Diabetes is a serious disease that you cannot treat on your own. Your doctor will help you make a diabetes treatment plan that is right for you — and that you can understand. You may also need other health care professionals on your diabetes treatment team, including a foot doctor, nutritionist, eye doctor, and a diabetes specialist (called an endocrinologist).
The plate method helps you control your portion sizes. You don’t need to count calories. The plate method shows the amount of each food group you should eat. This method works best for lunch and dinner.
Use any combination of the tricks below to accelerate your weight loss and return to good health. If you use all five wisely, you can get to your ideal weight in 6–12 months or less — even if that means losing 100 pounds or more. Yes, think about your weight 10, 20, 30 years ago. Another friend of mine started on this journey last year weighing 270 pounds. He’s in his mid-thirties and about to reach his college wrestling weight class of 197 pounds and just ran his fastest 2 miles ever. He got to this point by following the two rules above and just 3 of the 5 tricks below.
The American Diabetes Association (ADA), based on the 2018 guidelines, recommends routine screening for type 2 diabetes beginning at age 45 in those without risk factors. In people with body mass index (BMI) ≥25 kg/m2 and one or more additional risk factor for diabetes, screening should include the A1C, fasting plasma glucose, or two-hour oral glucose tolerance test (OGTT). Patients with prediabetes (A1C ≥5.7%, impaired glucose tolerance or impaired fasting glucose) should be tested yearly. Women who were diagnosed with gestational diabetes should have lifelong testing at least every 3 years. The test should be repeated every three years if the results are normal, dependent upon the risk status of the patient.
As diabetes management is affected by individual’s emotional and cognitive state, there has been evidence suggesting the self-management of diabetes is negatively affected by diabetes-related distress and depression. There is growing evidence that there is higher levels of clinical depression in patients with diabetes compared to the non-diabetic population. Depression in individuals with diabetes has been found to be associated with poorer self-management of symptoms. This suggests that it may be important to target mood in treatment.
The treatment goals are related to effective control of blood glucose, blood pressure and lipids, to minimize the risk of long-term consequences associated with diabetes. They are suggested in clinical practice guidelines released by various national and international diabetes agencies.
Moderation is advised with regard to consuming alcohol and using some drugs. Alcohol inhibits glycogenesis in the liver and some drugs inhibit hunger symptoms. This, with impaired judgment, memory and concentration caused by some drugs can lead to hypoglycemia. People with diabetes who take insulin or tablets such as sulphonylureas should not, therefore, consume alcohol on an empty stomach but take some starchy food (such as bread or potato crisps) at the same time as consumption of alcohol.
Insulin can’t be taken orally to lower blood sugar because stomach enzymes interfere with insulin’s action. Often insulin is injected using a fine needle and syringe or an insulin pen — a device that looks like a large ink pen.
Keep your blood pressure and cholesterol under control. Eating healthy foods and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. Medication also may be needed.
Like many people who receive an unexpected diabetes diagnosis, John was frightened. He started surfing the Internet and reading as much as he could about the disease. Unfortunately, the information only left him reeling with more questions than answers. To make matters worse, his doctor prescribed medication that made him hypoglycemic.
Your diabetes health care team will let you know what your blood sugar levels should be and how often to check them each day. In general, people with type 2 diabetes should test blood sugar levels with a blood glucose meter at least twice a day. But you may need to test more often if you’re taking insulin, have just been diagnosed with diabetes, or are having trouble keeping your blood sugar under control.
Prandin (repaglinide) and Starlix (nateglinide) are in the drug class known as meglitinides and can be used in place of sulfonylureas if they are not tolerated. These agents may also lead to hypoglycemia.
The best way to help prevent or delay nerve damage is to closely regulate your blood sugar levels. If you suffer from digestive issues due to nerve damage affects your digestive organs, you can benefit from taking digestive enzymes, probiotics and supplements like magnesium that can help relax muscles, improve gut health and control symptoms.
As someone who eats a lot of tofu, I have to admit it doesn’t taste like much. The good thing is that it will absorb just about any flavor you put on it, so you can use a wide variety of seasonings and sauces. We have many tasty tofu recipes on our site.
The kidneys are also working overtime to eliminate the excess sugar, and this leads to a loss of calories (and can harm the kidneys). “These are processes that require a lot of energy,” Dr. Collazo-Clavell notes. “You create a calorie deficit.”
. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2015;38:140–149
The fluctuation of blood sugar (red) and the sugar-lowering hormone insulin (blue) in humans during the course of a day with three meals. One of the effects of a sugar-rich vs a starch-rich meal is highlighted.
Jump up ^ Cheng J, Zhang W, Zhang X, Han F, Li X, He X, Li Q, Chen J (Mar 31, 2014). “Effect of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on All-Cause Mortality, Cardiovascular Deaths, and Cardiovascular Events in Patients With Diabetes Mellitus: A Meta-analysis”. JAMA Internal Medicine. 174 (5): 773–85. doi:10.1001/jamainternmed.2014.348. PMID 24687000.
