• Control blood sugar level. This can help prevent or delay loss of vision.
  • Have a healthy diet.
    • Use the diabetic plate method with each meal. Every meal, use a 9-inch plate, and fill:
      • ½of it with low-carbohydrate vegetables (e.g. carrots, broccoli, bok choy, cauliflower)
      • ¼of it with lean meats and protein-rich food (e.g. broiled, steamed, baked or stir-fried chicken, beef, fish, pork; beans, legumes, and tofu). Remember to trim excess fat of meat before cooking or eating.
      • ¼ of it with healthy carbohydrates (e.g. whole grain bread, cereals, brown rice, sweet potato, corn)
      • Add one serving of fruit (one small piece or cup of fruit)
      • Add one cup of skim milk
    • Eat variety of foods. Include high-fiber foods (e.g. vegetables, fruits, grains, and beans), lean meats or meat substitute (e.g. tofu), healthy fats and oils (e.g. olive, canola, and peanut oil), and non-fat dairy products in the diet.
    • Eat food with low glycemic index (GI) (≤ 55).
      • Food with low GI are slowly digested, absorbed and metabolized by the body, and hence, cause gradual increase in blood sugar and insulin levels.
      • Food with low GI (≤ 55) include: oatmeal, oat bran, barley, corn, sweet potato, legumes, lentils, low-fat milk, non-starchy vegetables (e.g. broccoli, cabbage, bok choy, carrots, eggplant, tomatoes, and dark leafy vegetables), fruits such as apple, grapes, orange, pear, peach, and strawberry.
      • For more information on glycemic index, please visit the following links:
        • http://sntpost.stii.dost.gov.ph/frames/julytosept04/pg47.htm
        • http://www.health.harvard.edu/diseases-and-conditions/glycemic_index_and_glycemic_load_for_100_foods
        • http://www.glycemicindex.com/
    • Use less added sugar, salt, and fat.
    • Avoid eating too much food.
    • Avoid skipping meals.
    • Eat about the same amount of food at the same time every day.
    • If physician had prescribed a proper time to take meals (usually, this is for diabetic patients who are prescribed with insulin), comply with the physician’s advice.
  • Exercise regularly.
    • Check blood sugar before doing exercises.
    • Do exercises 1-2 hours after a meal.
    • Do exercises at least 30 minutes a day. Even brisk walking is a good exercise. Do brisk walking at least 30 minutes a day and 5 times a week.
    • Do physical activities that you enjoy (e.g. swimming, badminton, basketball, cycling, jogging). Make exercises a pleasant experience by tagging along friends and family.
  • Manage stress levels.
  • Have plenty of rest. Sleep for 7-8 hours every night in a dark room, as melatonin – a powerful anti-oxidant that promotes healing through boosting the immune function – are found to be produced in higher amounts when sleeping in darkness. If sleeping in a dark room is not possible, wear an eye patch instead.
  • Take breaks from stressful situations.
  • Learn to say no. Acknowledge own limits.
  • Take breaks. Have rest periods from stressful situations.
  • Schedule time for hobbies and other enjoyable recreational activities.
  • Spend time with loved ones.
  • Let go of grudges. Learn to forgive.
  • Express gratitude.
  • Perform relaxation exercises (e.g. deep breathing, music therapy, meditation).
    • Perform deep-breathing exercises.
      • Find a quiet and comfortable place where you can be alone with yourself.
      • Sit upright in bed or chair, and find a comfortable position.
      • Place one or both hands over the abdomen, just below the ribs.
      • Deeply breathe in through the nose, while keeping mouth closed. Breathe in for a count of four.
      • Feel the abdomen rise with each inhalation, and as far as possible.
      • Through a pursed-lip, breathe out. Breathe out for a count of seven.
      • Feel the abdomen sink with each exhalation.
      • Perform deep-breathing exercises for 5-10 minutes at a time, and as many times each day.
    • Engage in music therapy.
      • Choose a soothing, therapeutic song. Research findings indicate that music with slower tempo (60 beats per minute) induces a calming, relaxing effect. Sounds of nature (drops of rain, flowing waterfalls) are also relaxing. But the best relaxation music ultimately depends on each person’s preference – whichever music one finds relaxing (albeit upbeat or moderately loud) – may be used for music therapy.
      • Relax before and during the music therapy by performing deep breathing exercises (see instructions above).
      • Listen actively to the music. Feel the music. Focus your mind on the music, get lost in it – listen to every beat and every silence in between. Let the music’s mood influence yours.
