Managing diabetes

Type 2 diabetes is a chronic disease, which means that you have it for life. Although there’s no cure, you and your doctor can work together to control your blood sugar, which can help reduce your risk for type 2 diabetes complications.
Managing type 2 diabetes over months and years can mean making changes in your treatment plan. Diet and physical activity may control your blood sugar at first, but you may need to take medicine down the road. Over time, may need to change medicines, or add medicines, to keep your blood sugar under control. You may even need to use insulin.

Diabetes Is A Changeable Disease

Type 2 diabetes is a progressive disease, which means that it can get worse over time. That's why most patients eventually need medicines, usually more than one, and sometimes insulin. Even when treatment controls your blood sugar, you need to stick with it, or your blood sugar will get too high again.

By checking your blood sugar yourself and getting regular A1C tests, you and your doctor can see how well your treatment is controlling your blood sugar. If your response to treatment changes, your doctor can make adjustments as needed. That’s important, because you don’t want to subject your body to high blood sugar, which can cause damage.

Part of what makes type 2 diabetes such a serious disease is that it can affect many different areas of the body, from the heart and brain to nerves, eyes and skin. By caring for your body, including seeing your doctor regularly and getting the health tests that he or she recommends, you can help reduce your risk for health complications.

Take Care Of Your Body

High blood sugar can affect your organs and cause serious health complications. Along with seeing your doctor and other members of your healthcare team regularly for tests and checkups, there’s a lot you can do yourself to take care of your body

Reduce your risk of heart attack and stroke

- Keep your blood pressure and cholesterol under control.
- Try to do some type of activity at least 30 minutes most days of the week. Check with your doctor to learn what activities are best for you.
- Eat heart-healthy foods like oatmeal, whole-grain breads and cereals, fruits, and vegetables. Cut back on foods high in saturated fat or cholesterol. Avoid foods with trans fat, such as snack foods.
- Quit smoking. Talk with your doctors about options that could help you.
- Ask your doctor if you should take an aspirin daily to lower your risk of heart disease and stroke.

Reduce your risk for kidney complications

- Keep your blood pressure below 130/80 Ask your doctor what numbers are best for you.
- Ask your doctor about pills to slow down kidney damage.
- Follow your healthy eating plan. If you already have kidney problems, your dietitian may suggest you cut back on protein, such as meat.
- Have any kidney tests your doctor recommends.
- Avoid taking pain medications regularly, because they can damage the kidneys.

Reduce your risk for foot complications

- Make sure your shoes fit well and always wear socks or stockings to prevent blisters. Blisters can become infected, which can cause serious problems leading to amputation.
- Wash your feet each day in warm water. Dry them well, especially between your toes.
- If your skin is dry, rub lotion on your feet after you wash and dry them. Don’t put lotion between your toes.
- Check daily for cuts, sores, blisters, redness, calluses, or other problems.
- File corns and calluses gently after bathing or showering.

Reduce your risk for skin complications

- Use mild soap when you bathe or shower, and rinse and dry yourself well.
- Check your skin after you wash. Make sure you have no dry, red, or sore spots that might lead to an infection.
- Apply lotion or cream after bathing to keep your skin moist.
- Drink lots of fluids (especially water), to keep your skin moist and healthy.

Complications

Good blood sugar control can reduce your risk of serious health complications from type 2 diabetes, like:

- Heart disease and stroke. Adults with type 2 diabetes are more likely to have heart disease or a stroke. Heart disease is the leading cause of death in people with diabetes.
- High blood pressure. Many adults with diabetes have high blood pressure or take prescription medicine(s) for high blood pressure.
- Eye problems. People with diabetes are at risk for cataracts, glaucoma, and problems with the retina (retinopathy), which can reduce vision or cause blindness. Diabetes is the leading cause of new cases of blindness in adults ages 20 to 74.

Blood Sugar Control

Checking your blood sugar level is a key part of your diabetes plan. It's a two-part process:

1. Blood sugar testing shows your blood sugar level at the exact time of the test.
2. The A1C test is done at your doctor's office. It shows your average blood sugar over the past two to three months.

Blood Sugar Targets

- Above 180 mg/dL = A blood sugar level greater than 180 mg/dL, one to two hours after the start of a meal, or greater than 130 mg/dL before a meal, shows that your diabetes is not under good control.
- 100 to 140 mg/dL = This should be your blood sugar range when you go to sleep
- 90 to 130 mg/dL = This should be the blood sugar range before you eat.
- 70 mg/dL or below = You may have low blood sugar (hypoglycemia)

How To Test Your Blood Sugar

One of the most important tests to help you manage your diabetes is the blood-sugar reading that you may take several times a day. Your doctor will tell you how often to test your blood sugar.

Often your home tests show blood sugar levels that are about 10% lower than levels found in lab tests. So, it's important to also have your blood sugar tested by your doctor.

Checking your blood sugar regularly helps you and your doctor see how your diabetes management plan is working. Your aim is to lower your blood sugar level and keep it there.

- A1C Test

The A1C test shows your average blood sugar level over the past two or three months. It's the best way to see how well your type 2 diabetes is controlled.

It usually takes two to three months to see changes in your A1C. So, you may get this test two to four times a year, depending on how well your treatment is working. The A1C blood test is usually done at your doctor's office.

It is recommended that people with type 2 diabetes reach an A1C goal of 6.5% or less. Reaching this goal is important, since every 1% increase above 6% raises your risk for diabetes-related complications . If your levels rise above your personal goal, you may need to change the diabetes medicine, or add new medicine

Low Blood Sugar

Low blood sugar (hypoglycemia) happens when you eat too little or not often enough, exercise more than usual, take too much of some diabetes medicine(s), or drink alcohol. Symptoms include:
- Hunger
- Nervousness and shakiness
- Sweating
- Dizziness
- Sleepiness
- Confusion
- Feeling anxious or weak

If you have any of these symptoms, test your blood sugar. If it's low, eat or drink a small amount of something that has sugar, like two or three glucose tablets, five or six pieces of hard candy, or 1/2 cup of fruit juice.

High Blood Sugar

Having too much sugar in the blood for long periods of time can cause serious health problems if it's not treated. Hyperglycemia can cause damage to the vessels that supply blood to vital organs, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems in people with diabetes. These problems don't usually show up in kids or teens with diabetes who have had the disease for only a few years. However, these health problems can occur in adulthood in some people with diabetes, particularly if they haven't managed or controlled their diabetes properly
Causes
- not taking your diabetes medicine when you're supposed to or not taking the right amounts
- not following the meal plan (like eating too much on a special occasion without adjusting your diabetes medicines)
- not getting enough exercise
- having an illness, like the flu, or stress
- taking other kinds of medicines that affect how your diabetes medicines work

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