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!