Managing Diabetes

Basic Facts

Diabetes mellitus is a condition in which blood glucose (sugar) levels are too high because the body cannot produce insulin or cannot use insulin efficiently.
If left untreated, diabetes can result in numerous complications, including atherosclerosis, heart attack, stroke, kidney disease, blindness, and amputation. Treatment lowers the risk of these devastating complications.
Controlling diabetes depends mainly on ensuring that blood glucose levels do not rise too high or fall too low. By controlling blood glucose levels, people with diabetes can delay or avoid many of the complications the disorder causes.
Diabetes mellitus is a condition in which the body cannot regulate the amount of glucose in a person’s blood. In diabetes, the body either produces too little insulin, no longer uses insulin efficiently, or both. There are several types of diabetes, including: type 1 diabetes, type 2 diabetes, and Gestational diabetes. There is also a condition called pre-diabetes (also called glucose intolerance or insulin resistance).

Positive Impact of Proper Management

Effectively managing diabetes will also help to lower the risk fora number of other health conditions, including:

Heart attack
Angina (chest pain)
Carotid artery disease
Compromised immune system
Connective tissue disorders
Diabetic vascular disease, gangrene, and limb loss
Enlarged prostate
Eye problems
High blood pressure
Hypoglycemia
Ketoacidosis
Kidney infection
Leg artery disease
Incontinence
Nephropathy
Nerve damage
Prostate infection
Renal (kidney) failure
Renal artery disease
Retinopathy
Sexual dysfunction
Skin problems
Stroke
Ureteral stones
Infertility

Getting Started

Physicians diagnose diabetes by measuring the amount of glucose in a person’s blood in one of the following tests:

Fasting glucose test
Oral glucose tolerance test
Hemoglobin A1c test
Finger stick test

After the physician diagnoses diabetes, he or she will screen the individual for any complications. Anyone who has been diagnosed with diabetes or pre-diabetes is a prime candidate to utilize methods that control diabetes.

Management Options

Target blood glucose levels are roughly as follows:

Before breakfast / dinner / snacks, blood glucose levels should be: 90 to 130 mg/dL
Two hours after meals, blood glucose levels should be: less than 160 mg/dL
Blood glucose levels at bedtime should range between: 110 and 150 mg/dL

Managing diabetes involves different methods and treatments that help stabilize and balance blood glucose levels.

Medications

People with type 1 diabetes must receive insulin replacement therapy. This treatment is delivered to the individual by insulin injections (manual) or an insulin pump (wearable device; automatic). Additionally, oral medications can help to increase insulin production or increase the body’s sensitivity to insulin, allowing it to work more effectively.

Blood Glucose Monitoring

Regularly monitoring and logging blood glucose levels is an important component of managing diabetes. Monitoring is typically done by regularly using a finger-stick test. Newer technologies allow an individual to draw blood from the forearm instead of the fingers.

Maintain a Healthy Diet

The physician will recommend that the patient meet with a nutritionist or dietitian after being diagnosed, in order to get assistance with developing a meal plan. The recommended daily dietary ranges typically include:

6 to 11 servings of grains and starches
3 to 5 servings of vegetables
2 to 4 servings of fruit
2 to 3 servings of dairy products
4 to 6 ounces of meats, poultry, and fish

To maintain proper blood glucose levels, individuals with diabetes should adhere to the following guidelines:

Plan regular times for meals and snacks
Eat at the same time every day
Do not go too long between meals
Do not skip meals
Take diabetes medications at the same time every day
Check with your physician to determine the best time to take medications, based on the meal plan

Exercise

It is recommended (after consulting with a physician) that people with diabetes should exercise aerobically for 30 minutes, at least 5 times per week. Because exercise lowers blood glucose, people with diabetes should consider the following exercise guidelines:

Exercise at about the same time every day
Measure blood glucose before and after exercising
Learn the symptoms of hypoglycemia
Have sugar readily available (such as glucose tablets, juice, or hard candy) in case blood glucose drops below 70 mg/dL during exercise
Stay hydrated during exercise

Lose Weight

People with diabetes and pre-diabetes should lose weight and aim to get to an optimal weight for their body frame, in order to better manage blood glucose levels.

Quit Smoking

Nicotine interferes with the functioning of insulin, making it more difficult to regulate blood glucose levels. People diagnosed with diabetes and pre-diabetes should quit smoking.

Limit Alcohol Consumption

Alcohol should be consumed in moderation, which means no more than an average of 1 to 2 drinks/day for men, and 1 drink/day for women. Alcohol is quickly converted to glucose but it can also lower blood sugar, especially in people who take insulin replacement therapy or oral medications. Therefore, diabetes patients should never drink on an empty stomach.

Check for Foot Ulcers

To minimize the risk of foot ulcers (sores that don’t heal well) that can lead to gangrene, people with diabetes should examine their feet every day and protect their feet from surface injuries and prolonged or excess moisture.

Monitoring for Complications

People with diabetes should make sure that they receive the following tests and procedures regularly, in order to ensure that they are meeting health goals for blood glucose, blood pressure and cholesterol, and to screen for any complications:

Hemoglobin A1c
Microalbuminuria
Cholesterol
Foot examination
Eye examination
Blood pressure
Vaccines
Preconception care
Ankle Brachial Index

Timeline of Effectiveness

Many of the above lifestyle changes will make a difference immediately. By maintaining tight control over blood glucose levels, a person can avoid hyperglycemia and hypoglycemia and retain a high quality of life. Exercise and weight loss greatly affect a person’s insulin sensitivity and can greatly improve cholesterol levels quickly.

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Medical Review Date: November 5, 2008 / Copyright © 2012 NorthPoint Domain, Inc. All rights reserved. This material cannot be reproduced in digital or printed form without the express consent of NorthPoint Domain, Inc. Unauthorized copying or distribution of NorthPoint Domain’s Content is an infringement of the copyright holder’s rights.