Jump up ^ Huang, ES; Brown, SE; Ewigman, BG; Foley, EC; Meltzer, DO (2007). “Patient Perceptions of Quality of Life With Diabetes-Related Complications and Treatments”. Diabetes Care. 30 (10): 2478–83. doi:10.2337/dc07-0499. PMC 2288662 . PMID 17623824.
If you have diabetes, it’s important that you partner with your doctor and dietitian to create an eating plan that works for you. Use healthy foods, portion control and scheduling to manage your blood glucose level. If you stray from your prescribed diet, you run the risk of fluctuating blood sugar levels and more-serious complications.
In patients without atherosclerotic cardiovascular disease, if monotherapy or dual therapy does not achieve or maintain the A1C goal over 3 months, add an additional antihyperglycemic agent based on drug-specific and patient factors (Table 8.1). A
Poor glycemic control refers to persistently elevated blood glucose and glycosylated hemoglobin levels, which may range from 200–500 mg/dl (11–28 mmol/L) and 9–15% or higher over months and years before severe complications occur. Meta-analysis of large studies done on the effects of tight vs. conventional, or more relaxed, glycemic control in type 2 diabetics have failed to demonstrate a difference in all-cause cardiovascular death, non-fatal stroke, or limb amputation, but decreased the risk of nonfatal heart attack by 15%. Additionally, tight glucose control decreased the risk of progression of retinopathy and nephropathy, and decreased the incidence peripheral neuropathy, but increased the risk of hypoglycemia 2.4 times.
Problems with sexual function (pain, vaginal dryness, or reduced sex drive): Women with diabetes may experience lower sex drive (libido), blood flow problems to the genital area, which can decrease sexual response and orgasm, and nerve damage (diabetic neuropathy) that can result in vaginal dryness and decreased sensation.
The relationship between type 2 diabetes and the main modifiable risk factors (excess weight, unhealthy diet, physical inactivity and tobacco use) is similar in all regions of the world. There is growing evidence that the underlying determinants of diabetes are a reflection of the major forces driving social, economic and cultural change: globalization, urbanization, population aging, and the general health policy environment.
Want to make your pizza dough, but don’t have time for it to rise? This is a quick and easy recipe for you! Just combine whole wheat flour, yeast, wheat germ, salt and honey, bake, and then top with your favorite toppings.
In addition to medications to control glucose, many patients with diabetes also need to take medicines to lower their blood pressure and cholesterol levels. Statins, such as atorvastatin (Lipitor), rosuvastatin (Crestor), or pravastatin (Pravachol) are typically first-line prescription treatment for high cholesterol, also along with diet and exercise. Angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) will be started in diabetic patients with protein in their urine to help protect the kidneys and other organs. Blood thinners (anticoagulants) such as aspirin or clopidogrel may be started in type 2 diabetic patients at higher risk for stroke or heart attack.
Meglitinides include repaglinide and nateglinide. They stimulate the release of insulin by the pancreas. Meglitinides are associated with a higher chance of hypoglycemia and must be taken with meals three times a day. As a result, these drugs are less commonly used.1,4
Adults with diabetes can drink alcohol and should follow the same guidelines as the general public—an average of up to one drink per day for women and up to two drinks per day for men, with no more than three or four drinks in any single day for women and men, respectively. “Research shows moderate alcohol consumption has minimal short- or long-term effects on glucose levels in people with type 1 or 2 diabetes,” says Marion Franz, RD, CDE.
“I try to give lifestyle strategies a chance to manage type 2 diabetes,” says Sivitz, adding that people with a very high blood sugar level may need to start medication and lifestyle changes at the same time.
Other forms of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.
The Diabetes Control and Complications Trial (DCCT) studied the effects of tight blood sugar control on complications in type 1 diabetes. Patients treated for tight blood glucose control had an average HbA1c of approximately 7%, while patients treated less aggressively had an average HbA1c of about 9%. At the end of the study, the tight blood glucose group had dramatically fewer cases of kidney disease, eye disease, and nervous system disease than the less-aggressively treated patients.
Diabetic hyperlipidemia sounds a bit intimidating, doesn’t it? As we always do here on EndocrineWeb, we’re going to break down that concept for you, and that’s why we’ve put together this Patient Guide to Treating High Cholesterol and Diabetes.
It may also be helpful to bring your family into the loop. Educate them about the warning signs of blood sugar levels that are too high or too low so that they can help in an emergency. If everyone in your home follows a healthy diet and participates in physical activity, you’ll all benefit.
Prediabetes indicates a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 DM. Many people destined to develop type 2 DM spend many years in a state of prediabetes.