Diabetes is on the rise in our society, affecting over 9{d0e74b8a3596e4326b45924d39792f257a1f9983beed4201831d386befd3d18e} of the population, with type 2 diabetes accounting for 90-95{d0e74b8a3596e4326b45924d39792f257a1f9983beed4201831d386befd3d18e} of all new diagnoses of diabetes (CDC, 2014). Type 2 diabetes results from decreased insulin sensitivity in the liver, muscle, and adipose tissues; and reduced pancreatic function leading to impaired insulin secretion. Insulin is a hormone that regulates the level of sugar (glucose) in the bloodstream. Some patients with type 2 diabetes may eventually require insulin if dietary changes and/or oral medications fail to control blood glucose levels sufficiently. Risk factors for developing diabetes include older age, obesity, family history of diabetes (or history of gestational diabetes), physical inactivity, and certain ethnicities, which are more at risk.

If diabetes is not adequately controlled, it can lead to serious complications such as cardiovascular disease, retinopathy and blindness, kidney damage, and neuropathy. Early blood sugar control, lifestyle changes, and risk factor reduction (such as stopping smoking, lowering blood pressure and hyperlipidemia by diet, exercise, and medications) can significantly improve outcomes for patients with type 2 diabetes.

Tips for Dealing with Diabetes

• Take control and responsibility for your health. Diabetes is a complex, chronic disease that people must learn to manage themselves for best outcomes. Educate yourself and find a support group. With proper interventions, diabetes can be managed. Check out Diabetes Support Group and to find a local group within the American Diabetes Association.
• Get your hemoglobin A1C blood test done at least twice a year or as recommended by your healthcare provider. This test will show how well your blood sugar has been controlled over time. The goal is to get this lab value below 6.5{d0e74b8a3596e4326b45924d39792f257a1f9983beed4201831d386befd3d18e}. Don’t be discouraged as the National Health and Nutritional Examination Survey found that only 55{d0e74b8a3596e4326b45924d39792f257a1f9983beed4201831d386befd3d18e} of patients taking antidiabetic medication in 2005-2010 achieved HbA1c less than 7{d0e74b8a3596e4326b45924d39792f257a1f9983beed4201831d386befd3d18e}.
• Make needed dietary changes. Diabetics generally should limit sugars and maintain steady carbohydrates in the diet. Increasing vegetables and unprocessed foods in the diet is recommended, as well as limiting saturated fat, salt and sugars. If you are a newer diabetic, consult with a dietician at your local hospital for resources. Many local hospitals offer free education classes for diabetics. The American Diabetes Association website offers meal planning tools. Check serving sizes and maintain a healthy weight. You can also use these three tips to eat right:
  • Make your plate more colorful. It’s an easy way to increase fruits, vegetables, whole grains, nuts, beans, and lean protein in your diet.
  • Find Fiber. Eat more plant foods such as whole grains, fruits, vegetables, beans, and nuts. Studies propose that type 2 diabetics who eat a high-fiber diet can improve their blood sugar and cholesterol levels.
  • Stay on Schedule.Never skip meals which can result in hypoglycemia. Eat meals and snacks at similar times every day. If you take diabetes medications, eat your meals and take your medicine at the same times every day.
• Exercise regularly. Exercise can lower blood sugar levels and boost your body’s ability to use insulin. The American Heart Association recommends at least 150 minutes of moderate exercise per week (that’s 30 minutes 5 days a week or however you want to divide it out). Exercise will help to maintain a healthy weight, fight stress and heart disease, and improve overall well-being. For exercise guidelines for people with diabetes, visit WebMD. You should always talk to your healthcare provider before beginning an exercise routine so they may make any needed adjustments to your medications or meal plans.
• Stop smoking It is never too late to quit smoking and there are many resources available to help support you. Visit Quitter’s Circle.
• Understand hypoglycemia (low blood glucose) and be ready to treat it. Hypoglycemia is when your blood sugar drops too low, usually as a complication of diabetes medications. It can have serious consequences such as seizures, unconsciousness, or even death. Recognize the symptoms of low blood sugar such as shakiness, nervousness, sweating, headache, coldness, or nausea. People with diabetes can carry with them glucose tablets or gel to treat hypoglycemia when it happens.
• Wear a medical ID bracelet or necklace that shows you have diabetes.
• Be aware of blood sugars. Check your own blood sugars at home before meals. Using a glucometer to check your own blood sugars is the main way to stay in control of the progression of your diabetes and to know whether it is improving. The goal is to have blood sugars less than 130 before eating. For more information on checking blood sugars visit website the American Diabetic Association.
• Understand your medications. Most diabetics will need higher doses and additional medications added over time to achieve glycemic control of blood sugars. There are many different types of antidiabetic medications, such as Metformin, Sulfonylureas, Meglitinides, TZD’s, GLP-1 RA’s, insulin, and others. Become educated on how your medications work and what side effects to anticipate. Follow instructions from your healthcare provider about when to take your medications and always be prepared should hypoglycemia occur. Newer medications such as SGLT2 inhibitors have less chance of hypoglycemia and may actually assist with weight loss.

More and more people are learning to live with type 2 diabetes. Living with any chronic disease can be challenging to one’s mental and emotional health. Finding others to support you in this journey is essential. Becoming educated and taking control of your own health maintenance is  crucial for improving diabetes and preventing complications.

References

1. Centers for Disease Control and Prevention. (2014).
2. National Diabetes Statistic Report: Estimates of diabetes and its burden in the US, 2014
3. Joslin Diabetes Center