Tigray Academy | August 23/2023

By Dr Gebrewahid Woldu

First, I would like to remind anyone with a chronic medical condition should work closely with their doctor

This advice/Tips are for those who have metabolic syndrome (see criteria previous discussion), prediabetes, and diagnoses of diabetes. Diabetes is a disorder marked by high blood sugar(glucose) levels in the bloodstream. Glucose is essential for energy used by every body cell, but blood sugar levels above the normal range are TOXIC and affect many body parts, resulting in serious complications. Poorly managed diabetes can lead to kidney failure, heart disease, stroke, blindness, amputation (losing a limb), and premature death. It has an enormous financial burden. For example, in 2017 the total cost of care for diabetes was $327 billion, which accounted for one in four dollars spent in the United States.

Guideline from the American Diabetes Association (ADA) on managing diabetes stresses tight blood sugar control for both type 1 and type 2 diabetes.

The ABC of diabetes control.

Because diabetes raises the risk of heart disease and stroke by 4 to 5 times over those people without diabetes, it is critical to monitor and control the following factors.

A -A1c (which indicates average sugar the previous 2 to 3 months)

B – Blood sugar

C – Cholesterol

Diabetes is cruel, resulting in serious complications if anyone with the disease does not work aggressively. This discussion is not about medications but about lifestyle changes one must make.

 And these are:

1.    Diet

2.    Physical activity

3.    Sleep

These lifestyle changes result in weight loss and long-term blood sugar, blood pressure, and cholesterol control.

 WEIGHT: controlling weight is critical because the evidence shows that being overweight/obese is the major reason for the epidemic of type 2 diabetes.

80 percent of people with diabetes are overweight/obese, weight loss even just 5 to 10 percent can make a big difference in controlling blood sugar.

Body fat is not just a storage site of extra. Calories are active tissue that produces hormones and other chemicals that affect appetite. Especially fat that accumulates inside surrounding the internal organs (visceral fat) produces hormones called cytokines. which play a role in insulin resistance (insulin not working properly).


  Our diet (the type and amount) is the primary cause of most chronic diseases, including diabetes. What is important: carbohydrates converted to glucose(sugar), fat, or how many calories. There are different opinions. They are all important for diabetics.

FAT: fat, especially saturated fat, is the primary cause of insulin resistance. Fat in the muscle and liver interferes with insulin action, by jamming the “door locks” on the muscle cells. Fat breakdown products create Toxic products that block insulin. Less fat intake has been shown to decrease insulin resistance (insulin works better). Not all fat affects our muscle cells. SATURATED fat from animals-meat, dairy, and eggs causes insulin resistance. Fat called monounsaturated and polyunsaturated found in – nuts, olives, and avocado, on the other hand, are protective.  Weight loss and eating healthy fat are key to managing diabetes.


The key to managing blood sugar is eating foods high in FIBER, including Geen vegetables, and legumes (peas, beans, lentils, and fruits.

limit highly processed foods (white bread, rice, cakes, cookies, juice, soda, etc.  Not only they have lost important nutrients such as fiber, vitamins, and minerals, and overeating refined carbohydrates, causes a significant rise in blood sugar.

Limit carbohydrates. Carbohydrates are digested to glucose (blood sugar) and diabetic people with less and ineffective insulin cannot handle the glucose surge in the bloodstream. Every time the blood glucose level is high, even for a few hours it damages our organs. Over time serious complications develop.  

FIBER: Fiber is a form of indigestible carbohydrate found in plant foods

There are two types of fiber: Insoluble fiber (meaning it can’t dissolve in water) found in whole grains. Soluble fibers found – beans, oats, fruits.

Soluble fiber improves both blood sugar by slowing absorption and insulin sensitivity. High-fiber diets may even lower the need for insulin. The risk for heart disease is very high in diabetes, eating high fiber lowers the risk of heart disease.  A study has shown that people, who consumed high fiber(more than 29 grams a day were 41% less likely to have heart disease.

PHYSICAL ACTIVITY/EXERCISE: for more look, up my previous discussion on activity

Physical activity and exercise are different. Physical activity is any body movement that requires energy, not sitting all day.

Exercise is a planned, structured activity that requires more heart and lung work; there are two types – aerobic and anaerobic exercise.

Aerobics exercise – requires oxygen such as walking, jogging, running, bicycling, swimming, basketball, soccer etc.)

Anaerobic exercise – that does not require oxygen, strengthening exercise.

Inactivity(sitting): If you don’t use it, you lose it.  1 to 2 percent loss of muscle mass every year. Weak muscle mass does not absorb blood sugar in addition to regular exercise (aerobic and aerobic.

So, avoid prolonged sitting. Some research shows that getting and moving around, even for a few minutes, every hour helps to lower blood sugar levels. Stand whenever you can.

Exercise: walking for about 15 minutes 40 minutes to 1 hour after each will help to lower blood sugar levels.

Strengthening exercise is one of the most important types of exercise for diabetes people because muscle is the largest organ in our body and strong muscle soaks up blood sugar like a sponge. The good thing is will continue to be active for 24 to 48 hours. If people with diabetes are not advised to do strengthening exercises, they are missing one of the most important components of managing blood sugar.

For exercise to work, you can’t stop exercising for more than a day.

SLEEP:  Sleep is the Third Pillar of health (sleep experts would it the pillar upon which all others are based on.)  We have a natural clock in our brain that regulates our sleep and wake cycle. There are different hormones that are active during wake and sleep time. At night our body is not able to digest food; instead, it is time for repair, cleaning up, detoxification, optimizing immune function, and consolidation of memories. The body needs enough time, 7 to 8 hours of sleep hours. Inadequate sleep can worsen diabetes and the accumulation of toxins that damage our cells. Since insulin is more effective during the day, diabetes is difficult to control without adequate sleep. A single sleep disturbance may reduce insulin sensitivity, even in a healthy person. It is also implicated in blood pressure and cardiovascular disease.

General steps to take:

Things that can help to control blood sugar (managing diabetes

1, drink 1 to 2 teaspoons of apple vinegar diluted in a medium size glass of water, 30 to 40 minutes before each meal. Use apple vinegar that says with the “MOM” (“MOTHER”).

2. Eat food with high fiber, such as vegetables, nuts, and legumes first, then, food with protein and carbohydrates last. This step will prevent the fast rise of glucose.

3. avoid eating late in the evening, because insulin works better early in the day. Never eat after 8 pm (last meal as early in the evening as you can manage, the earlier the better. But it may not be possible for shit work.

4. walking for about 15 minutes after each meal and regular exercise that includes resistance exercises.

5. sleep early and avoid eating for at least 1 hour in the morning after waking up because the day hormones are still low.

6. get 30 minutes of daylight in the morning

7. avoid small and frequent meals or snacks, as this will activate the pancreas to secrete insulin, and the cells that produce insulin will burn out.

8. avoid sitting for over 2 to 3 hours at a time (get up and move even for a few minutes).

9. adequate hydration.


11. watch an control your ABC(know their range at all times) and discuss with a physician.

This is not by no means a complete discussion, but it is a good start.

This applies also to general health but more to people in metabolic syndrome, prediabetics, and diabetes.

I will finish with my favorite saying of a cardiologist Dr. KIM Williams

“I don’t mind dying, I just don’t want it to be my fault.”

Do your best so that there are no regrets. After all that all we can do

Good luck

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