Living with Diabetes

 
For individuals living with diabetes, balancing work and health management can be a challenge. The key is to prioritize holistic self-care — enabling effective job performance while maintaining blood-sugar control and minimizing the risk of diabetes-related complications.
 

How Should Working-Age Adults with Diabetes Take Care of Their Health?

Working-age individuals with diabetes should focus on both their physical and mental health through the following practices:

1. Sleep and rest

• Get adequate sleep Adults should get 6–8 hours of sleep per day. Lack of sleep impairs the body’s recovery and increases stress hormones, which can raise blood sugar.

• Optimize your sleep environment — Keep the bedroom dark and quiet — night-shift workers who need to sleep during the day especially. Light exposure suppresses melatonin, the sleep-inducing hormone.

• Avoid screen time before bed — Refrain from using mobile phones or bright-screen devices at least one hour before bedtime, as light interferes with melatonin production.

2. Nutrition

• Eat regular meals — Maintain consistent meal times and balanced nutrition to prevent hunger and unhealthy snacking that may cause blood-sugar spikes and crashes.

• Choose high-fiber foods — Eat vegetables and fiber-rich foods that slow carbohydrate absorption, keeping blood sugar stable. Avoid sweets, fatty foods, and processed snacks.

• Plan early dinners — Blood sugar typically normalizes four hours after eating, so try to finish dinner by 5–6 p.m. Allow at least four hours before bedtime for digestion to help prevent fat accumulation.

3. Movement and exercise

• Move every hour — For desk-bound workers, stand up or walk for 3–5 minutes every hour to help the body use glucose for energy.

• Exercise regularly — Aim for at least 150 minutes of exercise per week, divided into 3–5 sessions. Walking is the simplest option; start with 5,000 steps a day (about 3 km) and gradually increase to 10,000 steps if weight loss is desired.

4. Stress management

• Stay organized — Stress triggers the adrenal glands to release excess cortisol, increasing heart rate, blood pressure, and blood sugar. Managing work and personal life efficiently helps reduce unnecessary stress.

• Seek support and relaxation — Having supportive friends and engaging in relaxing activities is vital. If stress feels overwhelming, seek help from mental-health professionals.

5. Consistent treatment

• Follow medical advice — Regularly take prescribed medication and attend follow-up appointments. Consistency is crucial for maintaining quality of life and preventing complications.

• Be cautious with supplements and self-medication — Avoid using over-the-counter drugs or supplements without medical advice — especially those containing steroids, which can raise blood sugar. Consult your doctor or pharmacist immediately if side effects occur.

Diabetes and the Risk of Heart Failure: A Complication to Watch

Poorly controlled diabetes accelerates damage to vital organs, including the eyes, kidneys, nerves, and particularly the heart, brain, and blood vessels. Chronic inflammation over time causes vascular stiffening and narrowing, which can lead to ischemic heart disease, arrhythmia, and heart failure.
 
Statistics show that men with diabetes face up to a 2.5 times higher risk of developing heart failure, stroke, movement disorders, and dementia compared to men without diabetes, and women with diabetes face up to a 5 times higher risk of developing these medical conditions compared to women without diabetes.
 

NT-proBNP: A Key Screening Marker for Heart Failure Prevention

NT-proBNP is a protein hormone produced by the heart’s muscle cells in both the atria and ventricles. When the heart muscle stretches excessively — due to high blood pressure or ischemia — the body releases more NT-proBNP. Elevated levels can appear long before any symptoms of heart failure occur.
 
The American Diabetes Association (ADA) now recommends NT-proBNP blood testing for all diabetic patients as a preventive measure against future heart failure. Although no fixed age guideline exists, doctors may suggest annual testing for patients aged 70–75 years and older. For those aged 50–55 years, with over 10 years of diabetes history, or with a family history of heart disease, at least one baseline NT-proBNP test is advised to assess long-term risk.
 

Comprehensive Diabetes Care at Bumrungrad International Hospital

The Endocrinology, Diabetes & Clinical Nutrition Center at Bumrungrad International Hospital provides comprehensive care for diabetic patients. The medical team emphasizes proactive prevention through advanced diagnostic tools such as NT-proBNP testing, an important measure for assessing and reducing the risk of heart failure among people living with diabetes.
 

By Asst. Prof. Dr. Varaphon Vongthavaravat