune system, reducing libido, and triggering acne.
It is particularly problematic for people with diabetes because in times of stress you need ready access to fuel for your muscles, so cortisol triggers the release of stored glucose and blood sugar levels rise.
Elevated cortisol also elicits food cravings, so it is harder to control your intake of problematic foods.
It promotes the accumulation of visceral belly fat, which, in turn, exacerbates insulin resistance.
Chronically elevated cortisol is linked to depression, blood vessel constriction, and elevated blood pressure.
Depression is associated with progressive insulin resistance and type 2 diabetes.
High blood pressure aggravates many of the complications of diabetes, such as eye and kidney diseases.
All in all, excess cortisol accelerates the progression and complications associated with diabetes.
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KICK DIABETES RECOMMENDATION
Reduce and manage daily stressors.
LEVEL 1: Identify the sources of excess stress in your life. Some will come from external sources, and some will stem from your own negative attitudes or stress-inducing thoughts.
LEVEL 2: Identify your current coping mechanisms and determine which are of benefit and which need to be replaced with ones that are more constructive. Consider ways that stressful situations might be avoided.
LEVEL 3: Alter, avoid, adapt, or accept your stressors. Put in place at least one new daily stress-management practice.
There are two main types of stress, acute and chronic.
Acute stress is caused by a single event in your life and is short-lived, so it doesn’t affect you for a long enough time to do extensive damage.
Such stresses are generally an unavoidable but manageable part of life.
Chronic stress results from repeated exposure to situations that cause the relentless release of stress hormones.
This type of stress does the most damage because our stress-response systems were designed for occasional, rather than constant, activation.
When our stress responses are chronically stimulated, all body systems are on constant overdrive.
Chronic stress often stems from issues of daily life, chaos in the home, an unhealthy relationship, or a miserable work environment.
Your first order of business is to identify the sources of harmful stress.
It can be helpful to keep a journal to record times of stress, what you believe caused the stress, and the response it elicited.
It is easy to blame external sources, but often stress arises from our own stress-inducing negative thoughts and attitudes.
In order to manage stress effectively, you need to take responsibility for your own role in fueling it.
Think about how you currently manage stress and determine whether each response serves you well.
Some people deal with stress by relying on addictive substances, such as alcohol, drugs, and cigarettes.
These may seem to help in the moment, but the reward is short-lived and the health cost is high.
A similar phenomenon occurs with emotional eating.
When you deal with stress by eating foods laced with sugar, fat, and salt, your blood sugar control deteriorates, insulin sensitivity declines, and GI distress (gas, bloating, and constipation) intensifies.
Whether you have an addiction to a substance or to a food, the worse you feel, the more apt you are to return to your vice, and a downward spiral ensues.
Other common stress responses that do not serve you well are oversleeping or not getting enough sleep, overworking, isolating yourself from others, getting angry at others, or treating others unkindly.
The best way to deal with stress is by reducing or removing its sources, learning to handle stressors in a healthy manner, doing things that take you away from the stress (even for a short period), and using techniques that build your resiliency and confidence.
No matter what the cause, effective stress-reduction strategies are a must. Get familiar with the four A’s, avoid, alter, accept, and adapt, and put them into action.
1.
AVOID.
Lighten your load by thinking ahead and taking ownership of your surroundings.
For example, if you’re bothered by long lines at your local supermarket, pick a less busy time to shop.
If you’re put out by the price of lunches at local restaurants, bring your own.
Keep your distance from people who trigger your stress.
Avoid engaging in conversations about topics that stress you out.
Don’t be afraid to say no, you don’t have to please everyone all the time.
Prioritize your to-do list, stick to things you really want or need to do.
2. ALTER. Even if you can’t avoid a stressor, you can make changes to alter the stressor. Put yourself in the driver’s seat, and be assertive rather than aggressive. If the stress is induced by an individual, respectfully express your concerns to that individual. Recognize that compromise may be necessary. Work on time management to alter common daily stressors, and set limits on your time.
3.
ACCEPT.
There are occasions when you need to accept a situation as it is and learn to manage the stress it brings.
You can’t change the loss of a loved one, the results of the last election, or how certain people behave, but that doesn’t mean your feelings aren’t valid.
You can accept that these things are out of your control and work on managing the stress and pain that they bring.
Talk with someone you trust, a family member, friend, colleague, or professional counselor.
If the situation involves anger toward someone, forgive and forget so you can move on.
Think positively and talk to yourself compassionately.
Don’t beat yourself up about bad decisions; rather, focus on the lessons they taught you and how they have helped you make wiser decisions today.
4.
ADAPT.
Negative thoughts can add serious stress to your life.
Adapting by changing your standards, attitudes, or expectations can bring tremendous relief.
If you are a perfectionist, recognize that no one is ever perfect and that striving for perfection is setting yourself up for disappointment.
Establish reasonable standards for yourself and for those around you.
If you’re in a frustrating situation, such as a traffic jam, train yourself to make the most of your time.
For example, turn up the music and enjoy the alone time, listen to an engrossing audiobook, or take time to pray or meditate.
When everything seems to be going against you, think about people who are less fortunate, those who aren’t sure where their next meal is coming from or whether their family will be able to escape a vicious regime. Think about the wonderful aspects of your life, where you live, your family or friends, your animal companions, or your work.
Stop yourself when you start to think negative thoughts.
Adopt a positive mantra.
Practice self-care.
Daily exercise increases brain chemicals that generate calmness and pleasure.
Exposure to warm sunshine produces vitamin D, which elevates a feel-good hormone called serotonin.
Creative activities, such as playing a musical instrument, knitting, drawing, or bird-watching, can help you feel calm and collected.
Mindfulness or a spiritual practice can help you put things into perspective.
Whatever techniques you choose, stick to a routine.
This reassures your brain that life is predictable, leading to more confidence and composure.
For some individuals, stress can be so overwhelming it can’t be managed alone. In such cases a qualified therapist or counselor can help you learn to cope with stress safely and confidently and slowly build resiliency.
SOCIAL ENGAGEMENT
S ocial connectedness is a prominent feature among the world’s healthiest elderly citizens. A meta-analysis of 148 studies involving over three thousand participants reported a 50 percent increase in the likelihood of survival in individuals with the strongest, healthiest social relationships. The most impressive results were for people who had a wide variety of social connections, and the most negative findings were for those who were living alone.
A 2018 study out of Denmark reported a 60, 70 percent increase in mortality in people who were socially isolated.
A twofold increase in mortality was associated with a lack of involvement with clubs or organizations.
Staying socially engaged appears to be on par with other major determinants of health, such as diet, obesity, physical activity, and alcohol abuse. Establishing and maintaining meaningful relationships provides a sense of purpose and fulfillment and reduces the risk of heart disease, dementia, depression, and sleep disorders.
KICK DIABETES RECOMMENDATION
Establish and maintain strong social ties.
LEVEL 1: Purposefully reach out to family, friends, neighbors, colleagues, and others every day. Begin by consciously doing one thing a day to improve your connection with others and build from there.
LEVEL 2: Spend quality time with a cherished friend or friends at least once a week. Have at least one person in your life with whom you communicate daily or very regularly.
LEVEL 3: Increase your social involvement through organizations, volunteer groups, clubs, meetups, and hobbies. Commit to joining at least one new group and becoming an active member.