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Diabetes management requires awareness, knowing what makes your blood sugar (glucose) level rise and fall — and how to control these day-to-day factors.
Effective management can help prevent complications and improve your quality of life.
Norton Community Medical Associates – Endocrinology and Wendy Novak Diabetes Institute, a part of Norton Healthcare, provide diabetes treatment for a variety of conditions. Treatment for diabetes depends on the type of diabetes and individual circumstances. Here are some common treatment approaches:Type 1 diabetes treatment: People with Type 1 diabetes require insulin therapy since their bodies do not produce insulin. Insulin is usually injected using syringes, insulin pens or insulin pumps. Blood sugar monitoring, a healthy diet, regular exercise and education on managing diabetes are also essential.
Type 2 diabetes treatment: Treatment for Type 2 diabetes may involve lifestyle changes, oral medications, and sometimes insulin or other injectable medications. Lifestyle modifications include adopting a healthy diet, regular physical activity, weight management and monitoring blood sugar levels.
Medications: Depending on the type and severity of diabetes, various oral medications may be prescribed to manage blood sugar levels. These medications work by increasing insulin production, improving insulin sensitivity or reducing glucose production in the liver.
Insulin therapy: In addition to people with Type 1 diabetes, some people with Type 2 diabetes may require insulin therapy to control their blood sugar levels. Insulin can be administered through injections or insulin pumps.
Blood sugar monitoring: Regular monitoring of blood sugar levels is crucial for managing diabetes. This helps individuals understand how their lifestyle choices and medications affect their blood sugar levels, enabling them to make necessary adjustments.
Healthy lifestyle: A healthy lifestyle plays a vital role in diabetes management. This includes following a balanced diet, engaging in regular physical activity, managing stress levels, getting adequate sleep and avoiding tobacco and excessive alcohol consumption.
It’s important to work closely with a health care team to develop an individualized treatment plan that suits your specific needs and goals.
Blood sugar testing is an important part of diabetes care. Although the A1C test through your provider is a great tool, it only gives your health care team an “average” of your blood sugar over three months.
Blood sugar monitoring at home helps the health care team look for day-to-day patterns. It also helps assess whether your diabetes care plan is working, including your diet and current diabetes medicines. There will be times when you need to check your blood sugar more often than usual, such as when you are sick, changing or adding medication, or are experiencing high or low readings. Always take your blood sugar log or meter to your office visits so your provider can review these numbers with you. Your health care provider will let you know how often to check your blood sugar levels.
People living with diabetes also may choose to use a CGM or continuous glucose monitor. CGMs are another way to check your blood sugar. It is a tiny sensor that is placed under your skin to measure blood sugar levels in the fluids between your skin’s cells every few minutes. You must have a prescription for these devices, and insurance coverage can vary. Talk with your provider about CGMs if you are interested.
There are many types of diabetes medicines that work in different ways to lower your blood sugar. Type 1 diabetes patients must be on insulin. Type 2 diabetes patients can be on oral medications, insulin or a combination of oral medications and insulin. Sometimes one medicine will be enough, but in other cases, your doctor may prescribe a combination of medications. Medications work better when you eat healthy meals and follow an exercise plan.
Insulin therapy often is an important part of diabetes treatment. It helps keep blood sugar under control and prevents diabetes complications. It works like the insulin that the body usually makes. Insulin is a hormone naturally made in your pancreas that helps move sugar (glucose) from your blood into the cells of your body, where it turns into energy.
Insulin must be injected. It comes in pre-filled pens or in a bottle (vial). Unopened insulin vials and pens must be kept in the refrigerator. Opened vials and pens can be kept at room temperature. Read your medication insert or check with your pharmacist about your specific insulin. Never store insulin anywhere that gets extremely cold or hot.
Below is general list of the types of insulin available:
Other diabetes medications may include:
Below is a general list of commonly prescribed diabetes medicines. Remember there are always new medicines being released, so check with your provider or pharmacist if you are prescribed a medicine not on this list:
Diet plays a crucial role in managing diabetes so that you can keep your blood sugar levels in your target range. Your diabetes care team can help compile a good meal plan that considers your goals, tastes, lifestyle and medication management.
Stay well-hydrated and follow a balanced diet that includes a variety of fruits, vegetables, whole grains, lean proteins and healthy fats. Avoid overconsumption of sugary and processed foods, as well as excessive carbohydrates — as carbohydrates in the food you eat can raise your blood sugar levels.
Carbohydrate counting or “carb counting” is a meal-planning tool that helps you make better decisions about how much carbohydrate you should eat at a meal. Do not think of it as a “diet.” Good nutrition should be realistic and sustainable so you can make healthy choices for the rest of your life. Carb counting is very individualized depending on your sex, age, physical activity, stage of diabetes and current diabetes medicines. It is always best to ask your provider for a referral to have a visit with a registered dietitian or attend a diabetes class so someone with dietary expertise can assess your specific needs.
Below are very general recommendations for how much carbohydrate to eat with meals. It is very important to look at carbohydrate intake per meal (for example: 45 grams of carbs per meal) versus the whole day (for example: 150 grams for the whole day) so your intake is consistent at each meal. The following examples are considered a reduced-carb plan from the average diet, and may take some time to achieve:
How do I know how much carbohydrates are in food?
Examples of common foods:
Our diabetes care team also recommends the “plate method.”
The plate method is a simple and practical way to plan balanced meals for individuals with diabetes. It helps in portion control and encourages a balanced intake of different food groups. Here’s how the plate method works:
Visualize your plate: Imagine dividing your plate into different sections.
Fill half your plate with nonstarchy vegetables: Nonstarchy vegetables include leafy greens, broccoli, cauliflower, peppers, zucchini and more. These vegetables are low in calories and carbohydrates but rich in essential nutrients and fiber.
Fill one-quarter of your plate with lean protein: Choose lean sources of protein such as skinless poultry, fish, tofu, legumes or lean cuts of meat. These provide essential amino acids and help with muscle maintenance and repair.
Fill one-quarter of your plate with whole grains or starchy foods: Include whole grains like brown rice, quinoa, whole-wheat bread or starchy foods like potatoes, corn or peas. These provide energy and fiber. Choose whole-grain options for added nutrients and fiber.
Add a serving of fruit or dairy: Include a serving of fruit or a small portion of low-fat dairy, such as a piece of fruit or a cup of yogurt, to complete your meal. Fruits provide natural sugars and fiber, while dairy products offer calcium and protein.
Be mindful of portion sizes: Pay attention to portion sizes to avoid overeating. Use smaller plates or bowls to help with portion control.
Stay hydrated: Drink water or unsweetened beverages throughout the day to stay hydrated and support overall health.
Remember, the plate method is a guideline, and individual needs may vary. It’s best to work with a registered dietitian or health care provider to personalize your meal plan based on your specific dietary requirements and blood sugar goals.
Making lifestyle changes is very important for people with diabetes. It’s essential to work closely with your diabetes care team to develop a personalized plan that suits your specific needs and goals. The team can provide guidance and support to help you make sustainable lifestyle modifications for effective diabetes management.
Regular physical activity: Engage in regular exercise or physical activity to help maintain a healthy weight, improve insulin sensitivity and manage blood sugar levels. Aim for at least 150 minutes of moderate-intensity aerobic exercise per week, along with strength training exercises.
Weight management: Achieve and maintain a healthy weight through a combination of healthy eating and regular physical activity. Losing excess weight can help with insulin resistance and blood sugar control.
Medication adherence: Take prescribed medications as directed by your health care provider. This may include oral medications or insulin injections to help manage blood sugar levels effectively.
Stress management: Practice stress-reducing techniques such as meditation, deep breathing exercises or engaging in hobbies and activities you enjoy. Stress can affect blood sugar levels, so managing stress is important for diabetes management. Discuss any sadness or anxiety with your provider.
General health: If you smoke, quitting is highly recommended, as smoking increases the risk of various complications associated with diabetes, such as heart disease and nerve damage. It’s also recommended to limit alcohol consumption, as alcohol can interfere with blood sugar control, quality of sleep, medication interaction, liver health and weight management. Other general health suggestions include getting a good night’s rest, brushing and flossing daily and staying up to date on vaccines.
Foot checks: A lot of diabetes-related complications can start in your feet. Patients with poorly managed blood sugar or high blood pressure may benefit from having their feet checked more often, such as every three to six months. Some common changes in foot health include:
Patients and their families have access to certified diabetes educators who teach about various topics, such as how to use nutrition and diet to manage blood sugar, how to operate a glucose monitor and more. We know that living with diabetes can be challenging and requires constant attention, and that’s why we provide a library of content to educate patients about the condition and share important management methods. Check out our patient support page for more.
