Treatment for type 2 diabetes requires a lifelong commitment to:
These steps will help keep your blood sugar level closer to
normal, which can delay or prevent complications.
If managing your diabetes seems overwhelming, take it one day
at a time. And remember that you’re not in it alone. You’ll work
closely with your diabetes treatment team — doctor, diabetes
educator and registered dietitian — to keep your blood sugar
level as close to normal as possible.
Monitoring your blood sugar
Depending on your treatment plan, you may check and record
your blood sugar level once a day or several times a week. Ask
your doctor how often he or she wants you to check your blood
sugar. Careful monitoring is the only way to make sure that your
blood sugar level remains within your target range.
Even if you eat on a rigid schedule, the amount of sugar in your
blood can change unpredictably. With help from your diabetes
treatment team, you’ll learn how your blood sugar level changes
in response to:
level. Blood sugar is typically highest one to two hours after a
meal.
into your cells. The more active you are, the lower your blood
sugar level.
sugar level, sometimes requiring changes in your diabetes
treatment plan.
hormones that raise your blood sugar level.
drinks can cause either high or low blood sugar, depending on
how much you drink and if you eat at the same time.
prolonged stress may prevent insulin from working properly.
levels fluctuate during your menstrual cycle, so can your blood
sugar level — particularly in the week before your period.
Menopause may trigger fluctuations in your blood sugar level
as well.
Healthy eating
Contrary to popular perception, there’s no diabetes diet. You
won’t be restricted to a lifetime of boring, bland foods. Instead,
you’ll need plenty of:
These foods are high in nutrition and low in fat and calories.
You’ll also need to eat fewer animal products and sweets.
Counting carbohydrates in your food is another thing you’ll need
to incorporate into meal planning. A registered dietitian can help
you learn to count carbohydrates and put together a meal plan
that fits your health goals, food preferences and lifestyle. Once
you’ve covered the basics, remember the importance of
consistency. To keep your blood sugar on an even keel, try to
eat the same amount of food with the same proportion of
carbohydrates, proteins and fats at the same time every day.
Low glycemic index foods may also be helpful. The glycemic
index is a measure of how quickly a food causes a rise in your
blood sugar. Foods with a high glycemic index raise your blood
sugar quickly. Low glycemic foods may help you achieve a more
stable blood sugar. Foods with a low glycemic index typically
are foods that are higher in fiber.
Physical activity
Everyone needs regular aerobic exercise, and people who have
type 2 diabetes are no exception. Get your doctor’s OK before
you start an exercise program. Then choose activities you enjoy,
such as walking, swimming or biking. What’s most important is
making physical activity part of your daily routine. Aim for at
least 30 minutes of aerobic exercise most days of the week.
Stretching and strength training exercises are important, too.
In fact, a combination of aerobic exercise and strength training
is more effective at controlling blood sugar than either exercise
on its own. If you haven’t been active for a while, start slowly
and build up gradually.
Remember that physical activity lowers blood sugar. Check your
blood sugar level before any activity. You might need to eat a
snack before exercising to help prevent low blood sugar if you
take diabetes medications that lower your blood sugar or insulin.
Diabetes medications and insulin therapy
Some people who have type 2 diabetes can manage their blood
sugar with diet and exercise alone, but many need diabetes
medications or insulin therapy. The decision about which
medications are best depends on many factors, including your
blood sugar level and the presence of any other health problems.
Your doctor might even combine drugs from different classes to
help you control your blood sugar in several different ways.
be prescribed metformin (Glucophage), a diabetes medication
that lowers glucose production in the liver. Your doctor will also
recommend lifestyle changes, such as losing weight and
becoming more active.
used to treat type 2 diabetes. Some diabetes medications
stimulate your pancreas to produce and release more insulin.
Still others block the action of enzymes that break down
carbohydrates or make your tissues more sensitive to insulin.
low-dose aspirin therapy as well as blood pressure and cholesterol
lowering medications to help prevent heart and blood vessel
disease.
insulin therapy as well. Because normal digestion interferes with
insulin taken by mouth, insulin must be injected.
insulin pen injector — a device that looks like an ink pen, except
the cartridge is filled with insulin.
about the size of a cell phone worn on the outside of your body.
A tube connects the reservoir of insulin to a catheter that’s
inserted under the skin of your abdomen. A tubeless pump that
uses disposable pods to hold the insulin and a wireless device
to tell the pump what to do is also available. A small catheter
from the pod is automatically inserted under the skin, and the
pod can be worn on the abdomen, lower back, thighs or upper
arms. Whichever insulin pump you use, it can be programmed to
dispense specific amounts of insulin automatically. It can also
be adjusted to deliver more or less insulin depending on meals,
activity level and blood sugar level.
long-acting insulin and intermediate options. Examples include
insulin lispro (Humalog), insulin aspart (NovoLog), insulin glargine
(Lantus) and insulin detemir (Levemir).
Depending on your needs, your doctor may prescribe a mixture
of insulin types to use throughout the day and night.
Bariatric surgery
If you have type 2 diabetes and your body mass index (BMI) is
greater than 35, you may be a candidate for weight-loss surgery
(bariatric surgery). Blood sugar levels return to normal in 55 to
95 percent of people with diabetes depending on the procedure
performed. Surgeries that bypass a portion of the small intestine
have more of an effect on blood sugar levels than do other
weight-loss surgeries. However, the surgery is expensive and
there are risks involved, including a slight risk of death.
Additionally, drastic lifestyle changes are required and long-
term complications may include nutritional deficiencies and
osteoporosis.
Pregnancy
Women with type 2 diabetes will likely need to alter their
treatment during pregnancy. Although there’s no evidence that
metformin is harmful to a growing fetus, studies haven’t been
done to definitively establish its safety in pregnancy. So, during
pregnancy, you’ll be switched to insulin therapy. Also, many
cholesterol and blood pressure lowering medications can’t be
used during pregnancy. If you have signs of diabetic retinopathy,
it may worsen during pregnancy. Visit your ophthalmologist during
the first trimester of your pregnancy and at one year postpartum.
Signs of trouble
Because so many factors can affect your blood sugar, problems
sometimes arise. These conditions require immediate care,
because if left untreated, seizures and loss of consciousness
(coma) can occur.
for many reasons, including eating too much, being sick or not
taking enough glucose-lowering medication. Check your blood
sugar level often, and watch for signs and symptoms of high
blood sugar — frequent urination, increased thirst, dry mouth,
blurred vision, fatigue and nausea. If you have hyperglycemia,
you’ll need to adjust your meal plan, medications or both.
cells are starved for energy, your body may begin to break
down fat. This produces toxic acids known as ketones.
Watch for loss of appetite, weakness, vomiting, fever,
stomach pain and a sweet, fruity smell on your breath. You
can check your urine for excess ketones with an
over-the-counter ketones test kit. If you have excess ketones
in your urine, consult your doctor right away or seek emergency
care. This condition is more common in people with type 1
diabetes.
symptoms of this life-threatening condition include a blood
sugar reading over 600 mg/dL, dry mouth, extreme thirst, fever
over 101 F (38 C), drowsiness, confusion, vision loss, hallucinations
and dark urine. Hyperosmolar syndrome is caused by sky-high
blood sugar that turns blood thick and syrupy. It tends to be
more common in people with type 2 diabetes, and it’s often
preceded by an illness. Hyperosmolar syndrome usually develops
over days or weeks. Call your doctor or seek immediate medical
care if you have signs or symptoms of this condition.
below your target range, it’s known as low blood sugar. Your
blood sugar level can drop for many reasons, including skipping
a meal and getting more physical activity than normal. However,
low blood sugar is most likely if you take glucose-lowering
medications that promote the secretion of insulin or if you’re on
insulin therapy. Check your blood sugar level regularly, and
watch for signs and symptoms of low blood sugar — sweating,
shakiness, weakness, hunger, dizziness, headache, blurred vision,
heart palpitations, slurred speech, drowsiness, confusion and
seizures.
If you develop hypoglycemia during the night, you might wake
with sweat-soaked pajamas or a headache. Thanks to a natural
rebound effect, nighttime hypoglycemia might cause an unusually
high blood sugar reading first thing in the morning.
If you have signs or symptoms of low blood sugar, eat or drink
something that will quickly raise your blood sugar level —
fruit juice, glucose tablets, hard candy, regular (not diet) soda
or another source of sugar. Retest in 15 minutes to be sure
you’re blood glucose levels are normal. If they’re not, treat
again and retest in another 15 minutes. If you lose consciousness,
a family member or close contact may need to give you an
emergency injection of glucagon, a hormone that stimulates
the release of sugar into the blood.
Treatment for type 2 diabetes requires a lifelong commitment to:
Blood sugar monitoring.. ">
Treatment for type 2 diabetes requires a lifelong commitment to:
Blood sugar monitoring.. ">
Treatment for type 2 diabetes requires a lifelong commitment to:
Blood sugar monitoring.. ">
