I had my first appointment at the diabetes clinic this morning. The nurse wanted to put me on medication straight away, but I asked to defer for a couple of months to see if I can control my symptoms with a combination of diet and lifestyle changes. (She said the probability was “at least 99%” I will have no choice but to use medication, but if there’s even a 1% chance I can avoid it – once you are on tablets, there is no going back – I want to give myself that opportunity.)
As a result, I am now formulating a firm plan for dealing with my diabetes. My next blood test will be in 12 weeks or so, and if things don’t improve significantly I will probably have no choice but to start popping pills – so the clock is ticking.)
To be fair, I already had a pretty good idea of the key things I needed to focus on, having already gathered some initial advice from my GP and by scanning the wealth of online resources, such as the Diabetes UK website.
The three key things for me – all, obviously, interlinked – are as follows:
1. Diet: This is easy, at least in principle; a bit trickier in reality. Given my somewhat less than healthy diet recently, a dietician would have a field day with me. At least that means there’s a huge upside, as there are a number of obvious quick wins I can focus on which will improve my diet enormously. In truth, a diabetic’s diet is little different to what you would tell someone to do if they needed to lose weight: cut down on fat, cholesterol and portion sizes; try to avoid ’empty’ calories (e.g. chocolate) which give you sugar but little else; grains, oily fish, fruit and vegetables are good, as are reasonable portions of starchy carbs.
Basically, less pie and chips – more pasta and salads. I’ve already started doing a lot of this over the past two weeks. Obviously, sustaining it is a trickier deal, but so far so good.
2. Weight loss: In addition to controlling my glucose levels, one of the obvious benefits of managing my diet more sensibly is, of course, weight loss. The less overweight I am, the more efficient my body should be at processing glucose, and the less likely I am to keel over from a heart attack. (Diabetes significantly increases the risk of heart disease.) Having already lost over a stone in the past two months (largely as a result of my diabetes), I’m already off to a good start, but I’ve been trying to work out what my ideal weight should be, or at the very least set a pragmatic target.
To this end, I calculated my Body Mass Index (BMI) over the weekend, which told me I need to be under 210lbs (15st) to be merely ‘overweight’ (as opposed to obese) and no more than 175 lbs (12st 7) to be ‘normal weight’. Having started out only just the right side of 18st after Christmas, that immediately had the theme tune from Mission Impossible playing in my head. Although I got down to 15st 3lbs five years ago – when I was walking 15-20 miles and going to the gym three times every week – the last time I weighed less than 210lbs was when I got married in 1997, and I have no idea when I was last as low as my maximum ‘normal weight’ of 175lbs. (13? 14? Certainly before I was fully grown.)
Now I don’t realistically think I could ever be as low as 175lbs – I’m way too thick-set for that – but I suspect that somewhere around 195lbs (just under 14st) would be my theoretical target weight. For now, I think my medium-term objective has to be to get from my current weight of 16st 12lbs down towards 16st – I don’t doubt that will require considerable and sustained effort on my part – because otherwise I’m beaten before I’ve even started. Losing – and then keeping off – the best part of 30lbs in nine months would be a pretty decent effort, wouldn’t it?
3. Exercise: Along with diet, this is the other big lifestyle change for me. During school, university and my twenties, I did sports regularly and still struggled to control my weight, but over the past three or four years exercise has become increasingly sporadic – and correspondingly my weight has ballooned – to the point where I have never been this unfit, and I realistically know that even a gentle half mile jog will leave me puffing, beetroot-faced and with a host of muscle twinges (assuming I can still actually run that far). So my starting point is, let’s face it, poor.
This is definitely the biggest challenge of the lot for me. Focussing on diet and weight does not require a significant investment in time; exercise does. The literature recommends I should be doing 30 minutes of moderately vigorous exercise three to five times a week. This is quite easy in theory, trickier in practice. But I need to find a way to make the time in my week to aim for a brisk walk on average every other day, just to start building some base fitness. I’ve bought myself a heart rate monitor – well, it’s a gadget, isn’t it? – to help me get the most out of whatever I do without overdoing it. The biggest single problem I have is constant and severe cramping in my calves – a symptom of my high sugar levels – which is really most unhelpful. It’s frustrating, but somehow I need to break the cycle and get myself out there.
Which is why I’ll be leaving work early this afternoon to make the time to go for a walk, even though my calves are still as tight as an overstretched drum skin.
So, overall I have two new, stretching targets for the end of June (that’s 11 weeks today):
Weight: Start point 16st 12lbs, target 16st 5 lbs – i.e. lose half a stone
Exercise: 33 sessions (i.e. three per week), starting at a minimum of 800 and rising to 1,000+ calories per week. Calorie expenditure target for the 11 weeks: 10,000 (about 900 pw).
As the cliche says: no pain, no gain. Off we go.