How to Managing Diabetes

Diabetes is a lifelong, total-body problem. Manage blood sugars and overall health with these smart tips.

Get your team together.
Although your primary-care physician may have been the one to order blood-glucose testing, you need a team of professionals to guide you through all of diabetes' medical details. Ideally your team will include your primary-care physician, an endocrinologist (a hormone specialist who understands the intricacies of insulin), a registered dietitian to help you fine-tune your eating plan, an ophthalmologist (an eye specialist who can look for diabetes-related signs of damage to the retina), a podiatrist (a foot-care specialist who can help prevent complications from diabetes-related nerve damage and skin sores), and a dentist to keep periodontal disease and other infections under control.

Monitor your blood-glucose levels every day.
Some people resist checking their blood-sugar levels, but daily monitoring really is the only way to know if they are under control. Foods, activity level, medications, illness, and even stress can affect blood glucose. Unless you check, you might not know whether your levels are holding steady or spiraling out of control. Ask your doctor how often you need to check — and what to do if your blood glucose readings are abnormal.

Take diabetes medication as directed.
Diabetes symptoms are silent, so you may not notice an immediate repercussion when you neglect to take your medicine — and that means far too many people decide against taking prescribed medications (or "forget" to take them). Don't be one of them! Untreated diabetes carries the grave risks of heart disease, nerve damage, and other complications. Take medications or insulin as directed by your physician. If you have uncomfortable side effects or questions about your medication or treatment plan, talk with your doctor.

Exercise.
Next to weight control and medical treatment, exercise is the most important thing you can do to take control over diabetes. Exercise decreases body fat and promotes weight loss — but even if you don't lose weight as a result, exercise will improve blood-sugar control and your body's response to insulin and even help prevent heart disease. Aim for 30 minutes of activity, five days per week. Studies show that all levels of exercise are beneficial, from moderate-intensity walking to high-intensity resistance training with weights. The key is to find something you enjoy doing and will stick with — whether it's walking, swimming, cycling, or dancing — and then get moving!

Keep a food record.
As you are learning to gain control over your weight and blood sugar, it can be helpful to keep a log that includes some specific information about your eating habits. Every time you eat, jot down where you are; what time it is; how hungry you feel before beginning to eat and again when you stop eating; the foods and amounts eaten; and your thoughts or feelings at the time. Over time, you'll start to see patterns. By identifying the situations in which you're most likely to make poor food choices — something we often do as a response to anxiety or stress — you can learn to substitute new activities.

If you smoke, quit.
Smoking increases the risk of developing diabetes, and once you have it, smoking makes every problem and complication associated with diabetes even worse. Smoking raises blood-glucose levels, constricts blood vessels, and causes inflammation, and smokers have an increased risk of kidney disease, nerve damage, blood-vessel damage, and foot and leg infections. Note that many people gain weight after quitting smoking because they try to satisfy their nicotine cravings by eating more — a particularly dangerous strategy for people with diabetes. Therefore, it's super-important to quit smoking, if you smoke — and to be mindful of your food intake as you kick the bad habit.

Drink alcohol only in moderation…if at all.
Drinking between one-half and two alcoholic drinks per day has been shown to reduce the risk of developing type 2 diabetes by an average of 30 percent, compared with nondrinkers or heavy drinkers. However, among people who already have diabetes, there is some question about the benefits of alcohol. Talk to your doctor to make sure that alcohol is safe for you and that you understand how it might affect your blood-glucose levels. And if you don't already drink alcohol, don't start.
Brush and floss regularly.
Just as unregulated diabetes leads to high levels of glucose in your blood, it also leads to higher-than-usual levels of glucose in your saliva, which raises the risk for dental decay. Plus, diabetes makes fighting infection harder, so that if gum disease develops, you'll have a more difficult time getting rid of it than someone without diabetes. However, research suggests that people with diabetes who gain control over their periodontal problems have better glycemic control after gum treatment than before. For healthy teeth and gums, dentists and nutritionists alike recommend that you see your dentist regularly, brush with a fluoride toothpaste at least twice a day, and remember to floss.

Seek treatment for sleep apnea or daytime sleepiness.

Excessive daytime sleepiness is often a sign of sleep apnea, a disorder that causes interruptions in breathing during sleep up to several times per night. It may be caused by faulty signals from the brain or because the soft tissue at the back of the throat relaxes and blocks the airway (called obstructive sleep apnea, or OSA). Most people with sleep apnea don't know what is happening or why they feel so tired after what seems like a full night's rest. People with diabetes are more likely to have sleep apnea than people without diabetes — and OSA itself increases the risk of insulin resistance and may be a roadblock to diabetes control. If you have sleep apnea, or if you experience unusual sleepiness during the daytime, talk with your doctor. A full night's sleep is not just a luxury, it's a health necessity.
Be meticulous with your foot care.
Diabetes can cause neuropathy, or nerve damage, in the extremities — usually starting in the feet, so good foot care is critical. The key words are clean and dry. Wash your feet daily in warm water, and dry with a clean, soft towel. Do not soak your feet or use hot water. If you have nerve damage, due to the lack of sensation in your feet you may not notice sores, blisters, calluses, swelling, bruising, or breaks in the skin — so you'll need to be meticulous about inspecting your feet every day. Also, talk to your doctor right away about how to treat any problems. Don't walk barefoot — always wear shoes or slippers — and wear clean, soft socks with your shoes. Talk with your podiatrist about other ways to keep your feet safe.