People living with Type 2 diabetes have a lot to manage. They have to be careful about what they eat, get adequate exercise and they may have to monitor their blood sugar and get insulin therapy. Those things are even harder to do during a pandemic.

Family nurse practitioner Virginia “Ginny” Czimber of Novant Health Endocrinology in Shallotte, North Carolina has been helping patients maintain healthy routines during COVID-19. Here, she shares a few practical tips.

What new challenges are people with Type 2 diabetes facing these days?

Many of my patients are in the high-risk age group over 60, and they may have underlying medical conditions like heart disease. These patients are trying to limit their exposure to the public – which is exactly what they should be doing – but that means they’re making fewer (if any) trips to the supermarket and pharmacy.

They have limited access to fresh foods. They are relying more on processed, shelf-stable or frozen foods that have lower nutritional quality. This affects their diabetes management as well as weight and blood pressure.

What suggestions do you offer them?

Even here – in a small town on the coast – we have grocery stores that deliver. You order online, and they bring your groceries to you, or you can pick them up at the store without leaving your car. That’s a great way to minimize your exposure and still get fresh fruits and vegetables every week.

I’ve also suggested that patients team up with their neighbors. If you can get three friends who live nearby to share the grocery shopping with you, then you’re only going once a month.

There are lots of pitfalls for all of us in spending so much time at home, right?

Yes. Even my younger patients who are working from home are spending more time in the kitchen and less time outside walking. Gyms are currently unavailable. The decreased activity level, in combination with easier access to snacking, leads to what I refer to as the “COVID-10.” It’s similar to the “Freshman Five” – the pounds many people gained during their first semester of college.

So, what can we do?

Gyms may be closed, but we can still walk outside – with a mask on. Down where we are, if you can get to the beach early enough, you can have it almost to yourself. We have lots of golf course communities in this area, and they offer good walking paths. I know people miss walking with a friend, but the safest way to exercise these days is by yourself.

Our local cable provider shows exercise classes three times a day that were filmed at the local college’s fitness studio. I tell my patients to DVR it if the times aren’t convenient.

Lots of my patients have been to physical therapy and they get those elastic bands to use for a gentle workout. I tell them to use those, even if they’re sitting down on the couch watching TV. They can still do stretches. We have to get creative.

What about the mindless snacking?

Research shows that people who track their food intake lose weight faster and keep it off longer. Writing it down make you more conscious of what you’re eating. Even if you’re the only one who sees your food log, you’re keeping yourself accountable.

All this isolation can have an emotional and psychological toll, right?

In some patients, pandemic anxiety added to the already present chronic disease stress decreases their ability to cope, and they can end up making unhealthy choices. I’ve been recommending the free apps you can get on your phone that walk you through meditation and relaxation exercises. There’s a free app for everything.

Learn something new. Pick up a new hobby.

You can stay in touch with friends and family. In fact, you need to. Reach out to them; don’t wait for them to contact you. My kids and grandkids are 700 miles away, so I get it. But I’m on the phone with one of them at least once a day.

Are your patients taking mask wearing seriously?

Yes. We’ve been offering video visits to patients. But when you come to our office, you have to wear a mask. But I always ask if they’re wearing a mask whenever they venture out, and almost all of them are. When you have a chronic condition, you really have to take care of yourself.

The coronavirus is here to stay for a while. We have to adjust.

Czimber offers these recipes to her patients. They’re both part of her own summertime repertoire.

Easy summer chicken

(Serves 4)

4 boneless, skinless chicken breasts 1 tsp. garlic powder

1 tsp. onion powder 1 tsp. paprika

¾ tsp. fresh ground pepper ¾ tsp. kosher salt

¾ tsp. dried rosemary 1 tbsp. olive oil or olive oil spray

Combine all dried spices. Sprinkle half the spice mixture on each side of the chicken. Pat the spices to make them adhere.

If you are grilling outside, spray the chicken with olive oil spray. If cooking on a grill pan, coat the pan with 1 tablespoon of olive oil. Cook over medium heat for five minutes on each side or until juices run clear and chicken is done.

Watermelon-feta salad

3 cups of seedless watermelon, cubed

1½ cups sliced English cucumber, seeded

1/3 cup feta cheese crumbled 1 tbsp. chopped mint

3 tbsp. olive oil 1 tbsp. balsamic vinegar

Salt and pepper, to taste

Mix the watermelon, cucumber and mint in a large bowl. In a separate bowl, mix the oil, vinegar, salt and pepper. Whisk to combine. Pour the dressing over the watermelon mixture and stir to coat. Sprinkle feta cheese on top and serve.

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