American Diabetes Association (ADA). Standards of Medical Care in Diabetes – 2018. Diabetes Care 2018 Jan; 41(Supplement 1): S1-S2. Accessed Jan. 27, 2018 at https://care.diabetesjournals.org/content/diacare/suppl/2017/12/08/41.Supplement_1.DC1/DC_41_S1_Combined.pdf
Jump up ^ Campbell LK, Gonder-Frederick LA, Broshek DK, Kovatchev BP, Anderson S, Clarke WL, Cox DJ (2010). “Neurocognitive differences between drivers with type 1 diabetes with and without a recent history of recurrent driving mishaps”. International Journal of Diabetes. 2 (2): 73–77. doi:10.1016/j.ijdm.2010.05.014.
Typically, a person needs to eat about every four to six hours during the day to maintain energy levels. “People with type 2 diabetes usually have better blood glucose control if their meals and grams of carbohydrates are spaced evenly throughout the day,” says Connie Crawley, M.S., RD, LD, a nutrition and health specialist.
Once you understand that, the remedy becomes clear: To reverse the disease, you need to recover your body’s insulin and leptin sensitivities. The ONLY way to accomplish this is through proper diet and exercise. Bariatric surgery, which is being increasingly recommended as a diabetes treatment, will NOT do the trick, and there is NO drug that can correct leptin signaling and insulin resistance..
Sugar and processed carbohydrates should be limited, says Massey. That includes soda, candy, and other packaged or processed snacks, such as corn chips, potato chips, and the like. And while artificial sweeteners like those found in diet sodas won’t necessarily spike your blood sugar in the same way as sugar, they could still have an effect on your blood sugar and even alter your body’s insulin response, though more research is needed to confirm this.
Long-term use of metformin may be associated with biochemical vitamin B12 deficiency, and periodic measurement of vitamin B12 levels should be considered in metformin-treated patients, especially in those with anemia or peripheral neuropathy. B
Type 1 Type 2 LADA Gestational diabetes Diabetes and pregnancy Prediabetes Impaired fasting glucose Impaired glucose tolerance Insulin resistance KPD MODY Neonatal Transient Permanent Type 3c (Pancreatogenic)
The good news about type 2 diabetes is that if you do the diabetes treatment steps listed above, your blood sugar levels can return to a healthier range. For some people with type 2 diabetes, that can mean not even needing to take diabetes medicines anymore.
Trick (important): Cut down on sweets, and if you can, cut them out entirely for a couple months. I still eat ice cream about once a week, and know people who are losing weight on this diet while eating ice cream almost every day. But this probably won’t be the case for everyone. Better to severely restrict sweets for the first few months, and then gradually reintroduce.
Physical activity. Everyone needs regular aerobic exercise, and people who have diabetes are no exception. Exercise lowers your blood sugar level by moving sugar into your cells, where it’s used for energy. Exercise also increases your sensitivity to insulin, which means your body needs less insulin to transport sugar to your cells. Get your doctor’s OK to exercise. 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 or more of aerobic exercise most days of the week. If you haven’t been active for a while, start slowly and build up gradually.
Aside from the financial costs of diabetes, the more frightening findings are the complications and co-existing conditions. In 2014, 7.2 million hospital discharges were reported with diabetes as a diagnosis. Patients with diabetes were treated for major cardiovascular diseases, ischemic heart disease, stroke, lower-extremity amputation and diabetic ketoacidosis.
© 2004-2018 All rights reserved. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.
Education regarding matching prandial insulin dosing to carbohydrate intake, premeal glucose levels, and anticipated activity should be considered, and selected individuals who have mastered carbohydrate counting should be educated on fat and protein gram estimation (3–5). Although most studies of multiple daily injections versus continuous subcutaneous insulin infusion (CSII) have been small and of short duration, a systematic review and meta-analysis concluded that there are minimal differences between the two forms of intensive insulin therapy in A1C (combined mean between-group difference favoring insulin pump therapy –0.30% [95% CI –0.58 to –0.02]) and severe hypoglycemia rates in children and adults (6). A 3-month randomized trial in patients with type 1 diabetes with nocturnal hypoglycemia reported that sensor-augmented insulin pump therapy with the threshold suspend feature reduced nocturnal hypoglycemia without increasing glycated hemoglobin levels (7). The U.S. Food and Drug Administration (FDA) has also approved the first hybrid closed-loop system pump. The safety and efficacy of hybrid closed-loop systems has been supported in the literature in adolescents and adults with type 1 diabetes (8,9).
High blood sugar can also cause numbness, burning, or tingling in the hands, legs, and feet. This is caused by diabetic neuropathy, a complication of diabetes that often occurs after many years of high blood sugar levels.
If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications. Talk to your doctor about ways to stop smoking or to stop using other types of tobacco.
The sneakiest source of simple carbs are sugary beverages: sodas, juices (fresh squeezed and from concentrate), sweetened tea and coffee beverages, drink mixers and the ilk. That’s why it’s crucial to cut these out as much as possible when you’ve been diagnosed with prediabetes or type 2 diabetes. Since they’re quickly digested and absorbed, they rapidly raise blood sugar — as soon as 15 minutes after drinking ’em.
In addition to the A1C test, your doctor will take blood and urine samples periodically to check your cholesterol levels, thyroid function, liver function and kidney function. The doctor will also assess your blood pressure. Regular eye and foot exams also are important.
The Diabetes Prevention Program conducted a randomized clinical trial over three years and found that diabetes incidence in high-risk adults was reduced by 58 percent after they followed intensive lifestyle intervention compared to 31 percent after taking medication (metformin). Both were significantly more impactful at preventing complications compared with taking a placebo or not making lifestyle changes. And the positive changes lasted at least 10 years after the study was done! (5)
Compared with repeated daily blood sugar tests, the A1C test is a better indicator of how well your diabetes treatment plan is working. An elevated A1C level may signal the need for a change in your medication, meal plan or activity level.
Hyperglycemic hyperosmolar nonketotic syndrome. Signs and symptoms of this life-threatening condition include a blood sugar reading over 600 mg/dL (33.3 mmol/L), dry mouth, extreme thirst, fever, drowsiness, confusion, vision loss and hallucinations. 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. Call your doctor or seek immediate medical care if you have signs or symptoms of this condition.
Jump up ^ Elkholy, Suzanne; Lardhi, Amer A. (2015-05-01). “Do we need to test for maturity onset diabetes of the young among newly diagnosed diabetics in Saudi Arabia?”. International Journal of Diabetes Mellitus. 3 (1): 51–56. doi:10.1016/j.ijdm.2011.01.006.
All vegetables are crucial to a healthy diabetes diet, but leafy greens pack a particularly powerful punch. Rich in nutrients such as magnesium and vitamin K, kale and its cousins have been linked to better blood sugar control, according to the Reader’s Digest 2-Day Diabetes Diet book. Cruciferous veggies also contain a compound called sulforaphane, which has anti-inflammatory properties that help control blood sugar and protect blood vessels from cardiovascular damage.
Marjan Apostolovic/shutterstockWhen your blood sugar is out of whack, you just don’t feel well, says Cypress, and might become more short-tempered. In fact, high blood sugar can mimic depression-like symptoms. “You feel very tired, you don’t feel like doing anything, you don’t want to go out, you just want to sleep,” Cypress says. She’ll see patients who think they need to be treated for depression, but then experience mood improvement after their blood sugar normalizes.
When lifestyle changes alone can’t control blood sugar, your doctor may prescribe medicine. Metformin is generally the first drug used to treat type 2 diabetes. It works by lowering your liver’s blood glucose production and improving insulin sensitivity in your muscles.
There are now three large randomized controlled trials reporting statistically significant reductions in cardiovascular events for two SGLT2 inhibitors (empagliflozin and canagliflozin) and one GLP-1 receptor agonist (liraglutide) where the majority, if not all patients, in the trial had ASCVD. The empagliflozin and liraglutide trials demonstrated significant reductions in cardiovascular death. Exenatide once-weekly did not have statistically significant reductions in major adverse cardiovascular events or cardiovascular mortality but did have a significant reduction in all-cause mortality. In contrast, other GLP-1 receptor agonists have not shown similar reductions in cardiovascular events (Table 9.4). Whether the benefits of GLP-1 receptor agonists are a class effect remains to be definitively established. See antihyperglycemic therapies and cardiovascular outcomes in Section 9 “Cardiovascular Disease and Risk Management” and Table 9.4 for a detailed description of these cardiovascular outcomes trials. Additional large randomized trials of other agents in these classes are ongoing.
Gardner DG, et al. Greenspan’s Basic & Clinical Endocrinology. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=13. Accessed April 27, 2014.
Although sugar does not cause the blood sugar to rise any higher than other carbohydrates, it should be eaten along with other healthy foods. If you choose to drink a 12-ounce can of a sugar-sweetened soft drink, that would use up about 45 grams of carba, and you wouldn’t have gotten any nutrition (protein, vitamins, or minerals). What a waste of calories!
Jump up ^ Jonsson T, Granfeldt Y, Ahren B, Branell UC, Palsson G, Hansson A, Lindeberg S (2009). “Beneficial effects of a paleolithic diet on cardiovascular risk factors in type 2 diabetes: A randomized cross-over pilot study”. Cardiovascular Diabetology. 8: 35–49. doi:10.1186/1475-2840-8-35. PMC 2724493 . PMID 19604407.