Sunday, May 22, 2011

Maintain Your Daily TER and Outsmart Diabetes

Take control of your diabetes! No one does it better than you do. Your doctor is your best friend who listens to your own account of what’s happening to your body, but it’s you who administers your treatment- with help from his expertise. He helps you keep your blood glucose to a safe level, but it’s you who do all means to do that daily. Your doctor is not there with you every day, any moment you need him.  It’s you who keep your blood glucose to normal, no less than 70mg/dl (to avoid hypoglycemia), and no more than 300mg/dl or greater (to avoid hyperglycemia). Every diabetic wants a quality life despite his romance with diabetes. 

Maintaining your daily total energy requirement (TER) answers a good part of your endless questions regarding ways to achieve normal blood glucose (BG) level, because you’ll be on a tight watch over your food intake and at the same time it encourages you to do and appreciate a regimen of exercises that go along in the event that you notice excesses. Diabetes is not a disease. It is a condition in which the body reacts to what you feed it. Your pancreas needs to breathe. Overloading your body with acids, fats, carbohydrates and sweets would put a strain on that organ that processes the food nutrients from these foods with your natural insulin. Diabetes is a result of a lifestyle, therefore, you can reverse that condition, if you try.

I have this attitude-change the time I waged my war on what I called “empowerment” as my new way to manage my condition. I realize today that it was almost 6 months ago when I posted that last article about empowerment.  Where have I been? I was enjoying life, doing great things that life has yet in store for me- activities I never thought I can still do because of diabetes! My diabetic peripheral neuropathy never poses hindrance, although I admit, I still suffer from pain in my lower limbs up to my buttocks and also my lower arms and hands. I thought that the damaged nerves need to be coaxed to regrow and so I indulge in activities that would somehow help me create some replacements, even allow new nerves to grow. I’m not an authority but I guess moderate exercise and balanced diet really works for me.

Today, I travel a lot with my two daughters, every time they have chance to pull away from work! We travel around in the country where there are beaches I can soak myself in, better than the swimming pools we used to visit. I enjoyed snorkeling with my 2 daughters last November on what I called a 4-day Thanksgiving Day retreat. Just this Easter I joined my daughter Kit  and her big boss’ family and office co-employees in what I called an Easter splash at the Montemar Beach Resort in Bataan. 

What surprised me and my daughter was my eating performance as if I’m not a diabetic. I helped myself with anything served because anyway, I couldn’t choose, but of course with moderation.   I had a tight watch over my insulin injection, oral medication, beach and swimming pool soaks and brisk walk exercise during our 2-day stay there, and I didn’t have any problem. Anyway, upon arriving home, I set up a three-day monitoring again as I went back to my usual diet of fruits and vegetables, less carbo and meat.  I’m feeling great! In my last month’s checkup, I asked my diabetologist for a month reprieve from my monthly check-up because of the Bataan trip, so I’m really careful not to fail him in our mutual desire to maintain my normal BG.

My diabetologist and I are on the best of terms. This is another factor that every diabetic must establish.  Mutual trust encourages me to look after myself with great care. On “examination” days, I see to it that I pass the tests. For the past six months, my blood glucose level has been kept to normal, and I dare eat even ice cream and dark chocolates! It’s my cholesterol level though that I’m wary about, although he said it’s not very alarming for a 20-40mg daily doses on the seesaw for the past 6 months. According to him, my Simvastatin maintenance might be a lifetime medication. Although chicken breast, minus the skin, is the only meat he prescribes, I still try on pork and beef dishes on occasions that I can’t prevent. I flush down the fats I ate with my reliable Guyabano Soursop tea and Bignay Tree tea with pandan flavor. I take a cup in the morning and another cup in the evening. I’m happy with my 6mg/dl BG count on good days and 7mg/dl on bad days.

Generally, I’m up, out, and about- but feeling a little guilty of not having enough time to sit and blog about life- my life as a diabetic. I’m glad I’m back to my usual active self- enjoying my time doing household chores and even venturing to go out alone to go to the market or buying my medicines . I have learned to talk to my body, a result of my recollection experiences in church during the Lenten season, to focus my attention away from my pains. When I look at myself in my morning mirror, I know the physical signs when my body tells me to calm down. Right away, I feel my body for its complaints.  I’m more confident now that I can beat the odds given a wide choice to make decisions. Peace of mind and healthy lifestyle positively help. Charge that to “empowerment”.

