Lifestyle Lessons: 9 Tips For Managing Type 2 Diabetes
Medically reviewed on Apr 10, 2018 by L. Anderson, PharmD
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.
What is insulin resistance? Insulin resistance occurs when your cells do not respond to the insulin made by the beta cells in your pancreas. Glucose is not well absorbed from the bloodstream and more and more insulin is required. Eventually, the beta cells can't make enough insulin to counteract the insulin resistance, and glucose levels rise in the blood, leading to prediabetes and eventually type 2 diabetes, along with other health conditions.
In adults, type 2 diabetes is increasing in incidence due to:
- the growing number of older Americans
- increasing obesity
- poor diets
- lack of exercise.
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.
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 a heart attack, angina, stroke and poor circulation.
- 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.
Research has shown that keeping A1c levels below 7 percent can help to prevent complications. However, higher targets may be appropriate for some patients. You and your doctor will decide on your best target A1C level.
Meal Planning in Type 2 Diabetes
If you have diabetes you need to know how food affect 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. 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.
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 dcotor'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 met 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% of your body weight (10 to 14 pounds if you weigh 200 pounds).
- Moderate exercise (such as brisk walking, swimming or bicycling) 30 minutes a day, for 5 to 6 days per week.
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.
are great aerobic exercises, too.
Check with your doctor before you start any exercise program, especially if you've not been active lately. Learn how to stretch out to help prevent injury, too.
Learn More: Lifestyle Tips for Better Diabetes Control
Relax and De-stress
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 Dose At The Right Time
There are many classes of type 2 diabetes medications available to lower blood sugar levels.
It is also fairly common to need a combination of medicines. Effectiveness depends on the timing and dose size.
Medicines such as glipizide (Glucotrol), glyburide (Diabeta, Glynase) and repaglinide (Prandin) work by helping the pancreas produce more insulin. It's important that these tablets are taken at the right time in relation to a meal.
Another commonly used medication called metformin 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.
Acarbose (Precose) works by slowing down the absorption of glucose and is usually taken with the first bite of a meal.
Medications are used as an adjunct to diet and exercise to treat type 2 diabetes.
Put the Smokes Down
Quit smoking and you will probably add years to your life if you have type 2 diabetes; 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 affect the 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 prolong your life and add many years to your life.
- Be sure to get your blood pressure and cholesterol level checked regularly.
- Make sure you have an annual foot check, dental check and eye exam.
- Keep up with your required vaccines -- including a yearly flu shot and consider a hepatitis B series and the pneumonia vaccine, too.
- Discuss all of these items with your trusted doctor.
Pay Extra Attention to Your Feet...
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 feet issues.
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
- American Diabetes Association. Diabetes Basics. Facts About Type 2. Accessed April 10, 2018 at http://www.diabetes.org/diabetes-basics/type-2/facts-about-type-2.html
- Cleveland Clinic. Diabetes: Frequently Asked Questions. Accessed April 10, 2018 at http://my.clevelandclinic.org/health/diseases_conditions/hic_Diabetes_Basics/hic_Diabetes_Frequently_Asked_Questions
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Your Guide to Diabetes: Type 1 and Type 2. Accessed April 10, 2018 at https://www.niddk.nih.gov/health-information/diabetes/types