    • Engage in meditation. Meditation is a calming activity which restores inner peace. It brings the body into a deep state of relaxation and produces a peaceful mind. It enables one to redirect the mind away from thoughts that bring stress, anxiety, or tension.
      • Walking meditation – Please visit the following link for a video guide on walking meditation: https://www.youtube.com/watch?v=7t70V__bnds
      • Qi Gong – Please visit the following link for a video guide on Qi Gong: https://www.youtube.com/watch?v=Ac08kMK-dyI
      • Yoga – Please visit the following link for a video guide on Yoga: https://www.youtube.com/watch?v=v7AYKMP6rOE
      • Guided Imagery – Please visit the following link for a video guide on Guided Imagery For stress relief: https://www.youtube.com/watch?v=gU_ABFUAVAs
  • Take diabetic medications as prescribed (if physician had already prescribed).
  • Monitor blood sugar levels:
    • Aim to have 70-130 mg/dL blood sugar before meals
    • Aim to have less than 180 mg/dL blood sugar 1-2 hours after meals
• Control blood pressure level. This can also help prevent or delay loss of vision. For people with diabetes mellitus, aim to have blood pressure less than 140/90 mmHg.
  • Maintain a healthy weight.Calculate body mass index (BMI) and see if it’s within normal range (5 to 24.99). If BMI is greater than 24.99, take steps to reduce weight. Lose weight gradually, around 0.5 – 1 kg per week.
    *Note: BMI can be calculated using the formula: kg/meter²
  • Reduce salt/sodium intake to less than 1,500 mg/day or less(¾ teaspoon of salt or less)
    • Read food labels and choose food and beverages with less sodium. Choose food stuff labeled with “low sodium”, “no salt added”, or “sodium-free”.
    • Avoid eating processed food (e.g. canned goods, bacon, tocino, longganisa, microwaveable meals, and other packaged or instant food)
    • Avoid eating fast food meals.
    • Avoid using salt in giving flavor to home-cooked meals. Alternatively, use vinegar, calamansi, and other herbs and spices to give flavor to food.
  • Limit intake of alcohol.
    *Note: 1 drink is equivalent to 12 ounces of beer or 5 ounces of wine
    • If male: do not have more than 2 alcoholic drinks per day
    • If female: do not have more than 1 alcoholic drink per day
  • Limit intake of caffeine.
• Quit smoking.
• At least once a year, have a diabetic eye check-up or a dilated eye exam by an ophthalmologist or optometrist. This is even if the person with diabetes mellitus hasn’t been experiencing any visual impairments (diabetic retinopathy usually goes unnoticed until loss of vision happens).

Other Diabetic Care Management Interventions:

• Diabetic Skin Care
  • Keep the skin clean and also dry.
  • Avoid baths and showers with hot water. Use moisturizing soaps.
  • For women, avoid using commercial feminine wash or sprays. Clean the private area with water.
  • Avoid having dry skin. After a bath, apply standard lotion to the body except in the area between the toes (as this area is prone to growth of fungi with excess moisture).
  • Promptly treat any cuts in the skin. With minor cuts, wash them with water and soap. Unless prescribed by the doctor, steer clear of using antibiotic creams. With major cuts, burns, and infection, promptly see the doctor.
  • If a skin problem (e.g. minor cut) remains unsolved despite home treatment, promptly see a doctor.
• Diabetic Foot Care
  • Check each foot every day. A mirror may be of help in this. See a doctor if any of the following are present: wounds or cuts, redness, swelling, and blisters in the foot, changes in the color and sensation (e.g. numbing of foot) of the foot, and ingrown nail.
  • Clean the feet every day and keep them dry, especially the skin between the toes.
  • Never use hot water when cleaning the feet. Test the water by checking the temperature with elbows. Never use heating pads or hot water bottles for the feet.
  • Apply a thin film of standard lotion on the top and bottom of the feet. Do not apply lotion between the toes.
  • Don’t ever walk barefoot. Always wear socks and a pair of well-fitting shoes.
  • Before wearing a pair of shoes, make sure there are no objects inside that may cause cuts in the foot.
  • Trim toenails straight across (don’t cut deep on the sides). File the edges with a nail file.
  • Elevate both feet when sitting by placing them in another chair. Do feet exercises: wiggle toes and move the ankles up and down for 5 minutes. Do this 2-3 times a day. Avoid crossing legs as this constricts blood flow in the feet.