supplement: managing alcohol and tobacco living with …preparing to quit smoking in order to...

Nutrition and Fitness Lifestyle Change Program

DiAMC - Diabetes Assessment and Management Center of Shreveport, LLC http://www.diamc.com | Phone: (318) 212-1194

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Supplement: Managing Alcohol and Tobacco Living

with Diabetes

Purpose The purpose of this chapter is to understand the effects of alcohol and tobacco consumption on your diabetes health, and to develop a strategy to minimize your use of both alcohol and tobacco for optimal health.

Learning Objectives In this chapter you will learn the following:

The risks of tobacco use

Tips for quitting tobacco once and for all

The risks of alcohol consumption

Tips for reducing alcohol consumption

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The Risks of Tobacco Use Living with Diabetes Smokers are 30‐40 % more likely to develop type 2 diabetes than non‐smokers. People with diabetes who smoke are more likely than non‐smokers to have trouble with insulin dosing and with controlling their disease.

The more cigarettes you smoke, the higher your risk for type 2 diabetes. No matter what type of diabetes you have, smoking makes your diabetes harder to control.

If you have diabetes and you smoke, you are more likely to have serious health problems from diabetes. Smokers with diabetes have higher risks for serious complications, including:

Heart and kidney disease

Poor blood flow in the legs and feet that can lead to infections, ulcers, and possible amputation (removal of a body part by surgery, such as toes or feet)

Retinopathy (an eye disease that can cause blindness)

Peripheral neuropathy (damaged nerves to the arms and legs that cause numbness, pain, weakness, and poor coordination)

If you are a smoker with diabetes, quitting smoking will benefit your health right away. People with diabetes who quit have better control of their blood sugar levels.




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Quit Smoking Today The good news is that it’s never too late to quit. Even if you have been smoking for 50 years, quitting smoking can have significant positive benefits on your blood glucose values and your overall health. The best time to quit is NOW.

The benefits of quitting smoking are listed here:

You can significantly increase your energy levels

You may see noticeable improvements in your skin clarity

You may be able to perform exercise more easily

You may significantly improve your sense of taste and smell

You can save hundreds of dollars every month and thousands of dollars every year

Preparing to Quit Smoking In order to prepare to quit smoking, here are some helpful tips that can increase your chances of success:

Step 1: Set a quit date.

Mark your calendar for a date in the future that you intend to be tobacco free.

Step 2: Ask a friend to quit smoking with you.

Accountability and support is invaluable.

Step 3: Tell 3 family members or friends of your commitment to quit.

One of the most powerful things that you can do when quitting smoking is to open your mouth and tell others about your commitment to quit. In the same way that




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you listed 2 accountability contacts for your dietary program, in the table below list 3 accountability contacts that you will communicate with every 2 weeks to inform them of your progress.

Full

Name Relationship Check in

Frequency

Accountability Contact #1:

Every 2 weeks


Every 2 weeks


Every 2 weeks

Step 4: Remove cigarettes from your home entirely.

You may have heard of the “out of sight, out of mind” rule before. This is one of the most powerful things you can do to keep you firm in your commitment to quit. Simply remove all cigarette and tobacco products from your home entirely, including:




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Full cigarette packages

Partially used cigarette packages

Loose cigarettes

Cigarette lighters

Matches

Tobacco pipes

Rolling paper

Loose leaf tobacco

E-cigarettes

E-cigarette oils

Take these items, place them in a bag, and donate them to charity or throw them out entirely. Even though they cost money, the monetary dollar amount is not worth your health.

Step 5: Make a rule that no one else is allowed to consume tobacco in your house.

Place a sign in your house that says the following:

This is a tobacco free zone. No smoking is permitted on the premises or within 50 feet of premises. Thank you for your cooperation, it is much appreciated.

To make your life simple, we have constructed this sign for you. Simply make a few copies of this page and place it in your house for everyone to clearly see:




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THIS IS A TOBACCO FREE ZONE

No smoking is permitted on the premises or within 50 feet of

premises

Thank you for your cooperation, it is much appreciated




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Step 6: Join a support group in your area for people who are trying to quit smoking.

