Lifestyle Lessons: 9 Tips For Managing Type 2 Diabetes
Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Aug 9, 2022.
Type 2 Diabetes: America's Expanding Epidemic
Diabetes is a common and chronic condition marked by high levels of sugar in the blood. Diabetes is problematic because it prevents your body from properly using the energy from the food you eat.
Type 2 diabetes is far more common than type 1 diabetes and makes up 90% or more of all cases of diabetes. In type 2 diabetes your body does not make or use insulin well due to "insulin resistance". The type 2 form usually occurs in adulthood, although more cases are now occurring in children due to obesity.
What is insulin resistance?
- Insulin resistance occurs when your cells do not respond to the insulin made by the cells in your pancreas.
- Glucose (sugar) is not well absorbed from the bloodstream and more and more insulin is required.
- Eventually, the cells can't make enough insulin to counteract the insulin resistance, and glucose levels rise in the blood.
- This may first lead to prediabetes and eventually type 2 diabetes, along with other serious health conditions.
In adults, type 2 diabetes is increasing in incidence due to: increasing obesity, unhealthy diets, lack of exercise, the growing number of older Americans.
Symptoms of Diabetes: What To Expect?
The symptoms of type 2 diabetes often come on gradually and can be quite vague at first. The most common symptoms are:
- increased thirst and hunger
- urinating frequently
- difficulty with healing; frequent infections, like thrush or vaginal yeast infections
- areas of darkened skin, known as acanthosis nigricans, which may be a sign of insulin resistance
- blurred vision
- weight loss.
Learn More: View the Drugs.com Type 2 Diabetes Overview
Long Term Effects of Poorly Managed Type 2 Diabetes
If your blood glucose levels are higher than normal over a long period of time it can gradually damage your blood vessels, which can lead to multiple complications.
- Hardening of the arteries can cause problems like poor circulation, a heart attack, angina (chest pain), and a stroke.
- Kidney damage may lead to kidney failure.
- Eye problems can affect vision.
- Nerve damage (diabetic neuropathy) and poor circulation can contribute to foot infections, dental problems and impotence.
It's important to have regular check-ups with your doctor, keep your blood sugar in line, and get regular exercise to help prevent complications from type 2 diabetes.
Your Goal A1C
The goal of treating type 2 diabetes is to keep your blood glucose levels in a normal range. This also helps to reduce the risk of developing complications.
A special blood test called HbA1c (glycated hemoglobin A1c test), often just abbreviated A1C, is used to check on blood glucose levels.
The A1C test gives a good indication of your average blood glucose level over the past 2 to 3 months. You and your doctor will decide on your best target A1C level; it is always a personalized approach.
Research has shown that keeping A1c levels below 7% can help to prevent complications in patients with diabetes. However, lower or higher targets may be appropriate for some people.
- Closer to 6.5% may be best for some patients to lower the risk from diabetes complications.
- Higher levels, closer to 8% may be better for older patients or those who experience low blood sugar levels.
Meal Planning in Type 2 Diabetes
If you have diabetes you need to know how food affects your blood sugar levels. The type of food you eat, the portion size, and the combinations are all important.
Make a diabetes meal plan with help from your health care team. Visit with a certified diabetes educator if you are able; many insurance plans will cover these visits.
Choose foods that are low in fat, sugar and salt, and high in fiber with plenty of fruit and vegetables. Drink water instead of sugary juice and soft drinks.
Switch to non-fat dairy. Avoid white breads, pasta, and rice, all sources of empty calories.
Portion size matters -- when eating a meal:
- fill half of your plate with fresh fruit and vegetables
- fill one quarter of your plate with lean protein such as beef, turkey or chicken (no skin)
- fill one quarter of your plate with a whole grain such as brown rice or whole grain pasta.
Avoid unhealthy snacking so you are hungry for nutritious food at meal time.
Plan your exercise in relation to when you eat for optimal effects, based on your doctor's recommendations.
Weight Loss Can Make a Difference
Don’t be unrealistic in your goal setting when it comes to losing weight.
