A diabetes diagnosis may seem overwhelming at first, but learning to manage diabetes mellitus enables you to start taking control of your condition, reducing the risk of further diabetes complications and improving your quality of life. Many healthcare professionals can help with diabetes management, and not only physicians; pharmacists, diabetes experts, and dieticians can also provide valuable input in creating an individual diabetes management plan.
Diabetes is one of the most prevalent medical conditions in the United States, affecting nearly ten percent of the population, according to the Centers for Disease Control and Prevention (CDC). There are three main varieties of diabetes: type 2 diabetes, the most common form, accounts for nearly 95 percent of cases in the US; type 1 diabetes is an autoimmune condition in which the pancreas does not create insulin; and gestational diabetes, which occurs during pregnancy.
It may be a lifelong condition, but fortunately, lifestyle adjustments and careful diabetes management can minimize many diabetes complications, such as diabetic neuropathy. These include managing diabetes medication, understanding blood glucose monitoring and how to prevent hypoglycemia, managing a diabetes diet, and exercising regularly. Understanding individual diabetes treatment plan and the different diabetes treatment options can improve your prognosis, give you confidence when discussing your condition with healthcare professionals, and make living with diabetes easier.
Managing your Diabetes Medication
Once you have a diabetes diagnosis, you will likely be started on a diabetes medication plan. Many different drug classes are used to treat the condition, and within these diabetes drug classes, there are often several diabetes medicines.
Among the most common prescription diabetes drugs are biguanides, for example, Glucophage (metformin); insulins such as Lantus (insulin glargine), administered by syringe or insulin pump; alpha-glucosidase inhibitors, Precose (acarbose) for instance; sulfonylureas; thiazolidinediones; selective sodium-glucose transporter-2 (SGLT-2); and meglitinide derivatives.
Know which diabetes drugs you take, both the brand and generic name
If you lose your medication or are in an emergency situation, knowing the brand names and generic names will make replacing medication easier. For example, Glucophage, one of the most common diabetes drugs, is a branded medication from Bristol-Myers Squibb, but a generic metformin or alternative brand, such as Fortamet (metformin), may also be suitable. Keeping a list of your medication, dosages, and their generic names aids in managing diabetes medication and will be invaluable when discussing your diabetes treatment plan with physicians.
Know how your diabetes medicines work
Understanding how your medicines work is particularly important when managing diabetes because it is often treated with more than one medication, or with drugs such as insulin, which may need to be administered in response to changing blood glucose levels. Part of learning how to manage diabetes effectively is learning to monitor blood glucose levels and how to administer insulin in the correct dosage.
Keep a schedule and set reminders
It is all too easy to forget to take medication, so having a schedule is important, particularly if you are on multiple diabetes drugs. Find what works for you. For example, you can set reminders on your phone, use a dedicated medication reminder app, purchase a pill box with a built-in alarm, or add taking your diabetes medication to one of your other regular daily activities, such as taking it with breakfast.
Know what to do if you miss a dose of diabetes medicine
Managing diabetes medication is not just about taking it at the correct time, you need to know what to do if you do forget to take your medication. This may vary depending on the medication, so make sure you discuss options with your physician if you are uncertain.
Speak to your doctor about your diabetes medication
If you are struggling with your medication, your healthcare team may be able to suggest alternative diabetes drugs or treatments. For example, if you regularly forget to take your medication, a doctor may be able to prescribe an extended release drug, such as Glucophage XR (metformin), which does not need to be taken as regularly, making it easier to manage your diabetes medicine.
Monitoring your Blood Glucose Levels
Taking insulin is an everyday part of life for many people managing type 2 diabetes and type 1 diabetes. Unlike many other medications, insulin is not always administered in the same dose and the same time each day; instead, the dosage and timing of administration depend on your blood glucose levels, which are measured through regular monitoring.
For people with type 1 or type 2 diabetes who take insulin, monitoring is crucial for managing diabetes effectively, enabling them to gauge the required quantity of insulin to avoid hypoglycemia (low blood sugar). Monitoring blood glucose is also important when managing certain type 2 diabetes drugs and other medications - for example, Saxenda (liraglutide), a GLP-1 agonist prescribed for weight loss - providing physicians with valuable data for determining the effectiveness of treatment.
Know when to measure your blood glucose levels
If you take insulin to manage diabetes, your physician may require you to check your blood sugar regularly throughout the day. Typically, patients measure blood glucose levels before eating and before bed but this will vary depending on the type of diabetes, severity of the condition, and the diabetes medication prescribed. Consequently, it is important to discuss blood glucose monitoring with your physician and put a clear monitoring plan in place. Doctors may also recommend regular A1c tests, which reflect the average blood glucose levels over the preceding three months.
Know your target blood glucose levels
Blood glucose target ranges vary for each individual and are based on several different factors, including the duration of diabetes, age, other medical conditions, hypoglycemia unawareness, and other considerations unique to each patient. Mayo Clinic recommendations provide a basic guideline of target blood sugar levels before meals, suggesting people under 59 years of age with no underlying conditions aim for between 80 and 120 milligrams per deciliter (mg/dL), and that those over 60 or with other underlying conditions, such as heart or lung disease, aim for between 100 and 140 mg/dL. However, with so many factors affecting target levels, you should consult with a healthcare professional to establish your normal levels.
