How to Improve What Really Matters: Quality of Life, not Longevity
For many years, I have focused on aspects of lifestyle and health management that can enhance quality of life, especially when living with diabetes, rather than simply on living a long time (longevity). Much of my motivation is derived from watching my maternal grandmother suffer through six (long) years of severe disability related to cardiovascular complications of diabetes starting at the age of 70 that left her unable to feed herself or communicate, bed bound, and with almost no quality of life for her final six years. Really, what is the point of simply being alive in that case? This topic has come up again recently. New research published online ahead of print in Diabetologia in Spring 2016 (1) presented results showing that the life expectancy and disability-free life expectancy at age 50 years were 30.2 years and 12.7 good years, respectively, for men with diabetes, and 33.9 years and 13.1 good years for women with diabetes.
Really think about what those estimates mean: If you’re female and have diabetes at age 50, you would be expected to live almost to age 84, but likely be disabled in some way from the age of 71 forward. If the disability is severe (as in the case of my stroked-out grandmother), then that is a lot of pointless years of being alive without really living, not to mention being a huge burden to your family.
Admittedly, that’s pretty discouraging. The best solution may be to focus on what we can do to prevent disability with aging rather than simply living longer. Here are three proven ways to improve your quality of life with diabetes (and likely your longevity):
Exercise regularly and be more physically active overall. Even if you already have some diabetes health issues like peripheral neuropathy, which can negatively impact quality of life, exercising regularly can help. In older adults with diabetes and neuropathy, engaging in just 8 weeks of moderate-intensity aerobic exercise improved their quality of life and led to less pain, more feeling in their feet, less restriction in their activities of daily living, better social interactions, and a greater overall life quality—just after 8 weeks of training (2). Other types of physical activity have similar and profound effects on living well with neuropathy (3), so choose what you enjoy doing the most and start with those.
Eat more fiber, found abundantly naturally in plant-based foods. We all know we should be eating more fiber, but where can you find it (besides in Metamucil, which may not have the same health benefits)? Look for it in plant-based foods, mainly fruits, vegetables, grains, beans, and nuts and seeds. Dietary fiber and whole grains contain a unique blend of bioactive components including resistant starches, vitamins, minerals, phytochemicals, and antioxidants, all of which are critical to healthy living. A higher fiber intake helps prevent or protect against health issues that can decrease both quality of life and longevity, including constipation, hemorrhoids, colon cancer, gastric reflux, obesity, diabetes, stroke, and cardiovascular diseases (4). It also keeps the healthful gut bacteria in your digestive tract more abundant, which directly can benefit health and even prevent obesity. Aim for as much as 50 grams of fiber in your daily diet for optimal health.
Improve the quality and quantity of your sleep. Both sleeping better and sleeping enough (7 to 8 hours a night for most adults) lower insulin resistance and can help improve diabetes control; alternately, not getting enough good sleep can make your blood glucose levels much harder to manage. As you age, it may require taking a melatonin supplement to help you fall asleep and improve diabetes control (5), but exercising regularly certainly assists as well, so try taking your daily dose of exercise to optimize sleep. Get started on these three easy changes today to improve your chances for living longer without disabilities. Remember, there's more to life than living a long time. What's the point of living longer if you can't live well and feel your best every day of your life? It really is your choice to make because you can affect the outcome.
1. Huo L, et al. “Burden of diabetes in Australia: life expectancy and disability-free life expectancy in adults with diabetes” Diabetologia 2016; DOI: 10.1007/s00125-016-3948-x. 2. Dixit S, Maiya A, Shastry B: Effect of aerobic exercise on quality of life in population with diabetic peripheral neuropathy in type 2 diabetes: a single blind, randomized controlled trial. Quality of Life Research 2014;23:1629-1640
3. Streckmann F, Zopf EM, Lehmann HC, May K, Rizza J, Zimmer P, Gollhofer A, Bloch W, Baumann FT: Exercise intervention studies in patients with peripheral neuropathy: a systematic review. Sports Med 2014;44:1289-1304
4. Otles S, Ozgoz S: Health effects of dietary fiber. Acta Scientiarum Polonorum Technologia Alimentaria 2014;13:191-202
5. Grieco CR, Colberg SR, Somma CT, Thompson A, Vinik AI: Melatonin supplementation lowers oxidative stress and improves glycemic control in type 2 diabetes. International Journal of Diabetes Research, 2(3): 45-49, 2013 (doi: 10.5923/j.diabetes.20130203.02)