Topic Overview
Is this topic for you?
This topic is for adults who have had
type 2 diabetes for more than a few months.
If this
topic does not answer your questions, see:
If you are looking for information about
type 1 diabetes, see the topic
Type 1 Diabetes.
What is diabetes?
Type 2 diabetes is a lifelong
disease that develops when the
pancreas cannot produce enough
insulin or when the body's tissues become
resistant to insulin. Insulin is a hormone that helps
the body’s cells use sugar (glucose) for energy. It also helps the body store
extra sugar in muscle, fat, and liver cells.
How can you manage diabetes?
Taking care of your diabetes takes time and
energy every day. The goal is to keep your blood sugar in a target range. It’s
the best way to reduce your chance of having more problems from diabetes. These
problems are called complications.
Just focus on one
day at a time, and:
-
Make healthy food choices.
Eat a balanced diet, and try to manage the amount of
carbohydrate you eat by spreading it out over the day.
If you're overweight, losing 10 to 20 pounds can improve your blood sugar
levels. There are many ways to manage how much and when you eat. Your doctor, a
diabetes educator, or a
dietitian can help you find a plan that works for
you.
-
Be active. Try to do
moderate activity at least 2½ hours a week. It's fine
to be active in blocks of 10 minutes or more throughout your day and week.
Activity helps control your blood sugar by using glucose for energy during and
after activity. It also helps you stay at a healthy weight, lower
high cholesterol, and lower
high blood pressure.
-
Test your blood sugar levels. Everything in your life can affect your blood sugar levels, from
what you eat, to how you feel, to how much activity you get. You may not like
having to check your blood sugar regularly and keep track of the results. But
testing can really help you keep your diabetes under control.
-
Keep
high blood pressure
and
high cholesterol
under control. Doing so can lower your risk of heart and
large blood vessel disease.
-
Take medicines,
such as metformin (Glucophage) or
insulin, if you need them. These can help you keep
your blood sugar levels on target.
And if you smoke, quit. Quitting
smoking can help you reduce your risk of heart disease and stroke.
How can you deal with high or low blood sugar?
Even when you are careful and do all the right things, you can have
problems with high or low blood sugar. It is important to know what signs to
look for and what to do if this happens.
High blood sugar (hyperglycemia) usually happens over a few days or weeks.
Early symptoms include:
- Feeling very thirsty.
- Urinating
more often than usual.
- Feeling very hungry.
- Having
blurred vision.
People with diabetes can get high blood sugar for many
reasons, including not taking their diabetes medicines, eating more than usual
(especially sweets), not exercising, or being sick or under a lot of stress.
If you have high
blood sugar, follow your treatment plan for lowering it. This may mean taking
missed doses of insulin or medicine. Make sure to drink plenty of
fluids so that you stay hydrated. Call your doctor if you don't know
what to do. Treating high blood sugar is important. If it is left untreated, it
can lead to
hyperosmolar state, a dangerous condition.
You can get low blood sugar (hypoglycemia) if you
take insulin or sulfonylurea pills for diabetes. Low blood
sugar can happen suddenly. Early symptoms include:
- Sweating.
- Feeling
weak.
- Feeling shaky.
- Feeling very hungry.
Symptoms of low blood sugar may vary over time. You may
also have these symptoms if you have a sudden large drop in blood sugar, even
though the level does not drop below your target range.
Eat 1 tablespoon of sugar, ½ cup of orange juice, or another carbohydrate. Wait
15 minutes, and then check your blood sugar.
What are the complications of diabetes and their symptoms?
Over time, high blood sugar can cause complications
such as problems with your
eyes, heart, blood vessels, nerves, and kidneys. High blood sugar also makes
you more likely to get serious illnesses or infections. Complications can lead
to blindness, kidney failure, removal of a limb (amputation),
heart attack,
stroke, and death. This is why it is so important to
keep your blood sugar in your target range.
If you had the disease
several years before you were diagnosed, you may already have a complication
from diabetes. Even if you don't have problems now, the longer you have
diabetes, the more likely you are to get one or more complications. And the better you manage your blood sugar levels, the lower your risk of complications.
Be sure to tell your doctor if you notice any new symptoms, such as
vision problems, chest pain, numbness, or a shooting pain
in your hands or feet.
How can you prevent complications?
You may be able
to prevent, or at least delay, problems from diabetes by keeping your blood
sugar level as close to your target range as you can. Treatment of high blood pressure or
high cholesterol can also help. If you smoke, quit. Smoking increases your risk
for complications.
People with diabetes are 2 to 4 times more likely than people who don't
have diabetes to die from heart and blood vessel diseases.1 Talk to your doctor about whether you should take low-dose aspirin.
Daily low-dose aspirin (81 milligrams) may help prevent heart problems if you are at risk for heart attack or
stroke.
See your doctor
every 3 to 6 months. During these visits, your doctor will review your
treatment and do tests and exams, such as an A1c test.
These tests can show if your blood sugar is staying within
your target range and if you have any complications.
It’s also
important to have regular checkups with your eye doctor and dentist. Diabetes
can cause vision and dental problems.
How can you cope with diabetes?
Trying to manage your diabetes isn't easy. Some days you may
feel like it's just too much work to do everything you need to do.
If you're having trouble coping with your feelings, try
talking with a
counselor. A professional may make it easier to say
things you wouldn't talk about with friends or family.
It might also help to:
-
Talk to your doctor. He or she
can help you deal with your feelings.
-
Talk with friends and family about how you feel and any help you
need.
-
Join a support group. You can find one
through your doctor, your local hospital, or the American Diabetes
Association.
Frequently Asked Questions
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Learning about living with type 2 diabetes:
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Monitoring your
diabetes:
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Getting treatment:
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Ongoing concerns:
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Living with type 2 diabetes:
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Causes of High and Low Blood Sugar
Even if you've
been careful to take care of yourself and manage your type 2 diabetes, there may still be times
when your blood sugar is too high or too low.
Over time, high blood sugar can lead to serious problems or a medical
emergency. When your blood sugar is too low, you can get shaky and weak. If
your blood sugar gets very low, you could pass out (lose consciousness).
High blood sugar can
happen if you:
- Skip a dose of your diabetes
medicine or skip a required dose of
insulin.
- Eat too much.
- Are
stressed or ill (such as with a bad
case of the flu) or if you have an infection, especially
if you are not eating or drinking enough.
- Are taking
medicines that raise blood sugar as a side
effect, such as sleeping pills, some anti-inflammatory medicines (corticosteroids), and some decongestants.
Being pregnant can also make your blood sugar levels go up.
If you take insulin, you may have some mornings when your
blood sugar level is very high, even if it was low when you went to bed. This called the
Somogyi effect. Talk with
your doctor if this happens. You may need to check your blood sugar during the night to find out why your levels are high in the morning.
You
aren't likely to get low blood sugar unless
you take insulin or some kinds of
oral medicines. You may
get low blood sugar if you:
- Take too much oral
medicine in a day, take your doses too close together, or
take your full dose of medicine when you are not going to eat your usual amount
of food.
- Exercise too much without eating enough
food.
- Skip a meal.
- Drink too much alcohol, especially
on an empty stomach.
- Take other
medicines that can lower blood sugar levels, such as
large doses of aspirin and medicines for mental health
problems.
- Have problems with your
kidneys.
- Start to have other problems with
your glands and hormones, such as
Addison's disease or
hypothyroidism.
Symptoms
High blood sugar
When you have type 2 diabetes, your blood sugar can
rise slowly over hours or days. You may not notice that
anything is wrong.
Symptoms of high blood sugar
include:
- Being very thirsty.
- Urinating a
lot.
- Losing weight without trying.
- Having blurry
vision.
It's important to know these
symptoms so you can treat them before they get worse and
you need medical attention. If your blood sugar stays higher than your target range and you don't drink enough liquids, you can get
dehydrated. This can make you feel dizzy and weak and
can lead to an emergency called a
hyperosmolar state.
Low blood sugar
When your blood sugar is
too low, it can also cause problems. And it can happen suddenly. Quickly treating low
blood sugar can help you avoid passing out (losing consciousness). You
can pass out when your blood sugar gets very low.
Low blood sugar can also lead to a heart attack. Symptoms of low blood sugar include:
- Sweating.
- Shakiness.
- Weakness.
- Hunger.
- Confusion.
If you aren't able to tell when your blood sugar is too low, it's a good idea to test your blood sugar often. But you're not likely to get low blood sugar
unless you take
insulin or
oral diabetes medicines.
Symptoms of complications
Talk
with your doctor if you notice any of these signs:
- Numbness, tingling, burning pain,
or swelling in your feet or hands. This could be a sign of
diabetic neuropathy. For more information, see the
topic Diabetic Neuropathy.
- Blurry or spotty vision or seeing
flashes. This may be a sign of
diabetic retinopathy. For more information, see the
topic Diabetic Retinopathy.
- Cuts or sores that won't heal
or that look infected. This could mean damage to
blood vessels.
- Chest pain or shortness of
breath. This may be a sign of
heart disease or blood vessel problems
(macrovascular disease).
- Other
symptoms of diabetic neuropathy, such as:
- Frequent bloating, belching,
constipation, nausea and vomiting, diarrhea, or belly pain
after you eat (gastroparesis).
