Taking control of type 2 diabetes: from New Year’s resolution to permanent lifestyle change

Another year, another January, another you? This is the time of year for New Year’s resolutions – promises that we make to ourselves that often involve an element of sacrifice, or of embarking on something new, in order to better ourselves. Common resolutions include: to lose weight; to drink less alcohol, or to stop it altogether for a while (dry January); or to start exercising. If you have type 2 diabetes, there are plenty of additional possibilities: from cutting down on sweet foods; eating more vegetables; performing more glucose tests; to a more general one to improve control of one’s diabetes. Dr David Cavan is an expert diabetes physician with over 35 years' experience helping patients in the management of the condition. Here he shares some useful tips, outlooks, and steps people can take in order to make lasting lifestyle changes.

Start with small changes

Many New Year’s resolutions rarely make the transition from good intention into action. Yet for someone whose resolution is to improve control of their diabetes, turning this into action, and making it last, can have a significant impact on improving short and long-term health. The key here is making changes that will last. There may be a temptation to adopt a radically different diet or lifestyle designed to have maximum impact; however unless the changes are sustainable in the longer term, then a lot of emotional energy will have been expended with little to show for it. Rather, try to identify some small changes that you can adopt into your everyday routine, and that do not require too much ‘sacrifice’.  For example, there are some steps that you can take immediately that will help reduce your glucose levels, get you feeling better and set you on the path to taking control of your diabetes. I call this my diabetes ‘first aid’ guide – simple steps that anyone can take. You may not feel that they all apply to you, but I would encourage you to look at the list below and choose one change that you feel you could make immediately (adapted from my book, ‘Reverse your diabetes – the step by step plan to take control of type 2 diabetes’).

First aid guide to taking control of type 2 diabetes

Drinks

1. Stop using sugar in tea or coffee (use sweeteners if necessary).
2. Drink plenty of water and avoid sweet drinks such as fruit juice, smoothies, squashes and fizzy drinks (use sugar-free drinks as much as is possible).
3. Cut down on the amount of alcohol you drink, especially drinks containing carbohydrate such as beer, cider, or sweet wines.

Food

1. Only have sweet foods such as cakes, biscuits, jam, sweets or chocolate as an occasional treat.
2. Eat less potatoes, rice, pasta and bread.
3. Eat more fresh leafy vegetables and limit fresh fruit to three pieces a day (apples, pears and tangerines are good choices).
4. Cut down the size of your usual food portions.

Physical activity

1. Take a 15 minute walk every day.
2. Use stairs instead of lifts or escalators.
3. Avoid sitting down for long periods – set your phone to buzz every hour and get up and walk around for a few minutes.
4. Walk or cycle instead of using the car or bus for short journeys.

As you make the first of these changes, you will hopefully begin to see some improvements in your blood glucose levels. However, this initial change alone is unlikely to be enough to achieve optimal control of type 2 diabetes. It is therefore important that as you plan to make more significant lifestyle changes, you set yourself realistic goals that are relevant to you and your situation. It is equally important to be honest with yourself about how motivated you are to make these changes.

What is your overall goal?

You are more likely to be able to maintain changes if they are directly related to the overall goal you are trying to achieve. In order to help decide on what that is, it might be helpful to ask yourself some questions, such as the following:

What frustrates you most about having diabetes?

How do you want things to be different?

How will you know when you have achieved this?

What is the main thing you would like to change in order to achieve this?

Your answer to the last question is the main goal you have just set yourself.

It doesn’t really matter what the goal is, as long as you are ready to make some changes to achieve it. It may be a relatively small goal such as stopping drinking fruit juice. In this case the change you need to make is quite obvious, and if you think it is achievable then to go for it. If you are successful this will spur you on to set yourself further challenges and goals.

It may be, however, that you set yourself quite a significant goal – such as no longer having type 2 diabetes. In this case, it will be worth considering what specific changes you feel you can make in order to ultimately achieve your goal – and to write them down. Then take some time to identify the most realistic changes you can make to help you achieve your goal. Success with your first small changes will give you the confidence to embark on some of the more difficult changes on your list.

Are you ready to change?

Here I want to point out that there is nothing wrong with not being ready to make changes. It is human nature that we all do the things we think are important for us right now.  If, at the moment, you do not think it is important to make a change, then it’s probably not worth trying; you could be setting yourself up to fail. That isn’t the same thing as saying you do not understand how a change may be beneficial to your health; rather it is an acknowledgment that your current situation, which perhaps includes a family or work issue that is consuming all of your energy, is more important to you right now than making lifestyle changes. The key is always - how ready are you change? In order for you to assess this, it might be helpful to ask yourself two questions:

1. On a scale of zero (not at all important) to ten (extremely important), how important is it for me to make changes which will help improve control of my diabetes?
2. On a scale of zero (not at all confident) to ten (extremely confident), how confident do I feel that I can make changes to help improve control of my diabetes?

My book, ‘Reverse your diabetes – the step by step plan to take control of type 2 diabetes’ explains in more detail how to use the answers to these questions to help you identify the changes that you are most likely to be able to achieve.

Keeping going during tough times

At the end of the day, the success you have will depend on your own motivation to make changes, and your ability to stick to them. Over time, motivation may well diminish, and everyday life will get in the way. What may be the high priority today (making changes to control your diabetes) may be superseded by a friend or family member becoming unwell, or a financial problem, or just about anything else that life can throw at us. It is completely natural that such events will take your focus away from lifestyle changes. Be aware that as a result, you may slip back into your previous eating habits, or lower activity levels. If this does happen, please do not fall into the trap of blaming yourself or criticising yourself for failing.

Instead, focus on what you have achieved so far, and give yourself time to concentrate on the new priorities that have emerged in your life – without feelings of guilt. However, if possible, see what changes you are able to maintain during this period, and whether it is possible to set yourself a plan to restart the changes you previously made in the near future.

A healthier you in 2018

As you succeed in making initially small changes, you will begin to see some improvements in your blood glucose levels, your feeling of wellbeing, or your weight – and possibly all three. This success will help build your confidence to make more significant changes that you can maintain in the longer term. And if you can achieve that, there is a real chance that your New Year’s resolution will mean that you will be in much better health at the end of 2018 than at the start. Good luck!