Healthy Lifestyle: Still the First and Best Line of Defense Against Diabetes
It’s no surprise that diet, nutrition and exercise are regarded as the most important factors in not only reducing diabetes, but keeping it under control. Postmenopausal women need to realize that even just a few hours of walking per week can greatly reduce health issues and prolong their lives.
During the North American Menopause Society Annual Meeting, speaker Jane E.B. Reusch, M.D. discussed a study from the Journal of American Medical Association on the relationship of walking to mortality among U.S. adults with diabetes.
A prospective cohort study with 2896 subjects showed that the mortality rates after two hours of walking dropped by 39 percent for all causes and 34 percent for cardiovascular deaths. The rates dramatically dropped to 54 percent for all causes and 53 percent for cardiovascular deaths for persons who walked three to four hours.
The conclusion of this study was that walking was associated with lower mortality across a diverse range of adults with diabetes. One death per year may be prevented for every 61 individuals who walk at least two hours per week, according to the study.
Lifestyle changes should always be a part of treating diabetes in postmenopausal women. But if lifestyle change does not work, then a diabetes management plan that includes medication in combination with lifestyle changes is the alternative.
Diabetes Management Plan
An important issue addressed in the conference was whether a postmenopausal patient can be a little diabetic, or is an actual diabetic. There is no such thing as a little diabetic. Either you are diabetic or you are not.
If diabetes is suspected, your doctor will order an A1C test. The A1C test measures what percentage of your hemoglobin, a protein in red blood cells that carries oxygen, is coated with sugar. A higher A1C level indicates a poorer blood sugar control and a higher risk of diabetes complications.
If it’s determined that you are in fact diabetic, the doctor will start you on the oral medication metformin unless your A1C is great than 9 percent. If it is higher, you will be put on insulin, which is an injectable drug that requires closer monitoring of your blood sugars.
It was stressed during the NAMS seminar that even if a patient is on diabetic medications, lifestyle changes are greatly encouraged. For example, speaker Dr. Robert G. Josse said that physical activity can be used to lower a patient’s A1C by a half percentage point, or 0.5 percent, if she exercises within ½ hour of eating.
The ultimate goal, whenever possible, is to bring A1C levels back down to a normal range by eating healthier and increasing physical activity.
Relationship of Walking to Mortality Among US Adults With Diabetes. Arch Intern Med. 2003;163(12):1440-1447. doi:10.1001/archinte.163.12.1440.
The A1C Test and Diabetes. The National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved October 29, 2015.
Reviewed October 30, 2015
by Michele Blacksberg RN
Edited by Jody Smith