- Heavy or reduced
sweating.
- Feeling weak or dizzy when you stand up
quickly.
- Not knowing when
your bladder is full or having problems emptying it.
- Erection problems or vaginal
dryness.
- Not being able to tell when your blood sugar is
low (hypoglycemia unawareness).
You won't have any symptoms of kidney damage (diabetic nephropathy) until the
problem is severe. Then you may notice swelling in your
feet or legs or all over your body.
Having regular tests to check for protein in your urine is
the only way to find diabetic nephropathy before symptoms
start.
What Happens
Now that you have had
type 2 diabetes diabetes for a while, you already know
how important it is to keep your blood sugar as close to
your target range as you can. Doing so can help you delay
or prevent more serious health problems later.
If your diabetes gets worse, your
pancreas may make less and less
insulin, which can make it harder for you to
control your blood sugar. When your pancreas
makes too little or no insulin, you will need to give
yourself shots of insulin.
It can be hard to
find the right balance of insulin and blood
sugar levels. So even if you take insulin or other
diabetes medicines, there may still be times when your
blood sugar is too high or too low. It's important to know the symptoms of both
of these and to treat them early. For more information, see the Symptoms
section of this topic.
High blood sugar emergencies
A
hyperosmolar state
is life-threatening and can occur
when your blood sugar level is very high (400
to 500 mg/dL or higher) and you get
dehydrated. You are more likely to have this
problem if your blood sugar stays above 200 mg/dL.
Hyperosmolar state is treated in a hospital.
You'll have frequent blood tests for glucose and
electrolytes. Insulin will be given to you through a
vein (intravenous, or IV) to lower your blood sugar level.
You'll get fluids through the IV to get rid of the
dehydration. The fluids will make you urinate, removing the excess
sugar from your body.
Diabetes complications
Over
time, high blood sugar that is not controlled
can lead to problems with your:
If you have had high blood sugar levels
for years, you may already have one or more of these complications. For more
information, see
Type 2 Diabetes: Living With Complications.
Other health problems
People with diabetes often
already have other health problems, such as
high blood pressure and
high cholesterol. Or they may get
them as diabetes gets worse. These
health problems can make it harder to avoid complications
from diabetes.
Living with diabetes
Uncontrolled high blood sugar is the main reason why
complications occur. So if you work closely with your doctor to keep your blood
sugar within your target range, you may be able to avoid or prevent these
problems. You may also feel better and be more in control of your
life. For more information, see the Preventing Complications section of this
topic.
Even if you have done all you can to
keep your blood sugar under control, you may still get a diabetes-related
health problem. You may feel sad, angry, and confused that you have to deal
with something new along with your diabetes.
Talking with others who have diabetes can help. Call your local
hospital, and ask if it has a support group or classes for people with diabetes.
Or visit the Web site of the American Diabetes Association, www.diabetes.org.
For more information, see the What Increases
Your Risk of Complications section of this topic.
|
One Man's Story:
Andy, 52
As a grocery manager, Andy
is on his feet all day. He also likes to bowl and play basketball with his
buddies. He started thinking about what he would do if he couldn't walk, work,
or play. "It finally just hit me how serious this disease is. I couldn't keep
ignoring it."—Andy
Read more about Andy and his diabetes routine.
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What Increases Your Risk Of Complications
You are more likely to
get complications from
type 2 diabetes if:
-
Your blood sugar
stays high over time. Your risk for complications
increases if your blood sugar gets too high and stays high too long.
-
You have
had the disease for a long time. The longer you
have diabetes, the more likely you are to have some related health
problems. This can happen even if your blood sugar levels are
controlled.
- Kidney disease (diabetic nephropathy) occurs in 20 to 30
people out of 100 who have type 2 diabetes.2
- Eye disease (diabetic retinopathy) occurs within 20 years after
diagnosis in more than 60
people out of 100 with type 2 diabetes.3
- Most people with
diabetes start to get some nerve damage (diabetic neuropathy) over the years. But
only about half of the people who get neuropathy have noticeable symptoms.4
-
You already
have one complication. If you have one diabetes-related
problem, you are at a higher risk for getting another one.
-
You have other risk factors,
such as:
People with untreated depression are also more likely to have complications. For more information, see the topic Depression.
For tips on how to reduce your risk, see the Home
Treatment and Preventing Complications sections of this topic.
When to Call a Doctor
Call
911
or other emergency services right away if you are:
- Unconscious or you suddenly become very sleepy or confused. You may have low blood sugar, called
hypoglycemia.
- Sleepy, confused, breathing very fast, or your breath smells fruity. You may have a life-threatening condition called
diabetic ketoacidosis.
Call a doctor right away if:
- Your blood sugar is 300 mg/dL or higher (or it is higher than the level your doctor has set for you).
