Lifestyle Changes to Manage Type 2 Diabetes
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Only a minority are able to manage type 2 diabetes with lifestyle changes without the help of medications. Most people need to do both.
Losing weight and beginning a regular exercise program can help bring your blood glucose levels to within the normal range. However, this does not mean that your diabetes has been cured. Rather, you must maintain these lifestyle habits, including a healthy diet, to keep your blood sugar in control and to minimize the chances of complications.
If you gain weight, reduce your exercise, or eat a poor diet, high blood sugar levels will likely return. Also, the high blood sugar and/or diabetic complications resulting from increased insulin resistance that led to your initial diagnosis of type 2 diabetes will gradually worsen over time and during periods of stress.
Eventually, diet and exercise alone may not be enough to maintain blood sugar levels within a normal range. You may need to take oral anti-diabetes medications or even insulin, Exenatide, or Pramlintide injections to keep blood sugars in a healthy range.
Weight loss is the first step you can take to help lower your blood glucose level. As you lose weight, your body's cells will be more responsive to insulin. This can lead to improved blood sugar control.
The safest and most effective way to lose weight is by exercising regularly, eating fewer calories, and following a healthy diet. You should strive for gradual and continual weight loss until you reach your ideal weight. If you are overweight, losing just 5%-10% of your body weight can make a big difference in your blood sugar control.
Talk with your doctor to determine a healthful weight for you and to design an exercise and diet program. Ask for a referral to a registered dietitian or athletic trainer for more personalized help. A study found that group education may help people reach their goals for losing weight.
The dietary guidelines for managing diabetes can seem complicated. However, you'll see that the recommendations are the same as those for general good health, and you can eat the same foods as everyone else.
A registered dietitian can help you make sense of these guidelines and help you develop healthful eating patterns that will work for you. Ask your doctor for a referral to a registered dietitian.
The basic eating guidelines for people with type 2 diabetes are:
Follow a Routine
Eat 2-3 snacks per day, and keep them with you at all times in case a meal is delayed. If you are looking for a good choice for a snack, try ]]>nuts]]> or peanut butter, which have been shown to lower the risk of cardiovascular disease in women with diabetes.
Just before bedtime, have a snack that contains both protein and starch. Eating at this time can help control the changes in blood sugar that may occur while you sleep.
Eat three meals per day, and don't skip meals. Each meal should be at about the same time each day and contain about the same amount of carbohydrate, protein, and fat as the same meal the day before. Your blood sugar rises and falls in response to your eating patterns. Therefore, by eating about the same amounts and types of food at the same times each day, you can easily predict when your blood sugar level will rise. This makes it easier to match your antidiabetic medications or insulin, Exenatide, or Pramlintide dose with these rises in blood sugar.
Eat a Varied, Healthful Diet
Follow the Food Guide Pyramid, which is the government's recommendation for healthful eating. However, for people with type 2 diabetes, there are a few modifications:
- Starchy vegetables, like green peas, corn, and potatoes are considered part of the grains group.
- Cheese is not part of the milk group, instead it is put in with the meat and others group.
Following the Food Guide Pyramid will also help you to eat a low-fat, high-fiber diet. Having type 2 diabetes puts you at greater risk of developing heart disease. A high-fat diet also increases your risk. Choose a diet that is low in saturated and trans fat and cholesterol to help protect your heart.
Fiber can help lower blood cholesterol and blood pressure. It is also thought to help your body use insulin better. Slowly increase your fiber intake to 20-35 grams of fiber per day. Good sources of fiber include whole grains, fruits, vegetables, and legumes. Be sure to increase your fluid intake with your fiber.
The Food Guide Pyramid provides a range of servings in each food group. A registered dietitian can help you determine where you fall in these ranges.
Sugar (glucose) and starch are both carbohydrates. Your body reacts to any type of carbohydrate in the same way, so the total amount of carbohydrate you eat is more important for blood sugar control than the source.
A dietitian can help you determine how many grams of carbohydrate you should eat per day. This amount should be dispersed evenly throughout your meals and snacks, and you may need to avoid foods high in sugar. Many foods contain carbohydrates. Grain products, fruits, and milk products contain the most. Sodas have a lot of sugars and should be avoided.
Keep a Record
Keep a record of your meals, include the time you ate, what you ate, and how much you ate. Include this information with your blood sugar levels and insulin dosages. This information is very helpful when you discuss how to modify your medication and/or diet regimen with your doctor and registered dietitian.
Regular exercise is essential for everyone to ensure better health. Exercise is especially beneficial in diabetes because it can help you:
- Lose weight and keep it off.
- Improve blood sugar control—Persistent fitness (aerobic) and resistance (weights) training have been shown to lower hemoglobin A1c (HbA1c) levels, a measure of average blood glucose levels over the past three months. . Long-term strength and endurance training may produce this effect even in the absence of weight loss.
- Decrease blood pressure.
All of these effects likely contribute to a lower risk of heart disease, a common complication of diabetes.
One study found that brief counseling during a doctor's appointment may help with exercise. Those in the study didn't have a difference in weight loss, but did have an increase in physical activity. Not only can exercising help you improve glucose control, but it can also reduce your
Talk with your doctor about your exercise program. Since exercise causes your blood sugar to drop, you may need to make some modifications in your medication dose and schedule, as well as your eating plan. Also, when you exercise, remember to wear your diabetes identification bracelet or use a shoe tag.
When to Contact Your Doctor
Contact your doctor if you:
- Are having difficulty losing weight
- Have any questions about your eating plan
- Feel that your eating plan is too difficult to follow
- Want to start an exercise program or make significant changes in your present program
Have any symptoms of hypoglycemia after exercising
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Last reviewed March 2010 by ]]>Bridget Sinnott, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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