Take Charge of Your Diabetes Introduction Self Program Participants – Icebreaker The goal of this program is to give you ideas about living well with diabetes. You will learn how food and activity affect your diabetes. You will also learn about actions you can take to feel more in charge of your diabetes. This lesson is about how foods affect your blood sugar. how to being more active can protect your health. how to cope with making changes to live well with diabetes.

Living Well with Diabetes Take Charge of Your Diabetes

MyPyramid for Diabetes Healthy eating is one of the steps that people can take to manage their diabetes. People with diabetes can eat the same foods as everyone else. The food that is good for your whole family is also good for you. When you have diabetes, it is helpful to eat about the same amount of food at about the same time each day. This discussion is about how to plan to eat the same amount of food at each meal. MyPyramid is a good guide for choosing healthy foods and deciding how much to eat from each food group. Handout: MyPyramid miniposter Take Charge of Your Diabetes

Choose a variety of foods Let’s take a closer look at MyPyramid. It shows us to eat a variety of foods. Each color band represents a food group. The person going up the stairs reminds us to be active every day. Activity and nutrition work together to maintain health.

Choose a variety of foods The six color bands represent the five food groups, plus oils. This illustrates that foods from all groups are needed daily.

MyPyramid Food Groups Choosing a variety of foods that include all of the food groups is important for health. The width of the color band denotes how much of each group we should eat. Grains, vegetables and fruits make up over ½ of the pyramid, so they should make up ½ of our diet. More specifically (for 2000 calories a day) we need to eat: 6 ounces of grain each day. 2 ½ cups each day. 2 cups of fruit each day. 3 cups of milk or other high calcium food each day. 5-6 ounces of meat or beans each day. 6-7 teaspoons of healthy oils in our diet each day. Within each food group there are a variety of foods. In each group there are some foods we should eat more often than others. It is helpful to understand how these foods fit into a healthy diet. We will spend time talking about healthy choices within each food group in the upcoming sessions.

My Pyramid Food groups Grains - 6 ounces Vegetables – 2 ½ cups Fruits – 2 cups Milk – 3 cups Meat & Beans – 5 ½ ounces Oils – 5-6 teaspoons Grains Vegetables Fruit OILS Milk Meat & Beans

MyPyramid Worksheet Activity: Lets look how my neighbor Nellie does with her food choices. Refer to Leader’s Guide - Neighbor Nellie’s food choices. Did she get a variety of foods? Did she include enough foods from each of the foods groups? Help participants figure out where foods fit in the food groups. Use “best guess” on amounts of food. Handout: MyPyramid Food Choices This week, look at your food choices. This will help you decide if there are any choices you could change to help you manage your diabetes. Use MyPyramid Food Choices, write down the foods you eat. Bring it back next week, to review during class We will not judge or grade your intake. You do not have to share it if you don’t want to. It is for you to use and make informed choices.

Be More Active We have talked about making healthy food choices to help manage your diabetes. Now let’s talk about another important thing you can do to take charge of your diabetes - be more active One of the best actions that most people can do to help control their diabetes is to be more active. Being more active helps control diabetes and prevent complications from diabetes. Being more active: helps control A1c and lower blood pressure, make your heart healthier. maintains a healthy weight. Physical activity helps you deal with stress, and feel more energetic and less tired. Let’s take a look at how activity has changed for people over time.

Be More Active Help control blood sugar Lower blood pressure Support a healthier heart Maintain a healthy weight Help cope with changes

Now and Then Over time we have engineered activity out of our lives. We could look as far back as the invention of the wheel and realize how that decreased our levels of activity. But big changes have occurred in more recent times as technology has advanced. Have a discussion around changes in the 20th century: What did wash day look like then? And now? A farmer in the late 1800s walked an estimated 100 miles per week. How much does a farmer walk today? What was the typical mode of transportation 100 years ago?

Now and Then

Balance food with physical activity! Most of us are not willing or able to give up the conveniences of modern life, but we still could benefit from being more active. Physical activity and nutrition work together for better health. Physical activity simply means movement of the body that uses energy. Let’s take a look at how active we are, so we can find move our bodies more. Handout: How Active Am I? Activity scan Activity: How Active Am I? Have participants record the activity they did yesterday. If some activities are done routinely that are not listed, cross out ones that aren’t used, and write in others. “What did you learn about yourself?” “What is one step that you will take to move towards a healthier you?” Let individuals volunteer their goal; if no one initiates after 30 seconds, educator can shares a goal set for her/himself.

Physical Activity Balance your food intake with physical activity. Maintaining a Healthy Weight is a Balancing Act Calories In = Calories Out

Physical Activity Recommendations for adults The goal is at least 30 minutes a day most days a week. Increasing activity to 60 minutes a day is recommended to avoid weight gain with age and to help lose extra weight. Up to 90 minutes is recommended to maintain weight loss. It all adds up. Ten minutes at a time a three or more times a day can add up to meet the goal.

Physical Activity Recommendations for Adults At least 30 minutes of physical activity most days of the week for health. To avoid weight gain with age or to lose weight, 60 minutes a day. To maintain weight loss, 60 to 90 minutes per day.