Take small steps to set realistic goals to meet your target. Consider working with a dietician to help with your meal planning and to help get your blood sugar levels on a daily even keel. Eating well and moving more will help reduce the pounds. You don't have to lose a lot to make a big difference.
Studies have shown that you can lower your risk for type 2 diabetes by 50% if you meet these two goals:
- Losing roughly 5% to 7% or more of your body weight (at least 10 to 14 pounds if you weigh 200 pounds).
- Moderate to vigorous aerobic exercise (such as brisk walking, swimming or bicycling) for at least 150 minutes per week, spread over at least 3 days/week. Ideally, there should be no more than 2 consecutive days without activity. An example of one schedule could be 30 minutes a day, for 5 or 6 days per week.
- Shorter durations (minimum 75 minutes per week) of vigorous-intensity or interval training may be sufficient for younger and more physically fit individuals.
And don't forget to reward yourself every once in a while for a job well done!
Active Time is Time Well Spent
Try to set a goal of being active most days of the week – brisk walking for 30 minutes at least 5 times a week is advised.
Take it easy at first, try 10 minute walks three times a day and gradually increase time and distance. It's just as beneficial to exercise in smaller amounts of time several times per day; it all does not have to be done at one session. Other great aerobic exercises include:
Check with your doctor before you start any exercise program, especially if you've not been active lately. Learn how to stretch out before exercise to help prevent injury, too.
Relax and Unwind
Take time for yourself, and learn to lower stress.
It is common to feel overwhelmed, sad or angry when you are living with diabetes. These emotions can raise your blood sugar levels.
Ways you could lower your stress may include:
- Deep breathing, yoga, or tai chi
- Walking with a friend
- Listening to music
- Working on a hobby
- Ask for help if you are feeling down – from a family member, friend or counselor.
- Join a diabetes support group to learn from others and share your experiences, too.
- Volunteer your time to do good deeds and help others.
The Right Medicine to Control Blood Sugar
There are a wide range of classes of type 2 diabetes medications available to lower blood sugar levels. It is also fairly common to need a combination of medicines or even the addition of insulin. Medications are always used in combination with diet and exercise to treat type 2 diabetes, so don't give up on your good habits.
A commonly used oral medication called metformin (brand name: Glumetza, Riomet) helps insulin to work better on the body’s cells and should always be taken with food. This is often the first medication a patient receives in their regimen, and is a very affordable generic. It is classified as a biguanide. It can also be found in many combination medications with other classes of type 2 diabetes medicines.
Other drug classes used to treat type 2 diabetes include:
- Sulfonylureas, such as glipizide (Glucotrol), glyburide (Diabeta, Glynase) help your body secrete more insulin.
- Meglitinides, such as repaglinide (Prandin) and nateglinide (Starlix) stimulate the pancreas to secrete more insulin.
- Thiazolidinediones (also called glitazones) make the body's tissues more sensitive to insulin. Examples are rosiglitazone (Avandia) and pioglitazone (Actos).
- DPP-4 (Dipeptidyl peptidase 4 inhibitors) inhibitors include sitagliptin (Januvia), saxagliptin (Onglyza) and linagliptin (Tradjenta). They work by regulating the levels of insulin your body produces after eating, but can have a modest effect.
- GLP-1 receptor agonists (incretin mimetics) include exenatide (Byetta, Bydureon), liraglutide (Victoza) semaglutide (Rybelsus, Ozempic) and dulaglutide (Trulicity). They work by acting like the incretin hormones that the body normally produces naturally to stimulate the release of insulin in response to a meal. They slow digestion, lower blood sugar and prevent a steep rise in blood glucose after eating. They exist as mainly injectable medicines, although Rybelsus is now available as an oral option for semaglutide. They can lead to weight loss, and some may reduce the risk of heart attack and stroke. The Saxenda brand of liraglutide is used for weight loss only, not treatment of type 2 diabetes.
- SGLT2 Inhibitors (sodium-glucose cotransporter-2 inhibitors) help to increase sugar (glucose) excretion through the kidneys and urine. Like GLP-1 agonists, they have been shown to lower the risk of heart attack and stroke in high risk people. They have a low risk of hypoglycemia and can aid in weight loss. Examples include canagliflozin (Invokana), dapagliflozin (Farxiga), ertugliflozin (Steglatro) and empagliflozin (Jardiance).