Ask your health care team about resources in the local area

Join a support group at a local church or community center

Call 1-800-QUIT-NOW, they can help you setup a plan to quit smoking

Step 7: Cultivate your hobbies where smoking is not allowed.

Examples include jogging, shopping, going to the movies, going out to eat with friends, playing sports. Write down your hobbies in the table below:

Activity Individual? Partner?




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Step 8: Plan for what you will do when you feel the urge to smoke.

There is a 100% guarantee that you will feel an urge to smoke at some point in the process. Instead of pretending like this situation won’t happen, prepare for what you can do when it does happen.

Will you call a friend or family member?

Will you distract yourself with another hobby?

Will you perform exercise?

Will you watch TV? Go to a movie?

Write down a list of things you can do when you experience a strong urge to smoke:

Activity Individual? Partner?




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The Risks of Drinking Alcohol Living with Diabetes Alcohol can cause hypoglycemia shortly after drinking and for up to 24 hours after drinking (73,74). If you are going to drink alcohol, check your blood glucose before you drink while you drink and for up to 24 hours. You should also check your blood glucose before you go to bed to make sure it is at a safe level – between 100 and 140 mg/dL.

If your blood glucose is low, eat something to raise it. The symptoms of too much alcohol and hypoglycemia can be similar – sleepiness, dizziness and disorientation. You do not want anyone to confuse hypoglycemia for drunkenness, because they might not give you the proper assistance and treatment.

The best way to get the help you need if you are hypoglycemic is to always wear an I.D. that says "I have diabetes."

Alcohol may lessen your resolve to stay on track with healthy eating. If you plan to have a glass of wine at dinner or if you are going out for the night, plan ahead so you'll be able to stick to your usual meal plan and won't be tempted to overindulge.

Some Tips to Sip By

Do not drink on an empty stomach or when your

blood glucose is low. If you have diabetes, practice caution when drinking. If you choose to drink, follow the guidelines above and have it with food. This is especially important for those on insulin and diabetes pills such as sulfonylureas and meglitinides (Prandin), which lower blood glucose by making more insulin.

Do not omit food from your regular meal plan and replace it with alcohol. If you use carbohydrate counting to plan meals, do not count alcohol in your plan as a carbohydrate choice.




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Wear an I.D. that notes you have diabetes. This is a simple way to tell the world that you have diabetes and that you may need some assistance at times, above and beyond non‐diabetic individuals.

Sip your drink slowly to savor it and make it last. Aim to have no more than 1 drink per 2 hours. Keep your intake of alcohol at this pace in order to avoid drinking too much too quickly.

Have a zero calorie beverage by your side to keep yourself hydrated like water, diet soda or iced tea. Often times when drinking in social situations, keeping a non‐alcoholic zero calorie beverage around you gives the “illusion” that you are drinking an alcoholic beverage even though you are not. This is a simple strategy to keep you drinking at a slow pace.

Try a light beer or wine spritzer made with wine, ice cubes and club soda. Watch out for heavy craft beers, which can have twice the alcohol and calories as a light beer. For mixed drinks, choose calorie‐free drink mixers like diet soda, club soda, diet tonic water or water.

Do not drive or plan to drive for several hours after you drink alcohol. Driving a car or operating heavy machinery after drinking alcohol is extremely dangerous, and can result in injuries or death. Drinking and driving is punishable by law, and can result in jail time, steep financial penalties and a permanent criminal record. If you have had something to drink, calculate the total number of drinks that you had and wait for 2 hours per drink before operating a car. When in doubt, call a taxi or bus to come pick you up, your safety is worth it!




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How Many Drinks are OK? People with diabetes should avoid heavy drinking; moderation is important. If you

have any questions about whether alcohol is safe for you, check with your doctor. People with diabetes should follow the same guidelines as those without diabetes if they choose to drink:

Women should have no more than 1 drink per day.

Men should have no more than 2 drinks per day.

Note: one drink is equal to a 12 oz beer, a 5 oz glass of wine or 1 ½ oz distilled spirits (vodka, whiskey, gin, etc.)


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