Call a doctor if you:
- Are sick and having trouble controlling your blood sugar.
- Have had vomiting or diarrhea for more than 6 hours.
- Often have problems with high or low blood sugar levels.
- Have trouble knowing when your blood sugar is low (hypoglycemia unawareness).
- Have questions or want to know more about diabetes.
Who to See
Health professionals who may be
involved in your treatment for type 2 diabetes include:
Exams and Tests
See your doctor
about every 3 to 6 months to:
-
Check your blood sugar levels since your last visit and see if
your treatment needs to be changed.
-
Check your blood pressure and start or adjust treatment if
it's high.
-
Check your feet for
signs of problems.
-
Have a
hemoglobin A1c test
. This test shows how steady your blood
sugar levels have been over time. And it can show high blood sugar at times
when you might not normally be checking, such as after meals and overnight.
With this information, your doctor will know how well your treatment for type 2 diabetes is
working.
Have these exams and tests every year:
As needed, you may have a
blood glucose test. During this test, you'll be able
to check your blood sugar meter to find out if your
home blood sugar tests are reliable. This
test may also be done if your doctor adjusts your diabetes
medicine.
You can print out a list of
tests to monitor diabetes to help you remember what to do and when.
Eye exams during pregnancy
If you get
pregnant, you will need to have an
eye exam sometime during the
first 3 months. You'll also need close follow-up
during your pregnancy and for 1 year after you
have your baby. Pregnancy increases your risk for diabetic retinopathy.1 If you already have eye disease and
get pregnant, the disease can quickly get
worse.
Treatment Overview
Your treatment for
type 2 diabetes will change over time to meet
your needs. But the focus of your treatment will always be
to keep your blood sugar levels within your target range. That will help prevent complications from diabetes,
such as eye, kidney, heart, blood vessel, and nerve disease.
To help you stay on track with your treatment, you'll need
regular tests. For more information, see the Exams and Tests section of this
topic.
You play an important role in managing your
condition. By learning about diabetes and working with your doctor
to create a plan for treatment, you can improve your health and
quality of life.
The keys to managing your diabetes are
to:
-
Make healthy food choices. Eat a balanced diet, and try to manage the amount of
carbohydrate you eat by spreading it out over the day.
For help, see:
- Quick Tips: Smart Snacking When You Have Diabetes.
Diabetes: Using a Plate Format for Eating.- Diabetes: Counting Carbs if You Don't Use Insulin.
- Diabetes: Eating a Low Glycemic Diet.
-
Be active.
Walking is a great way to get started. See:
- Quick Tips: Getting Active at Home.
- Fitness: Adding More Activity to Your Life.
- Fitness: Walking for Wellness.
-
Test your blood sugar.
Everything in your life affects your blood sugar levels, from what you eat, to
how stressed you feel, to how much activity you get. That's why
testing your blood sugar regularly is so important. The American Diabetes
Association (ADA) recommends that you keep your blood sugar levels at:
- Diabetes: Checking Your Blood Sugar.
- Diabetes: Preventing High Blood Sugar Emergencies.
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Keep
high blood pressure
and
high cholesterol
under control. Losing weight and getting plenty of
exercise, such as walking at least 2½ hours a
week, can help lower blood pressure. But you may also need to take
medicines, such as an
ACE inhibitor or beta-blocker, to achieve your
goal.1 You may also need to take cholesterol-lowering
medicines called
statins. See:
- Therapeutic Lifestyle Changes (TLC) for High Cholesterol.
- High Blood Pressure: Checking Your Blood Pressure at Home.
-
Take medicines,
such as metformin (Glucophage) or
insulin, if you need them. If you're
taking diabetes medicine or insulin, you will need to know
how to deal with low blood sugar and how to give yourself an insulin shot. For
more information, see the Medications section of this topic and:
- Diabetes: Dealing With Low Blood Sugar From Medicines.
- Diabetes: Dealing With Low Blood Sugar From Insulin.
- Diabetes: Giving Yourself an Insulin Shot.
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Quit smoking, if you smoke. Quitting smoking can help you reduce your risk of heart disease and
stroke.
Pregnancy and diabetes
If you get pregnant, your diabetes treatment
may change. For example, some medicines could harm your baby. If your blood sugar gets too high while you're pregnant, your baby might have problems at birth. Talk with your doctor. For more information, see:
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Pregnancy and Diabetes: Planning for Pregnancy.
Staying motivated
You've likely already had to make some big changes in the way
you live your life. It can be hard to
stay motivated when you have diabetes. Just try to
focus on one day at a time.
Remember that
untreated type 2 diabetes can lead to serious health problems.