Insulin, blood pressure medications, cholesterol-lowering treatments, and low-dose aspirin are other medicines often prescribed to patients with type 2 diabetes.
For a full overview of drug treatments and side effects for medicines used in type 2 diabetes, see the Drugs.com Diabetes Treatment Resource Guide.
Other Lifestyle Habits
Quit smoking and you will probably add years to your life - but get started now.
Smoking will raise your risk for many complications, including an elevated risk of vascular disease and a heart attack. Ask for help if you have trouble giving up.
Smoking cessation agents combined with group therapy may be the best way to quit smoking or tobacco of any form.
If you choose to drink, do so in moderation and always with a meal. The recommended limit of alcohol in patients with type 2 diabetes is:
- one drink per day for women
- two drinks per day for men age 65 or younger
- one drink a day for men over 65 years of age.
If you have an alcoholic drink, be sure to check your blood sugar before you go to bed, as alcohol can lead to swings in your glucose. Remember, alcohol is also empty calories, possibly adding weight to the scale. Instead, when at a party try a spritzer made with lime juice, soda water, and a twist.
Don't Put It Off: Add Years to Your Life
Your doctor and other health care providers can look for diabetes related complications and check that you are maintaining good control of your diabetes.
In fact, studies show that intensive diabetes control can add many years to your life.
- Be sure to get your blood pressure and cholesterol levels checked regularly, as recommended by your doctor.
- Make sure you have an annual foot check, dental check and eye exam, or as recommended by your doctor.
- Keep up with your required vaccines -- including a yearly flu shot, COVID vaccine and boosters, and consider a hepatitis B series and the pneumonia vaccine, too. All patients with type 2 diabetes should get the COVID vaccine if they are otherwise able to have the shot, as they may be at greater risk of more serious effects due to COVID infection.
- Discuss all of these preventive actions with your physician.
Feet Don't Fail Me Now
If you have diabetes, you're at greater risk of developing problems with your feet, including foot ulcers and infections from minor cuts. High blood sugar can lead to nerve damage and increase the risk for foot problems.
- Keep your nails short and your feet clean.
- Wear properly fitted shoes.
- Check your feet every day for blisters, cuts, sores, redness and swelling and see your doctor if you have sore feet or a foot problem that isn’t healing.
Good attention to foot care can help to prevent serious infections and even a toe, foot, or leg amputation.
Poor circulation can have a similar vascular effect on gums in your mouth, weakening them and making them more prone to infection.
Saliva is likely to contain higher than normal levels of glucose which will encourage the growth of gum disease-causing bacteria.
Good oral hygiene including brushing and flossing your teeth twice a day is essential. Visit your dentist on a regular schedule.
Finished: Lifestyle Lessons - 9 Tips For Managing Type 2 Diabetes
Are the latest diet pills the cure-all for the obesity epidemic? Here, see if prescription medicines for weight loss can help you lose weight.
Society tends to treat menopause as a disease; something to be avoided at all costs. But menopause can be positive. No more monthly mood swings, period accidents, or pregnancy worries. Self-confidence and self-knowledge...
- American Diabetes Association; Introduction: Standards of Medical Care in Diabetes—2022. Diabetes Care 1 January 2022; 45 (Supplement_1): S1–S2. https://doi.org/10.2337/dc22-Sint
- American Diabetes Association. Type 2 Diabetes Basics. Accessed August 9, 2022 at https://www.diabetes.org/diabetes/type-2
- American Diabetes Association; 4. Lifestyle Management. Diabetes Care 1 January 2017; 40 (Supplement_1): S33–S43. https://doi.org/10.2337/dc17-S007
- Cleveland Clinic. Diabetes Mellitus: An Overview. Accessed August 9, 2022 at https://my.clevelandclinic.org/health/diseases/7104-diabetes-mellitus-an-overview
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). What is diabetes? Accessed August 9, 2022 at https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes