Here's a closer look at the main treatments :
Blood sugar monitoring
Blood sugar is the most crucial marker for diabetics. Elevated blood sugar levels — a condition called hyperglycemia — can lead to a range of adverse symptoms. So patients with diabetes must frequently check their own blood sugar (aka blood glucose) levels.
Called self-monitoring of blood glucose (SMBG), this practice also helps you recognize trends in your glucose levels and gives your health care provider the information he needs to better manage your diabetes.
The whole process takes less than 2 minutes and should be performed with a frequency prescribed by your doctor (usually between 1 to 5 times a day, depending on how difficult your sugars are to control or how active you are), before or after meals or exercise, with a small, sharp needle, test strip and glucose meter. The ideal glucose range may vary slightly from patient to patient, so make sure your doctor clearly states what yours should be.
Pricking the sides of your fingers (not the fatty middle part) and rotating fingers from one SMBG check to the next can make monitoring more comfortable.
Get more information and tips on blood-glucose monitoring.
Diet
While diet is a key to health for all of us, it is even more important for people with diabetes to eat the right foods in moderate portions and at regular times. By sticking to a diet with a fairly consistent calorie count and carbohydrate level, you can keep your blood sugar and weight under control, says Caren Feingold Tishfield, a registered dietitian at Foodtrainers and Mindful Menus in New York City.
That doesn't mean you have to eat the same food every day. "Overall, I suggest a varied diet, with [a healthful mix of] carbs, fats and proteins," Tishfield says. And that should include your favorite foods because attempts to make immediate, drastic changes to your diet tend to be unsuccessful.
So you can have that occasional piece of apple pie. "But you have to adjust," says Tishfield, by working closely with your dietitian to choose foods that you’ll enjoy but that also help support any weight-loss goals or medications you’re taking.
Counting carbs is a popular tool for diabetics, especially those taking medications or insulin. But merely limiting carbs probably isn’t the best answer, she says.
"It's not just about low carbs only anymore," Tishfield adds. "It's about the type and amount of carbs." For example, opt for foods with a low glycemic index (i.e., they don't incite a rapid rise of blood sugar) such as brown rice and sweet potatoes rather than white rice or white or red potatoes.
Create your diabetes healthy-eating plan.
Exercise
Regular exercise can greatly reduce the risk of cardiovascular disease (a major risk for those with diabetes), help you lose weight and manage stress, says Greg Rothman, a certified personal trainer and president of emPower Fitness Studios in New York City.
"I talk to people about the disease process being reversible, [and] that can be a great motivator," he says.
Rothman starts most of his clients with diabetes on strength and cardiovascular programs — beginning with as little as 10 minutes a day. "You don’t want people to get frustrated," he says. "But if you can eventually build a low ratio of fat to muscle and increase insulin sensitivity because of this, you can improve the [type 2] disease."
Exercises that lead to a total body workout are preferable, even for beginners. Rothman also suggests traditional push-ups. (If you can't do them, try the modified version with knees on the floor for support). "Just do as many as you can do, and build up to eventually completing 3 sets of 10 reps," he says.
Try to eat 1 to 2 hours before you exercise (to optimize your energy for a workout), and check your blood sugar before and after exercising. If you can’t work with a personal trainer, get regular exercise by joining a gym or social club thats centered around physical activities (mall walking, for example), or get family members to join you for walks or bike rides.
Take control of your diabetes with exercise.
Weight loss
A healthful eating plan definitely helps you manage blood sugar, but so does losing any excess weight. (Most people with type 2 diabetes are about 20% heavier, on average, than they should be). Dropping pounds also minimizes blood vessel damage, lowers blood pressure and reduces risk of heart disease.
In theory, losing weight is simple: You must burn more calories than you consume. Some common tools for losing weight include calorie counting and portion control, but counting calories takes vigilance, Tishfield says.
"Even people like dietitians underestimate what they'll eat in a day," she says. "People are very bad at calorie counting. Unless you measure and weigh out all your food, it's hard to get an accurate calorie count."
Portion control is being able to visualize your food — a serving of meat or fish, for example, should be about the size of your fist or a deck of cards — and using that to keep your portions under control.
If you're determined to count every calorie, buy an inexpensive food scale, and weigh and measure your food so you're able to "eyeball" your meals anywhere you are. "You need to ask yourself 'What does 300 calories of chicken look like?' So if you're at a restaurant, you'll have a visual to draw from," Tishfield says.
Keeping a food journal and knowing your body mass index (BMI) — which takes into account your height and weight to estimate your percent of body fat — is also helpful when it comes to weight loss.
Learn more about portion control for weight and diabetes.
Oral medications
Even with a combination of exercise, healthful eating and glucose monitoring, sometimes an oral medication may be needed to keep blood sugar under control for people with type 2 diabetes.
For many people, the best thing about these medications is that they don’t require an injection, says John Buse, M.D., Ph.D., president-elect for the Medicine & Science Division of the American Diabetes Association and a professor at the University of North Carolina School of Medicine in Chapel Hill.
"In some cases, [oral medications] are not as effective as insulin because of potential side effects," among the 8 classes of medications for diabetes now available," he says.
"There are a lot of options — from drugs that have no side affects to drugs that may cause weight gain, fluid retention, hypoglycemia and nausea... though they're relatively rare. Most people will tolerate any of the oral meds just fine," adds Buse, who points to metformin as one of the first options for diabetes patients. "The advantage [of metformin] is that it's not associated with hypoglycemia or weight gain and is proven to reduce complications."
Get a detailed look at all the oral medications and side effects.
Insulin therapy
Insulin therapy — usually injected several times a day — can help prevent diabetes complications by keeping your blood sugar within your target range. If your doctor says that you need insulin therapy, take it seriously. For people who have type 1 diabetes, since their pancreas produces little or no insulin, insulin therapy is necessary for survival.
"Twenty years ago, the needles we used were big like small nails. Now they're tiny, about the size of a hair," Buse says. "Insulin is arguably the most effective drug we have and the best proven treatment for avoiding complications such as nerve disease, heart attacks and stroke. If patients really understood insulin therapy, they would beg for it."
If you’re afraid of even a small needle, insulin treatments now come in inhalers and insulin pens, which allow you to dial up the dose you need and deliver them with a short and essentially painless injection.
Just like all drugs, insulin has side effects —"weight gain and low blood sugar are par for the course," Buse says. So be extra careful with a lifestyle plan, especially your diet.
Find out how insulin works in the body.
Alternative therapies
Though there's no definitive evidence for the use of specific alternative therapies in diabetes, herbs, supplements and vitamins are used by millions to treat virtually every disease. "It's not very well-documented, but the use of chromium supplements and cinnamon extracts have been found by some to be moderately effective," Buse says.
The use of chromium supplements is not uncommon, and the accumulating evidence from small, non-controlled clinical trials suggests that chromium supplementation may alleviate symptoms associated with diabetes and reduce the need for extraneous insulin in patients with type 2 diabetes. However, a recent large study did not confirm any benefits for chromium supplementation in type 2 diabetes.
In one double-blind study of 60 people, the use of cinnamon at a dose of 1 gram or more daily reduced blood sugar levels by 18% to 29% after 40 days of consumption. On the other hand, another study showed no effect of cinnamon on blood sugar levels of postmenopausal women with type 2 diabetes.
By : Mitch Rustad