Scheduling regular office visits with your endocrinology care team and an annual checkup with your primary care provider to address your overall health can help reduce the possibility of long-term complications from diabetes.
Other visits recommended for people with diabetes include:
Checkups enable early detection of any complications associated with diabetes. Guidelines from the Centers for Disease Control and Prevention describe what should happen with your diabetes care throughout the year to reduce your risk of long-term complications. These guidelines are called the standards of care. They list what you and your provider need to do to take care of your diabetes and prevent long-term complications.
Long-term complications can lead to:
The standards of care also list targets for your “diabetes ABCs.” Talk with your provider about your specific goals:
Below are recommendations of how often you should have health checks to manage your diabetes:
With diabetes, hypoglycemia and hyperglycemia are two conditions that result from imbalances in blood sugar levels:Hypoglycemia: Hypoglycemia occurs when blood sugar levels drop too low, typically below 70 milligrams per deciliter. It can be caused by factors such as excessive insulin or diabetes medication, delayed or missed meals, increased physical activity, or alcohol consumption. Symptoms of hypoglycemia may include shakiness, dizziness, sweating, confusion, irritability, weakness, rapid heartbeat and, in severe cases, loss of consciousness or seizures. Immediate treatment involves consuming a fast-acting carbohydrate source like glucose tablets, fruit juice or regular soda, followed by a snack containing protein and carbohydrate to stabilize blood sugar levels.
Hyperglycemia: Hyperglycemia occurs when blood sugar levels rise too high, typically above the target range set by an individual’s health care provider. It can be caused by factors such as inadequate insulin or diabetes medication, consuming excessive carbohydrates, illness, stress, or lack of physical activity. Symptoms of hyperglycemia may include frequent urination, increased thirst, dry mouth, blurred vision, fatigue, slow-healing wounds and recurrent infections. If left untreated, it can lead to diabetic ketoacidosis in individuals with Type 1 diabetes. Treatment involves following the health care provider’s instructions, adjusting medications as needed, drinking plenty of water to stay hydrated and monitoring blood sugar levels closely.
It’s important for individuals with diabetes to monitor their blood sugar levels regularly, adhere to their prescribed treatment plans and seek medical advice if they experience persistent episodes of hypoglycemia or hyperglycemia. Proper management and prompt treatment of these conditions help maintain optimal blood sugar control and reduce the risk of complications.
Emergency preparedness is crucial for individuals with diabetes to ensure their safety and well-being during unexpected situations. Here are some key steps to consider:
Emergency kit: Prepare an emergency kit that includes essential diabetes supplies. This should include extra glucose monitoring devices, insulin (if applicable), syringes or insulin pens, oral diabetes medications, extra batteries for glucose meters, and a glucagon emergency kit if prescribed. Ensure the supplies are stored in a cool, dry place, and regularly check expiration dates.
Medical information: Keep a copy of your medical information in your emergency kit. Include details such as your diagnosis, current medications, dosages, allergies, emergency contacts, health care provider’s information and health insurance details. Also, consider wearing a medical ID bracelet or necklace that indicates you have diabetes.
Emergency contacts: Maintain an updated list of emergency contacts, including your health care provider, family members and close friends. Make sure they are aware of your diabetes and understand how to assist you during an emergency.
Communication plan: Establish a communication plan with your loved ones in case of an emergency. Determine a designated meeting place or a point of contact to ensure everyone’s safety and well-being.
Stockpile supplies: During emergencies, access to medical supplies may be limited. Consider keeping a stockpile of diabetes-specific supplies, including glucose test strips, lancets and medications, to last for at least a week.
Food and water: Have nonperishable food items available that align with your dietary needs. Include snacks or glucose tablets to treat low blood sugar. Also, store sufficient amounts of water for drinking and other purposes.
Power sources: Have alternative power sources available, such as battery-operated glucose meters or portable chargers, to ensure you can monitor your blood sugar levels and stay connected during power outages.
Emergency evacuation plan: Develop an emergency evacuation plan tailored to your specific needs. Identify accessible routes, shelters or medical facilities in case you need to evacuate due to natural disasters or other emergencies.
Educate others: Inform family members, friends and co-workers about your diabetes and how to recognize and respond to signs of low or high blood sugar levels. Teach them how to administer glucagon (if necessary) and when to seek medical help.
Remember, consult with your health care provider for personalized emergency preparedness recommendations based on your specific health condition and needs. Being proactive and prepared can help you effectively manage your diabetes during emergencies and ensure your safety.
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