People with diabetes have a higher risk of
dying from heart and blood vessel diseases than people who
don't have the disease.5
But also remember that you can prevent or delay these problems
by taking care of yourself. Eating right, staying active, and keeping your
blood sugar under control are all things you can do. You don't have to do it
alone. For help and how-tos, see the Home Treatment section of this topic.
|
One Man's Story:
Andy, 52
"I'm doing so much better
than I was 2 years ago. I eat better, I take walks, and I feel pretty good. I
talk to other people who have diabetes. But I have to remember that what works
for them may not work for me. Diabetes is different for everybody."—Andy
Read more about Andy and his diabetes routine.
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Preventing Complications
Because you've been managing your
type 2 diabetes diabetes for a while now, you probably
already know that keeping your blood sugar levels within your
target range is the best way to reduce your risk of
other health problems. The higher your blood sugar level,
the greater your risk for developing eye, kidney, heart, blood vessel, and
nerve disease.6
Just focus on
one day at a time, and:
- Make healthy food choices, and lose weight if you need to.
- Be
active.
- Test your blood sugar levels.
- Keep
high blood pressure and
high cholesterol under control.
- Take medicines, such as metformin (Glucophage) or
insulin, if you need them.
And if you smoke, quit.
Quitting smoking can help you reduce your risk of heart disease and
stroke.
For tips on how to do these things,
see the Home Treatment section of this topic.
Get the tests you need
Make sure to
schedule the important
tests you need to monitor diabetes and watch for complications. These
include:
Flu shots
Diabetes
affects your immune system. This increases
your risk for getting sick. It's important to keep your
flu shots and other
immunizations up to date. Getting sick can make your blood sugar harder to control, so avoid illness if you can. See the topic
Immunizations for guidelines on these and
other shots.
Daily aspirin
People with diabetes have a higher risk of dying from
heart and blood vessel diseases than people who don't have diabetes.1 Talk to your doctor about whether you should take low-dose aspirin. Daily low-dose aspirin (81 milligrams) may help prevent heart problems if you are at risk for heart attack or stroke.
Set a Goal to Prevent Complications
Losing weight, getting active, eating
better, and quitting smoking are all important changes you can make for your
health when you have
type 2 diabetes. But you don't have to do them all at once. Just pick one to start.
Maybe it's losing weight, or adding more activity to your life. Three steps can
help you get started.
1. Know your reason.Before you set a goal, think about why you want to make a change. If your
reason comes from you—and not from someone else—it will be easier for you to
make a healthy change for good.
Maybe you want to prevent your
diabetes from getting worse. Perhaps you're worried about losing your eyesight
or even a limb. You might simply want to enjoy your life and have more energy
for all the things you enjoy doing. Your reason for wanting to change is
important.
2. Set long-term and short-term goals.Start by setting a big, or long-term goal. Maybe you want to lose 10%
of your body weight to reduce your risk of health problems linked to type 2
diabetes. If you weigh 90 kilograms, that means losing 9 kilograms. Break down your
big goal into smaller, short-term ones. These are the steps you'll take to
reach your big goal.
Do what works best for you. It's important to
set goals you can reach. For example:
- Week 1: Set a goal to walk 15 minutes, 5 days
a week.
- Week 2: Continue to walk 15 minutes, 5 days a week. And
this week, when you reach for a snack, make it carrot or celery sticks instead
of potato chips or crackers.
- Week 3: Keep up your walking program
and eating healthy snacks. Pay attention to your hunger levels when eating
meals. Stop eating when you feel full.
For help, see:
-
Fitness: Adding Activity to Your Life.
-
Fitness: Walking for Wellness.
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Healthy Eating: Starting a Plan for Change.
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Healthy Eating: Recognizing Your Hunger Signals.
3. Prepare for slip-ups and barriers.Plan for setbacks. Use a
personal action plan(What is a PDF document?) to write down your goals, any
possible barriers, and your ideas for getting past them. By thinking about
these barriers now, you can plan ahead for how to deal with them if they
happen.
For help, see:
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Quitting Smoking: Preventing Slips and Relapses.
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Healthy Eating: Overcoming Barriers to Change.
Tips for staying on track
-
Get support. Tell
family and friends your reasons for wanting to change. Tell them that their
encouragement makes a big difference to you in your goal, whether it's losing
weight or quitting smoking. Your doctor or a professional counselor can also
provide support.
-
Pat yourself on the back.Don't forget to give yourself some positive feedback. If you slip up, don't
waste energy feeling bad about yourself. Instead, think about how much closer
you are to reaching your goal than when you started.
Home Treatment
Your treatment goals
When it comes to managing your
type 2 diabetes, it's really up to you. You
can learn how to take care of yourself, how to stay motivated, and how to find
the support you need to do it.
