Have you or someone you know been diagnosed with diabetes? Chances are likely, as the CDC estimates that one in nine people in the United States has diabetes. With the proper self-management strategies to keep blood sugars in target range, people with diabetes can live a long, healthy life.
What is diabetes?
Diabetes is a condition in which the body has trouble managing blood sugar (glucose), which is the body's main source of energy. This happens because the body either doesn't make enough insulin (a hormone that helps regulate blood sugar) or doesn't use it properly. Without insulin working correctly, sugar stays in the blood instead of being used as energy, which can cause serious health problems over time.
What are the types of diabetes?
There are two main types of diabetes that people are generally aware of, Type 1 and Type 2.
Type 1 diabetes
This type is an autoimmune disease where the body's immune system attacks the cells that make insulin. As a result, people with type 1 diabetes need to take insulin every day. It is usually diagnosed in children or young adults, but can develop at any age.
Type 2 diabetes
This is the most common type of diabetes, where the body becomes resistant to insulin or doesn't make enough of it. It's often linked to lifestyle factors such as nutrition, activity level, and weight, though genetics also play a role. It usually develops in adults, but more young people are being diagnosed, likely due to lifestyle factors. People with type 2 diabetes may or may not take medication, including pills, insulin or other injectable medications.
There are other types of diabetes that are less common, including gestational diabetes.
What are the symptoms of diabetes?
Symptoms of high blood sugars include increased thirst, more frequent urination, increased hunger, fatigue, blurred vision and/or weight loss without trying. If you are experiencing any of these symptoms, please contact your provider’s office so that you can be evaluated.
How is diabetes managed?
You can still live a healthy, active life with diabetes. Diabetes is managed through nutrition, physical activity, and medications. Specific management will look different between the types of diabetes.
Medication for diabetes
People with type 1 diabetes will require insulin, either through subcutaneous injections or via insulin pump. This is because their body does not make insulin. For people with type 2 diabetes, since their bodies are making less insulin over time, or their bodies are not using the insulin properly, lifestyle changes are the first line of defense.
If lifestyle changes are not enough, medication may be prescribed to help lower blood sugar. This may be in the form of pills, insulin or other injectable medications. If you are prescribed diabetes medication, be sure to take it as directed, including the proper time of day to take your medication. Additional important information to know includes proper storage of the medication and length of time the medication will last before expiring.
Lifestyle change for diabetes
There are six main components of lifestyle behaviors that can be modified over time to help manage your diabetes. They are:
- Healthy Eating - focus on whole foods, lean proteins, healthy fats and fiber while reducing carbohydrates and processed sugars. Carbohydrates are the body's form of energy, so even people with diabetes need carbohydrates. The key is to choose more nutritious forms of carbohydrates, such as whole grains, beans, starchy vegetables and fruit, along with limiting portion sizes. Limit sugary beverages and aim to drink water or zero-calorie beverages.
- Weight Management - losing even a small amount of weight can improve blood sugar control.
- Regular Activity - aim for 150 minutes of activity per week, including flexibility and strength training two times per week. Don't underestimate the power of movement--interrupting long periods of sitting every 30 minutes can be impactful.
- Quit Smoking - smoking increases the risk of complications from diabetes, including heart disease.
- Limit Alcohol - excess alcohol can spike blood sugar and impact diabetes management.
- Sleep - aim for seven to nine hours of sleep per night. Sleep deprivation can negatively impact blood sugar levels and heart health.
How do I know if my diabetes is well-managed?
Well-managed diabetes means you're able to meet or make progress towards the goals for managing your disease as discussed by you and your healthcare provider. For example, a patient may have a target goal of getting their A1c under seven percent. When that person tests their blood sugar, they'd like their numbers to be in the 70-130 range before meals and less than 180 after meals. Please note that A1c and blood sugar targets can vary depending on age and potential risk for low blood sugars; speak with your healthcare provider directly regarding your goals. Diabetes goals and treatment plans are made on an individual basis and can vary person to person.
Regular follow-up visits and lab work
It is recommended that people with diabetes be evaluated by their provider and have lab work completed every three to six months. The hemoglobin A1c is a lab test that reflects the average of your blood sugar levels over the past two to three months. Studies have shown that people with diabetes who keep their A1c below seven percent are far less likely to experience complications from the condition in the future. If you currently have an A1c greater than seven percent, fear not—benefits of lowering your A1c are still there. Other studies have shown that a one percent reduction in A1c is associated with a 30 percent reduced risk for diabetes complications, including cardiovascular events and all-cause mortality.
Checking your blood sugar at home
This can provide valuable information on a day-to-day basis about how different factors such as food, activity and medication impact your diabetes management. This can be done via fingerstick with a glucometer or by wearing a continuous glucose monitor; insurance coverage for these devices can vary or they can be purchased over the counter. Common times of day to check your blood sugar include first thing in the morning before breakfast (fasting) or one to two hours after a meal. If you take any diabetes medication, speak to your provider directly about what time of day may be most beneficial for you to check, as this could vary.
How can I work on managing my diabetes and meeting my goals?
Take control of your diabetes by setting specific and measurable goals for your personal care plan that you work on over time. On our Brown Health Medical Group Primary Care webpage, we have a robust list of resources that provide additional information about managing diabetes. We also offer Health Information Classes on diabetes management as well as other common health conditions for our patients.
For more tips on living well, visit the Be Well blog.
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