We all are aware that Diabetes is a chronic metabolic disease, where every diabetic patient has to keep their blood sugar level, blood pressure, lipid level, and body weight under control to prevent its long term microvascular and macrovascular complications and also avoiding hypoglycemia and weight gain.
During situations like lockdown or curfew or quarantine where there are no outdoor activities as such because one has to be confined within their house or within a place where they are located, if when extended for days to weeks to months, becomes a challenging situation for diabetes patient and it demands a systematic approach to overcome it and achieve the goals of treatment.
Situations like lockdown may worsen the control of diabetes due to many factors like non-availability of medicines and insulin injections, non-availability of consumables needed for diabetes monitoring and treatment devices like glucometer, infusion pump, etc, changes in the daily schedule, behavioural changes, stress, lack of physical inactivity, increased eating which may be due to snacking while watching TV or using mobile, and above all, there could be also inappropriate sleep which may play a role in worsening of blood sugar and blood pressure level.
In such situations what a diabetes patient should do to avoid and have all the above discussed parameters under control:
- Try to maintain the routine, the basic of diabetes care, and have adequate physical activity along with balanced healthy and controlled eating behaviour with ongoing medications which are prescribed to be taken daily as ongoing prior to lockdown like situation.
- Ensure a good stock of all required medications, insulin syringes, injection needles, insulin vials so that even a single dose is not missed. Not only that, if you are using glucometer for glucose monitoring than also ensure adequate stock of strips, batteries, its lancets, etc…., and ensure all consumables stock at hand if one is on an insulin pump.
- Maintain your eating pattern as it was prior to lockdown, and keep an eye on your portions of what? And how much you are eating? And if possible reduce the portion size. While at home there is constant availability of food which is handy, and along with stress and boring environment may induce extra eating, this, by all means, should be avoided.
- Avoid excess of carbohydrates and identify low caloric food like salads and soups, nuts, pulses, and lentils to be preferred as the activity level during lockdown situation is bound to below.
- Avoid in-between meals snacking especially when sitting idle or watching a TV or busy with mobile on social media, and if you are snacking keep an eye on the amount and type of snacking done, so that to compensate it with the main meal. Try to have low caloric liquids like buttermilk, black tea /coffee, lemon tea, etc instead of snacking.
- Always keep a watch on weight, it should not increase, but try to maintain at least if not able to reduce the weight.
- Physical activity would be key to achieve, for those who go regularly to the gym or jogging park or swimming pool or sports club, etc due to lockdown are compelled to perform physical activity at home, like walking, gardening, dancing, aerobics, etc, and for those who have space, constraints can perform spot walking, spot jogging or floor exercise and yoga. Avoid sitting for a long time and have a walk-in between while answering a phone call or looking at net or media on the phone which may help burn calories.
- Ensure adequate intake of water.
- Try to overcome and address stress with positive talk and discussions within family members, playing indoor games with children and elders to spend quality time with them and build good bondage amongst the family members.
- It’s time to learn new things, which you were not able to start or do while you were busy with work, it may be weight management program, learning and strengthening exercise schedule, learning new low carbohydrate recipe, new diabetes recipe, and thus utilize the lockdown extra time to learn new things which is suitable and beneficial to an individual.
- Adequate sleep is also very essential to remain rejuvenated and refreshed the next day.
- Ensure regular check of blood sugar monitoring to keep it under control, and whenever in doubt increase the frequency of checks to ensure better control and act accordingly.
Lockdown is a sudden unchanging environment where you can’t go outside, and imparts a lot of psychological implications similar to what we are undergoing now, try to enjoy what is there within the space, so that you don’t feel lonely and bored, utilize this time to prioritize your health, as discussed above so that you can use lockdown period effectively.
Dr.Joozer Qaiyoom Rangwala | Consultant Internal Medicine | Narayana Multispeciality Hospital, Ahmedabad