So, what about this TER thing? I read about TER a long time ago but it’s only these days that I consider trying it and I believe it is the best ever I now follow. (Outsmart Diabetes, Abbot Nutrition booklet). It was given to me by my former nephrologist when I first suffered extreme pain in my lower limbs which I learned was peripheral neuropathy due to long uncontrolled blood glucose that made my finer nerves suffer. The booklet has become my daily guide that trains me to keep watch of my daily food servings and resort to exercise to shed off excesses I can’t avoid that add to my weight. To me, it follows that when my weight has exceeded its normal count, my BG count is also at risk. TER is presented in a table form with factors required separately for a male and a female. It reflects values like height, ideal body weight (IBW), and activity level. Based on the table, our daily TER is easily solved with this formula:

TER = Ideal Body Weight (IBW) x Activity Level (kcal/kg IBW

For example: I’m a female, 5’7” in height, with a supposed ideal body weight of 61 kilos
As a single mother (widow) without a maid, I have a moderate level of activity of 40
My Suggested TER -  61 kg x 40 = 2,440 kcal/day

My doctor told me, I’m still safe with 65kg weight, so I try daily to maintain this weight, because I feel light, dizzy, and therefore, uneasy with any below it. In the same vein, I know I’m overweight even without stepping into my scale. These are no tell-tale signs. They are my red lights I obey strictly. 

The excesses I have due to my Bataan escapade, gave me a weight of 68kg at this writing, so I know I have still today until tomorrow, or 3 days after I had broken my prescribed meal plans, to tone down and shed off 3 kilos. This means that I have to measure my food, do some exercises, to keep my weight down and forget that I may have my sugar surge to avoid stress. I’ll listen to what my body tells me.  When I know I had done all these, then I’m ready to get my own BG count- my lancets and strips are always ready! Wish me luck, haha! Simple, isn’t it? 

Empowerment makes me more aware of the things I ought to do and not to do. When I feel I’m suffering one of those bad days, (as diabetics are ought to suffer), I’m quick to analyze the factors that might have triggered it. Did I take my medicines on the dot? Did I eat more than my usual load? Did I have enough exercise to make me perspire? Am I suffering from an emotional strain? Do I have sort of sleep problem because of physical stress and or psychological burdens? Anger is just one letter away from danger and so it’s smart to be feeling light, healthy, and happy all day. 

God is my sole refuge in times of eminent troubles. Prayer keeps me buoyed up. Prayer calms me down. And most importantly, I’m transparent with my daughters and my doctor as far as my health status is concerned, careful not to over or underestimate what I feel. I believe that my progress is also due to my own growing passion to educate myself about diabetes, through the internet. My personal mission to share my experiences led me to blogging. However, I’ll advice you again and again, that your doctor knows what’s best for you.

To fellow diabetics, life is beautiful! Let’s maintain daily a safe TER and outsmart diabetes!


  1. Hello Lita,

    Hey.......great post lady! I'm so glad to hear that you are taking charge of your life, and not letting the diabetes get the best of you. You are one of the strongest women I know, and I'm so glad and proud to call you my friend.

    Ohhh, and I'm right there with ya when it comes to the lack of 'recent' posts! I just started blogging again after not having written anything since January, LOL! I was WAY BEHIND in that respect. Soooo.......I am determined to keep up with my Posts.

    I had what might have been close to a heart attack back in April, and that scared the heck out of me. I found out that I had about 90% blockage in my left anterior heart artery. Anyway, long story short, I'm fine now and trying to loose some weight myself. Last time I had blood work done, I was right at the borderline of being diabetic.

    Sooo......I just wanted to say, glad to have you back and everything is going so well for you my friend! ((Hugs))

  2. JulyJeanie,
    Wonderful first comment here from a wonderful lady! It's good to hear from you again. Thank you.

    Hey, great Lady, you almost scared the wits out of me. I actually winced when you mentioned stint or stent, whatever! My elder brother got one and he was diabetic. Glad you're back, too- and with a vengeance! LOL! Before answering your comment, I went over your posts to find out the long story of the 90% blockage in your artery. OMG! This is your second chance of life!

    Thank God you say you're fine now and I can see that. I had a good read in your site. And what a makeover you made there. Beautiful layout, best writing, too. I couldn't had done that much writing in that situation of yours. When I suffered from a mild TIA(Transcient Ischematic Attack), I pulled myself away from yes- depression and overwork, too. Please take care my dear friend. You have lots to share here in blogsphere. I owe you a lot of my strength to go on with my life as a sufferer from diabetes.

    May we both share this happiness of reinventing and rediscovering ourselves, despite our health conditions and be a source of strength for others. God Bless us!

  3. You really are a health buff ate Lita, this is a very informative post especially to those who has or know someone with diabetes.

  4. chubskulit,
    "A health buff!" I love that! I'm not one to just sit and wait for what will happen to me. I'm happy to help my doctor treat me, hence, this blog about my personal experiences as a diabetic.

    Rose, I'm glad to know that you are a dieter from your post I just read. I trust that you can prevent diabetes in your family. I enjoyed my read there just looking at your wonderful family especially the burritos. God bless and take care!

  5. Great post. I like the way you say you feel your weight/health. I say every time I get on the tennis court it's like a stress test. If I can't get to the short balls and I puff, then I didn't pass. You can be your own doctor.

  6. Neil Killion,
    Absolutely right! It's our own body and it's us who feel what it tells us. And we don't stop from there. We must listen to our body and do something to get out of trouble. Thanks for the rejoinder here.



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