Know your monitoring options
Medical technology has made significant strides recently, providing more options to those learning how to manage diabetes properly. If you take insulin, particularly for managing type 1 diabetes, you may opt for a continuous glucose monitor (CGM) rather than the traditional fingerstick blood test using a blood glucose meter. A fully implantable blood glucose sensor is also now available in the US.
Preventing and Treating Hypoglycemia
Hypoglycemia is a complication experienced by diabetics when their blood has an excess of insulin and insufficient sugar levels. Several factors can cause hypoglycemia, including skipping meals, doing more exercise than usual, or taking too much insulin or other diabetes medications.
It can be a serious complication if left unaddressed, with severe or untreated cases potentially resulting in seizures, loss of consciousness and even death. However, proper diabetes management and awareness of the symptoms of hypoglycemia enable diabetics to catch low blood sugar early and take corrective measures.
Know the symptoms of hypoglycemia
Early symptoms of diabetic hypoglycemia include dizziness, shakiness, hunger, sweating, irritability, anxiety, and headaches. More severe symptoms include clumsiness, muscle weakness, speech difficulties, blurred vision, confusion, sleepiness, and seizures. If you use a blood glucose monitor, you can test to see if you have hypoglycemia. Generally, you are considered to be hypoglycemic if blood sugar levels drop below 70mg/dL.
Know how to prevent hypoglycemia
Simple measures can minimize the chance of diabetic hypoglycemia. Eating regularly and avoiding skipping meals, and taking care that diabetes medication is properly measured and taken promptly will help keep blood sugar levels within a normal range. Monitoring and recording blood sugar levels may also help prevent hypoglycemia, providing your physician with useful data for establishing its cause.
Know how to treat hypoglycemia
Simple measures can help restore your blood sugar levels once you realize it has dropped below normal levels. Small quantities of sugary foods, such as candy, fruit juice, or those high in carbohydrates quickly raise blood sugar levels (avoid foods high in fat as these will not be as effective). After eating, check your blood sugar level again in 15 to 20 minutes to ensure it has returned to a normal level. In severe cases, prescription diabetes drugs, such as Glucagon, can help maintain stable blood sugar levels.
Managing your Diabetes Diet
Healthy eating is an important consideration in any diabetes management plan and can have a significant impact on the progression of diabetes as well as your day-to-day quality of life. Eating a healthy and balanced diabetes diet is a good place to start and your physician, dietician, or a diabetes specialist can help create a meal plan to get you on the right path.
Eating regular meals helps maintain stable blood sugar levels so make sure you don’t skip breakfast or snacks throughout the day.
Eat plenty of fresh fruit and vegetables
An apple a day may not quite keep the doctor away, but it certainly helps! Fresh fruit and vegetables are always healthy food choices and contain plenty of fiber, as well as a variety of essential vitamins and minerals.
Be carbohydrate conscious
Carbohydrates are an important part of a balanced diet, but they do affect blood glucose levels, so be aware of how much you eat and the effect it has on your blood sugar. Carbohydrate counting and monitoring and recording blood glucose levels will help you gain an idea of how certain foods affect you personally and assist in following a suitable diet for diabetes.
Watch the sugar
Sugar isn’t off-limits for people with diabetes, but you do need to be careful of quantities as it can cause high blood glucose levels if you eat too much. Fortunately for those with a sweet tooth, there are many artificial and natural alternatives to add sweetness to food without significantly impacting your blood sugar, such as fruit or saccharin.
Choose healthy fats
Fat is an important part of your diet but try choosing healthy fats rather than saturated fats. The American Diabetes Association (ADA) recommends avoiding food high in saturated fat, such as high-fat meats (for example, sausages, hot dogs, and bacon), as well as butter, high-fat dairy products, and coconut oil. Try adding more healthy or good fats to your diabetes diet, such as avocados, nuts, olives, and peanut butter.
Exercise and Managing Diabetes
Regular exercise has many health benefits, including lowering the risk of heart disease and heart attack, aiding weight loss, and lowering blood cholesterol. However, it is particularly important for people managing diabetes, as it increases the amount of glucose used by muscles for energy, lowering blood glucose levels and helping the body utilize insulin more efficiently, potentially reducing the frequency or dosage of insulin injections. Furthermore, being active helps you maintain a healthy weight or lose weight, and helps control blood pressure.
Get regular aerobic exercise
The ADA recommends at least 30 minutes of moderate-to-vigorous aerobic exercise for diabetes at least five times a week. This includes physical activity such as brisk walking, cycling, swimming, hiking, jogging, and even moderate-to-heavy gardening.
Add strength training to help manage diabetes
Strength training, also known as resistance training, increases the body’s sensitivity to insulin and can help lower blood glucose levels. Muscle burns more calories than fat, so increasing muscle mass through this form of physical activity can help with weight loss. Examples of strength training include weight machines, free weights, body-weight exercises, or even heavy lifting around the house.
Monitor blood glucose levels before and after exercising
Exercise can lower your blood glucose levels, so it is important to monitor your blood sugar to avoid diabetic hypoglycemia. Monitoring your glucose levels also gives you a clearer picture of how exercising affects your diabetes type 2 or type 1 and provides useful data to share with your physician.
If you find it difficult managing diabetes type 1 or type 2, speak to your physician or diabetes educator for and support and advice on finding a good diabetes education program. Your care team will work with you to adjust your diabetes management plan and ensure you get the best outcomes while minimizing the short and long-term impact it has on your life.