For the best chance at a long,
healthy life, you need to set goals for your treatment, including:
- Making healthy food choices.
- Being
active.
- Testing your blood sugar levels.
- Keeping your
high blood pressure and
high cholesterol under control.
- Taking
medicines, such as metformin (Glucophage) or
insulin, if you need them.
-
Quitting smoking,
which can help you reduce your risk of heart
disease and stroke.
Make a healthy eating plan
If
you're overweight, losing 5% to 10% of your weight may
help you reach normal blood sugar levels. For
example, if you weigh 200 pounds, losing 10 to 20 pounds may lower your blood
sugar.
Managing the amount of
carbohydrate you eat is an important part of a healthy
diet for diabetes. Carbohydrate is found in:
- Sugar and sweets.
- Bread, rice, and
pasta.
- Fruit.
- Starchy vegetables,
such as potatoes and corn.
- Milk and
yogurt.
The best diet is a balanced one. A healthy
eating plan doesn't have to be complicated. Try to:
- Limit how much fat you eat. Eat foods low in
saturated fat and high in
fiber.
- Cut down on foods that are high in
calories but low in nutrition, such as soda.
- Limit sweets.
You may want to work with a
dietitian or certified diabetes educator to help you plan menus that spread
carbohydrate throughout the day. This will keep your
blood sugar from rising sharply after meals.
It's normal to have some negative feelings
about diabetes and how it's affecting your life, especially when it comes to how and what you eat. But try not to let those
feelings get in the way of taking care of yourself. For help, see:
-
Diabetes: Coping With Your Feelings About Your Diet.
For more ideas about healthy eating,
try:
-
Quick Tips: Smart Snacking When You Have Diabetes.
-
Diabetes: Using a Plate Format for Eating.
-
Diabetes: Counting Carbs if You Don't Use Insulin.
-
Diabetes: Eating a Low Glycemic Diet.
Get active
The
more active you are, the more sugar (glucose) your body uses for energy. This
keeps the sugar from building up in your blood. Being active also:
Don't worry. You don't have to sign up for a gym
membership or train for a marathon to get the activity you need to control your
blood sugar. Even everyday activities can make a difference.
Try
to get about 30 minutes of activity on most days of the week. You can even
break it up into two 15-minute sessions or three 10-minute sessions.
Try to include
resistance exercises in your program
3 times a week. 1 These activities can include things like weight lifting or yard
work. See the topic
Fitness for more ideas.
For more help, see:
-
Quick Tips: Getting Active at Home.
-
Fitness: Adding More Activity to Your Life.
-
Fitness: Walking for Wellness.
Test your blood sugar
Everything in your life can affect your blood sugar levels,
from what you eat, to how stressed you feel, to how much activity you get. You may not
like having to check your blood sugar regularly and keep track of the results
over time. But it can really help you keep your diabetes under
control.
- Checking how your blood sugar rises or falls in
response to certain foods, exercise, and other things can help you reduce
symptoms, prevent blood sugar emergencies, and prevent
complications.
- Having a record of your blood sugar over time can
help you and your doctor know how well your treatment is working and whether
you need to make any changes.
For more information, see:
-
Diabetes: Checking your Blood Sugar.
-
Diabetes: Preventing High Blood Sugar Emergencies.
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Know what your results mean
Rhonda O'Brien, certified diabetes educator
As important as regular testing is, you also need to know what the
results mean and how to use them. "Look for patterns. If your blood sugar is
always high before lunch, take a look at what you had for breakfast. Maybe you
need to make some changes."—Rhonda
Learn blood sugar testing tips from Rhonda O'Brien.
|
Control blood pressure and cholesterol
Try to keep your
blood pressure and
cholesterol at healthy levels.
Doing so can lower your risk of heart and large blood
vessel disease.
Being active can help keep
your blood pressure at the recommended level of less than 130/80
millimeters of mercury (mm Hg). In some cases,
you may need to take medicines to help you reach your
goal.
A low-fat diet, activity, and weight
loss can also lower your cholesterol. Aim for a goal of
less than 100
milligrams per deciliter (mg/dL) of low-density lipoprotein (LDL), the "bad" cholesterol.
Try to get it even lower if you can.
Your doctor may suggest that
you take cholesterol-lowering medicines called
statins. For more information, see the topics
High Blood Pressure (Hypertension) and High Cholesterol, or see:
-
Therapeutic lifestyle changes (TLC) for high
cholesterol.
-
High Blood Pressure: Checking Your Blood Pressure at Home.
Take medicines if you need them
You may need to take oral medicines, such as
metformin (Glucophage) or
insulin, to help you keep your blood sugar levels on
target.
