Tips for Controlling Diabetes
By Betsy Dokken, NP, PhD, (formerly) assistant professor, Endocrinology, University of Arizona College of Medicine - Tucson
1. Diet: There is no such thing as a “diabetic diet.” (That was so 1970s!) Follow general recommendations for a healthy, balanced diet. Of the three major nutrients (carbohydrate, protein and fat), carbohydrate has, by far, the greatest effect on the blood sugar level. All sugars (sucrose, fructose, lactose) and starches are converted to glucose when absorbed into the circulation. Eating a high carbohydrate meal is literally “dumping” glucose into your blood. For help with this, ask your health care provider for a referral to a registered dietitian (RD).
2. Attain or maintain a healthy weight. Although weight loss is not always a “cure” for type 2 diabetes, excess body fat interferes with the ability of insulin to control blood sugar levels. Most sensible weight loss plans are safe for diabetic patients.
3. Exercise AT LEAST 150 minutes every week. The most effective exercise for blood sugar control is a combination of aerobic or “cardio” training, like walking or cycling, AND strength training, like weight lifting or using a resistance band. Resistance bands are inexpensive, versatile, and effective at strengthening muscles, and can be found (along with instructions) at most department or fitness stores, or online.
4. Monitor your blood sugar. If you don’t monitor your blood sugar, you will not know if it is in the target range, both before and after meals. The first step in controlling blood sugar is to know whether it is within the target range, or above it, and if it is above target, what might be causing this. All insurance plans are required to cover basic blood glucose monitoring supplies with a prescription.
- Keep a record of your blood sugar results and bring them with you to all medical appointments.
5. Know your blood glucose targets. For most people, they are as follows:
- Before meals: Less than120 mg/dl
- 2 hours after meals: Less than160 mg/dl
- This is dependent on the amount of carbohydrate eaten in the meal. If your blood sugar is typically higher than 160 mg/dl after eating, try decreasing the portions of the high-carbohydrate foods in your diet. Refer to the sample nutrition label on the back of these tips to learn how to estimate your carbohydrate intake.
- Always: Greater than 70 mg/dl
- This target is important only for those taking medications that can cause low blood sugar (hypoglycemia). Many diabetes medications are unable to cause hypoglycemia. If you don’t know, ask your health care provider. Any time you have a blood sugar level less than 70 mg/dl, treat with fast-acting carbohydrate and notify your diabetes care provider.
- If your blood sugar is usually ABOVE target, notify your diabetes care provider. Waiting until the next appointment may not be a good idea. Many medication adjustments can be made between appointments, or you can request an earlier appointment to discuss.
6. Keep your A1c in a healthy range. The A1c test, also called the hemoglobin A1c or glycated hemoglobin, indicates your overall blood sugar control over the three-month period prior to the test (lower numbers are closer to the non-diabetic range). For most people, an A1c of less than 6.5 percent is healthy. However, patients who are at high risk for hypoglycemia may need to keep their A1c in a higher range for safety.
7. Be aware of the presence of complications. Complications of diabetes are not inevitable, but may occur after several years of uncontrolled blood sugar (high A1c levels). Two exceptions are heart attack and stroke, which tend to affect diabetic patients (even well-controlled patients) more frequently than non-diabetic patients. Complications associated with diabetes include:
• Heart attack
• Eye disease (diabetic retinopathy)
• Kidney disease (diabetic nephropathy)
• Nerve disease (diabetic neuropathy)
• Amputation (from nerve damage and vascular disease).