Moderate and Vigorous activities Physical activity simply means movement of the body that uses energy. For health benefits activity should be moderate or vigorous, for at least 30 minutes a day. Increasing the intensity or the amount of time can have additional health benefits. Some activities are not intense enough to increase your heart rate (for example grocery shopping or light household chores) and should not be counted as activity. Some activities may be harder for some individuals, depending on your fitness level. As you become more active, these activities will be come less intense. The most important thing is to be active every day

Moderate Activities Vigorous Activities Dance Aerobics Swim Hike Bike Garden Play sports Walk

Getting Started If you have not been active start small to build strength and endurance. Start Low and Go Slow! Start with a few minutes of some activity each day. Add 2 minutes per week. Increase to 10 minutes a day and build from there. Men over 40 and women older than 50, or those who have a chronic condition like diabetes should check with their health care provider before starting a vigorous activity program. Start with some gentle stretching to prevent soreness. Demonstration – gentle stretching using handouts. Be sure to wear shoes that fit well. Keep hydrated, drink water while you are exercising. If you experience pain while being active, stop right away. Activity: Role play talking with health care provider about starting a physical activity plan. See leader’s guide.

Getting Started Start Low, Go Slow See your health care provider Drink plenty of non -caloric fluids Wear shoes that fit well

Changes with Diabetes We live in a time of ever growing demands on us. There are many Things to take care of in everyday life. Living with diabetes may require some changes in everyday life. Living with diabetes may effect our food and activity choices. Living with diabetes means planning regular health checks. How we adjust to these changes can effect how we take care of our health and diabetes.

Changes with Diabetes

Moods Changes can effect our moods. Having a disease like diabetes can add more stress, and the everyday stresses can make it more difficult to take care of our diabetes Over time too much stress can cause illness. One of the body’s automatic responses to stress is to cause blood sugar and blood pressure to rise. Stress comes out in different ways. Some people may feel scared, worried, angry, sad, or overwhelmed. Ask participants: Are there any other feelings people have had? We need to recognize these signs and feelings so we can better manage when it becomes too much. So it is important to learn methods to manage stress to help control blood sugar and your diabetes.

Moods Surprised Sad Angry Denial Afraid

How do you see it? Every one has blind spots. This limits how we see things. If we can keep ourselves open to look at things differently, we may find other solutions to the challenges we face. Activity – share the Old lady/ Beautiful Lady picture. Discuss what they saw in the picture? Can they see anything else? Has there been a time when they could only see things one way? What was their mood at the time? Were moods or emotions getting in the way of seeing things differently. When our moods take over, thinking is more emotional. It can be hard to see solutions. Once we recognize the moods and accept them for what they are we can move on and see more solutions to the challenge. Summarize – the emotions are normal. Recognizing emotions for what they are can allow you to move on and see things in a new way.

How do you see it? Source: UGA Fanning Leadership Guide

Problem Solving Challenges We often know that making some changes is a good thing. Let’s go through a process to help us figure out ways to reach our goals. Identify the challenge. Being clear about what you want to do makes it easier to solve a problem. It may be helpful to break it into small steps. Think about why do it. Think about the benefits you may get from solving the challenge. This can motivate you. Think about why not do it. This can help find what gets in the way. List possible solutions. The more ways to solve a problem the easier it will be to find a solution. Choose one solution, make a plan to try. Be specific and take small steps. Check back. How did it work? Often problems may need more than one solution. Don’t get discouraged, try another solution.

Problem Solving Challenges Identify the problem List possible solutions Choose one solution and try it Check back to see how it worked If it did not work try another solution

Planning Your Physical Activity Let’s use these questions to problem solve being more active. Ask participants: Identify the challenge. Why become more active? Why not become more active. Why do it anyway? List as many possible ways to become active. The longer the list the more opportunity for success. What will you try this week. Once you choose a solution decide When will I try it? What do I need to do to get it done? Who will support me? When will I check back? Change is made in small steps. The more times you work through challenges the easier it will become. The more success you will have. Handouts: Choose to Move, Ideas for Staying Fit in Fall and Winter, Exercises for Flexibility and Reducing Stress

Planning Your Physical Activity Make activity part of every day. Choose activities you enjoy. Keep it interesting. Have Fun!

Take Charge of Your Diabetes Today we learned about things you can do to take charge of your diabetes. Healthy eating is one of the steps that people can take to manage their diabetes. People with diabetes can eat the same foods as everyone else. The food that is good for your whole family is also good for you. Using MyPyramid is a good place to start when choosing healthy foods. Physical activity is helpful in lowering blood pressure, lowering risk of heart disease and keeping your blood sugar at a healthy level. To be active everyday. Start low and go slow. Work towards doing activities 30 minutes or more most days a week, Remember 10 minutes at a time add up to the 30 minutes each day. Living well with diabetes may mean making some changes. Change is accomplished in small steps. Looking at challenges in a new way can help us be more successful and live will with diabetes. This week, put your plan into action. Next week we will check back to on what worked and what got in the way to being more active and making healthy food choices.

Take Charge of Your Diabetes Make healthy food choices. Be active everyday. Change happens in small steps.