If your diabetes get
worse, your
pancreas may make less and less
insulin, which can make it harder for you to
control your blood sugar. When your pancreas
makes too little or no insulin, you will need to give
yourself shots of insulin.
If you get sick,
have surgery, get pregnant, or breast-feed, you may need
insulin shots for a short time, even
if you normally only take pills. You should be able to
go back to your regular treatment
after the situation is over.
If you take diabetes
medicines, you need to know how to deal with
low blood sugar. If you use insulin, you need to know how to give yourself a
shot. For help, see:
-
Diabetes: Dealing With Low Blood Sugar From Medicines.
-
Diabetes: Dealing With Low Blood Sugar From Insulin.
-
Diabetes: Giving Yourself an Insulin Shot.
For more information, see the Medications section of
this topic.
Daily aspirin
People with diabetes have a higher risk of dying from
heart and blood vessel diseases than people who don't have diabetes.1 Talk to your doctor about whether you should take low-dose aspirin. Daily low-dose aspirin (81 milligrams) may help prevent heart problems if you are at risk for heart attack or stroke.
Take care of yourself in other ways
Be aware of other things you can do to help yourself
stay healthy.
How to cope with your feelings
Trying to manage your diabetes isn't easy.
Some days you may feel like it's just too much work to do everything you need
to do. There will be times when you just don't feel like testing and tracking
your blood sugar.
It's normal to feel sad
or even angry sometimes when you have a health problem. Even though you've had a while to get
used to the idea of having diabetes, you may still have trouble adjusting. You
may find it hard to
stay motivated.
When you feel sad, give yourself time to
grieve your losses. If you feel overwhelmed,
just try to focus on one day at a time. Do the best you can. You don't have to
be perfect.
For more help,
see:
-
Depression: Using Positive Thinking.
Get the support you need
If you're having trouble coping with your feelings,
try talking with a
counselor. A professional may make it easier to say
things you wouldn't talk about with friends or family.
If you have
symptoms of depression, such as a lack of interest in things you used to enjoy,
a lack of energy, or trouble sleeping, talk with your doctor. For more help,
see the topic
Depression.
You might also want to:
-
Talk with friends and family
about how you feel and any help you need.
-
Ask a friend or family member to come to counseling with
you.
-
Talk to your spiritual advisor if you
belong to a church or spiritual group. He or she will have experience helping
people deal with their feelings.
-
Join a support group. You can find one through your doctor, your local hospital, or the
American Diabetes Association.
Medications
How medicine helps manage diabetes
Some people with
type 2 diabetes need pills (oral medicines)
to help their bodies make insulin, decrease
insulin resistance, or slow down how quickly
their bodies absorb carbohydrate.
You may take no
medicine, one medicine, or a few medicines. Some people need to take medicine
for a short time, while others always need to take medicine. How much medicine
you need depends on how well you can keep your blood sugar within
your target range. You may need more medicine over time, even if you have good control of your blood sugar.
Taking two or more medicines may work
better to lower your blood sugar level than taking one
medicine alone. Also, taking two or more
medicines may mean fewer side effects if
you are taking a lower dose of each.
Medicine choices
-
Oral
medicines that help your body make insulin. These include:
- Sulfonylureas,
such as glipizide (Glucotrol), glyburide (DiaBeta, Glynase, and
Micronase), glimepiride (Amaryl), and other medicines that work in combination
(Glucovance, Metaglip).
- Meglitinides,
such as repaglinide (Prandin), nateglinide (Starlix), and a
combination medicine (Prandimet).
- DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), and a
combination medicine (Janumet).
-
Oral medicines that
lower insulin resistance. These include:
- Biguanides,
such as metformin (Glucophage) and other medicines that are combined
with metformin (Prandimet, Avandamet).
- Thiazolidinediones, such as pioglitazone
(Actos) and rosiglitazone (Avandia).
-
Oral
medicines that slow down absorption of carbohydrates.
These include:
-
Medicines that help lower blood sugar. If you are having trouble controlling your blood
sugar with pills, your doctor may suggest one of these medicines:
- Incretin mimetics, such as
exenatide (Byetta). You take this medicine as a shot 2 times a day.
- Amylinomimetics, such as pramlintide (Symlin). This
medicine works with insulin and
glucagon to help control blood sugar. It
is given as a shot before meals.
-
Insulin
.
Insulin lets sugar (glucose) in the blood enter cells, where it is
used for energy. Without insulin, the blood sugar level gets too high. Most of the time, people who take
insulin use a combination of
short-acting and long-acting insulin. This helps keep
blood sugar within your target range. You may want to learn
more about
when insulin is needed for type 2 diabetes.
You may also need to
take:
Managing your
medicines
Medicines can help you manage your
diabetes and other health problems, but only if you
take them correctly. It can be hard to keep track of
when and how to take your medicine, especially if you are taking more than one.
