In an earlier post, I explained prediabetes and how to prevent or delay the onset of type 2 diabetes. Perhaps you were not aware that you ever had prediabetes and didn’t know you were headed down this road. That’s ok. Although, diabetes is not curable, it can still be well managed to minimize risk of complications. Let’s start first by understanding what it means to be diabetic (with type 2 diabetes).
What is type 2 diabetes?
When you have type 2 diabetes, your body has a hard time using blood sugar (glucose) to fuel your cells. As a result, your blood sugar level becomes too high. Over time, elevated blood sugar levels cause damage to your blood vessels, both small and large. This can lead to complications such as heart attack, stroke, eye disease, kidney problems, erectile dysfunction, nerve damage, and risk of limb loss (or amputation).
While the potential complications are serious, making a few lifestyle adjustments to control your blood sugar can have a positive impact on long-term quality of life. Change isn’t easy, and managing diabetes will require a shift in routine. However, with practice, your new lifestyle can become a habit.
Know Your Numbers
It is important to monitor the level of glucose in your blood, so that you can make informed decisions about your diabetes management.
A diabetes educator (often a nurse) can teach you how to use a blood glucose meter to track your blood sugar daily, and show you how to use your insulin, as prescribed, if needed. The blood sugar reading should be in your target range as often as possible. These numbers are often tracked in the morning, before and 2 hours after a meal, and/or at bedtime.
Monitoring your levels daily is important, but checking your A1C is how you can tell if your treatment plan is working over time. An A1C is a blood test that measures your average blood glucose (by measuring how much glucose is inside red blood cells) and is often tested every 2 to 3 months.
Food, physical activity, and certain medications can raise or lower blood sugar, and sometimes by too much. When your levels get too high or low, it can be very dangerous! Your healthcare provider can determine what levels are dangerous for you.
Managing Blood Sugar
The goal in maintaining blood sugar control is to remain within your target range as much as possible. Lifestyle management is crucial for long term benefits, however there are also immediate resolutions to reaching this objective when blood sugar spikes or dips outside of range.
To prevent blood sugar levels outside of the target range, a healthy lifestyle is the first line of defense. Similar to the lifestyle modifications recommended for prediabetes, managing type 2 diabetes includes:
However, unlike prediabetes, type 2 diabetes sometimes involves the use of insulin for blood sugar control.
A balanced diet is full of lean animal and plant proteins (chicken,turkey, fish, beef, pork, beans, and quality protein supplements), starchy and fibrous vegetables, nuts, seeds, and healthy fats and oils. Of the macronutrients (carbohydrates, proteins, and fats), carbohydrates have the greatest impact on blood sugar levels. That means it is important to know which food sources have carbohydrates and understand portion sizes. Keeping carbohydrate intake consistent day-to-day has shown to have a positive effect on long-term glucose control. Additionally, increasing fiber intake to as much as 44-50 grams daily can help keep prevent blood sugar spikes and dips. This topic will be discussed in more detail in a post on “Meal Planning for Diabetes”.
Physical activity, even in the absence of weight loss, improves blood sugar control both immediately and over time. It is recommended to include 60-90 minutes of moderate-intensity exercise on most days of the week. Start small, then work your way into longer and more intense sessions. Aerobic activity as well as high intensity interval training (HIIT) shows improvement on insulin sensitivity (which is directly correlated with blood sugar control). Therefore, choose an activity that you enjoy, so you are more likely to be stay consistent. As always, talk to your healthcare provider before starting a new program.
Weight loss, if you are overweight, also improves insulin sensitivity. A 5-10% reduction in weight is enough to see benefits, however you can establish your weight goals with your health care team.
A healthy lifestyle can help manage blood sugar levels most of the time, however there may be occasions when blood glucose levels go too high or low. This requires more immediate action and close monitoring.
Hypoglycemia, or low blood sugar, means your blood sugar is under 70. This can happen quickly and you may experience symptoms such as sweating or clammy skin, dizziness, shakiness, tingling feeling, hard or fast heartbeat, headache, confusion or irritability. Always check your blood sugar right away if you feel symptoms. If it is too low, eat 15 grams of fast-acting sugar (such as 3-4 glucose tablets or 4oz fruit juice), and re-check in 15 minutes. If it remains too low, repeat eating 15 grams of fast-acting sugar. If it is still too after checking again, then call your healthcare provider. Once your blood sugar rises, eat a balanced snack or your next planned meal.
Hyperglycemia, or high blood sugar, means your level may be around 200 or higher. Symptoms such as increased thirst, increased urination, increased tiredness, and blurred vision may occur. Again, check your blood sugar if you feel any of these symptoms. If it is too high, drink plenty of water, go for a walk, and if you take insulin, you may need to take an extra dose (ask your healthcare provider about taking extra insulin). Check blood sugar every few hours and contact your provider if levels do not go down or if symptoms worsen.
Being diagnosed with type 2 Diabetes can be overwhelming, but you don’t have to feel alone. A team of healthcare experts can teach you how to manage diabetes effectively. Having family (and friends’) support is very helpful as well.
Your diabetes healthcare team often includes a primary care provider, an endocrinologist, registered dietitian, diabetes educator, health psychologist, and a pharmacist.
Your family and friends can support in a variety of ways. They want to help you and care about your health, so ask for their assistance when needed. A healthy lifestyle benefits everyone, and sometimes it is helpful to make adjustments in diet and physical activity together.
American Heart Association: heart.org
National Diabetes Information Clearinghouse: www.diabetes.niddk.nih.gov
Academy of Nutrition and Dietetics: Eatright.org
American Diabetes Association: Diabetes.org
Please email me at StephanieBrustRD@gmail.com if you have any questions.
American Diabetes Association. (2014). Diagnosis and Classification of Diabetes Mellitus. Diabetes Care , 37, Supplement 1.
Chandalia, et al. (2000). Beneficial Effects of High Dietary Fiber Intake In Patients with Type 2 Diabetes Mellitus. The New England Journal of Medicine. 342, 1392-1398
Duncan, et al. (2003). Does Exercise Without Weight Loss Improve Insulin Sensitivity? Diabetes Care. 26 (3) 944-945