Maybe you aren't sure why you are taking a medicine or if it is working. Or you
might have trouble paying for your medicine. For help, see:
Surgery
There are no surgeries to treat
type 2 diabetes.
Studies show that the large weight loss provided by
stomach surgery (bariatric surgery)
improves blood sugar control in people who are very
overweight. 1 But the surgery can be risky.
It's not a good choice for everyone with diabetes. And keep in mind that there is more than one kind of weight-loss surgery. It's not known for sure which one is best.
If you are
very overweight, talk with your doctor about
whether stomach surgery would be right for you. For more
information, see the topic
Obesity.
Other Treatment
Avoid products that promise a “cure”
for
diabetes. There is no cure.
If you have questions about a diet product for diabetes, check
with your local American Diabetes Association office, your doctor, or a
diabetes educator. Talk with a
dietitian before
choosing a meal plan for your diabetes diet.
Complementary therapies
Some complementary
therapies may help relieve stress and muscle tension. They might help you feel better in general. But
they should not be used alone to treat your diabetes.
Talk with your doctor if you are using any of these
treatments:
Other Places To Get Help
Organizations
|
American Diabetes Association (ADA)
|
| 1701 North Beauregard Street |
| Alexandria, VA 22311 |
| Phone: |
1-800-DIABETES (1-800-342-2383) |
| Email: |
AskADA@diabetes.org |
| Web Address: |
www.diabetes.org |
| |
|
The American Diabetes Association (ADA) is a national organization
for health professionals and consumers. Almost every state has a local office.
ADA sets the standards for the care of people with diabetes. Its focus is on
research for the prevention and treatment of all types of diabetes. ADA
provides patient and professional education mainly through its publications,
which include the monthly magazine Diabetes Forecast,
books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also
provides information for parents about caring for a child with diabetes.
|
|
|
National Diabetes Education Program
(NDEP)
|
| 1 Diabetes Way |
| Bethesda, MD 20814-9692 |
| Phone: |
1-800-438-5383 to order materials
(301) 496-3583 |
| Email: |
ndep@mail.nih.gov |
| Web Address: |
http://ndep.nih.gov |
| |
|
The National Diabetes Education Program (NDEP) is
sponsored by the U.S. National Institutes of Health (NIH) and the U.S. Centers
for Disease Control and Prevention (CDC). The program's goal is to improve the
treatment of people who have diabetes, to promote early diagnosis, and to
prevent the development of diabetes. Information about the program can be found
on two Web sites: one managed by NIH (http://ndep.nih.gov) and the other by CDC
(www.cdc.gov/team-ndep).
|
|
|
National Diabetes Information Clearinghouse
(NDIC)
|
| 1 Information Way |
| Bethesda, MD 20892-3560 |
| Phone: |
1-800-860-8747 |
| Fax: |
(703) 738-4929 |
| TDD: |
1-866-569-1162 toll-free |
| Email: |
ndic@info.niddk.nih.gov |
| Web Address: |
http://diabetes.niddk.nih.gov |
| |
|
This clearinghouse provides information about research
and clinical trials supported by the U.S. National Institutes of Health. This
service is provided by the National Institute of Diabetes and Digestive and
Kidney Disease (NIDDK), a part of the National Institutes of Health (NIH).
|
|
References
Citations
-
American Diabetes Association (2011). Standards of medical care in diabetes – 2011. Diabetes Care, 34(Suppl 1): S11–S61.
-
American Diabetes Association (2004). Nephropathy in
diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S79–S83.
-
American Diabetes Association (2004). Retinopathy in
diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S84–S87.
-
American Diabetes Association (2005).
Diabetic neuropathies. Position statement. Diabetes Care, 28(4): 956–962.
-
American Diabetes Association (2004). Aspirin therapy
in diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S72–S73.
-
Gerstein HC (2001). What is diabetes? In HC Gerstein,
RB Haynes, eds., Evidence-Based Diabetes Care, pp.
62–67. Hamilton, ON: BC Decker.
Other Works Consulted
- American Diabetes Association (2004). Influenza and
pneumococcal immunization in diabetes. Position statement. Clinical Practice
Recommendations 2004. Diabetes Care, 27(Suppl 1):
S111–S113.
- Riddle MC, Genuth S (2007). Type 2 diabetes mellitus.
In DC Dale, DD Federman, eds., ACP Medicine, section 9,
chap. 2. New York: WebMD.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
Caroline S. Rhoads, MD - Internal Medicine |
|
Specialist Medical Reviewer
|
David C.W. Lau, MD, PhD, FRCPC - Endocrinology |
|
Last Revised
|
October 19, 2010 |