Daily Management
The Basics
Using diet and exercise, and sometimes medications, Type 2 diabetics can keep their blood sugar levels in a healthy range. As a Type 2 diabetic, you have a daily challenge to:
- Make healthy choices about when, what, and how much to eat
- Exercise
- Take medication (if prescribed by your doctor), which may include insulin
- Test your blood sugar…a lot!
If you haven’t already, please read the “What Is Type 2 Diabetes” on the Type 2 home page.
Controlling Your Blood Sugar Levels
The four components listed above are key to controlling your blood sugar levels. Let’s bite them off one at a time.
Making healthy choices about when, what, and how much to eat
Eating healthy will help keep your blood sugar lower. It is important to remember that there is no one-size-fits-all diet for Type 2 diabetics.
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You need to learn how your body responds to what you eat, how much you eat, and when you eat it. Medication plays an important role, but it is also critical to understand that diet and exercise are the two most important tools you already have at your disposal. In some cases, they can prove an effective cure for Type 2 diabetes.
Eating a well-balanced diet and controlling both the number of calories and the type of calories you consume are the most fundamental parts of any diet. Check out our Type 2 Nutrition section for more.
Please remember, simply keeping your BG in control is only a part of the task here. Controlling your weight is equally as important. The thought here is if you simply shoot up with insulin to get your BG down, you may be piling on weight. Understand there is a correlation between getting high BG down via insulin and weight gain, IF you’re consuming too many carbohydrates/calories. Your BG may be in control but if you are piling on the weight, you need to adjust your eating habits….which could result in less insulin to no insulin needed.
Exercise
When you exercise, your body will need to take glucose out of your bloodstream and use it for energy to fuel your body; this helps lower your blood sugar, making exercise another fundamental ingredient for Type 2 diabetic success. Easier said than done, right? The key is to find an exercise you enjoy. Not everyone wants to be a runner. Not everyone enjoys biking. But everyone, everyone can find some form of physical activity they enjoy, and it doesn’t have to require a fancy gym membership. It can be as simple as putting your shoes on and going for a walk around the block. It can be as low maintenance and “undercover” as popping in a Zumba DVD and enjoying getting sweaty to the music. Try a variety of things until you find something you like, that you are comfortable doing, and that gets your heart rate up and makes you sweat. And then do it for at least 30 minutes, 5 times per week.
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If you’re like most people, you might not enjoy doing the same activity all the time, so try to mix it up. Even if you don’t like the other activity as much, throw it in a couple of times per week to give your body (and your brain) a change of pace.
They say it takes 21 days to form a habit. I don’t know if that’s true for everyone, but you must mentally prepare yourself for those first 21 days because they aren’t going to feel natural if you don’t exercise regularly already. But once it becomes a habit, it’s a whole new ballgame. You might not necessarily look forward to your workout every day, but you will feel downright strange when you don’t do it.
Now, when you start to exercise regularly, that’s when the magic begins to happen. Not only are you going to enjoy all of the benefits that non-diabetics enjoy from exercise (e.g. improved mood, weight loss, less stress, more energy, etc.), you are going to notice a dramatic effect on how your body handles blood glucose. Check out our Exercise section, specific to Type 2 diabetics for tips about how to monitor your body’s positive reaction to exercise.
Take medications (if prescribed by your doctor)
Some Type 2 diabetics can manage their diabetes with a healthy diet and exercise alone, but some must take insulin and/or oral medication (pills), or other injectable medications in addition to diet and exercise.
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There are many types, brands, and variations of medications available to help Type 2 diabetics control their blood sugar. In the Type 2 Management Tools section, we have divided them into three different categories: oral medications, insulin, and other injections.
Oral medications are the most commonly used among diabetics and they can help to lower your blood sugar in a number of ways. They are divided into six different classes based on how they function to lower blood sugar in the body.
Insulin use is more common among Type 2 diabetics than you might think. The longer you’ve had diabetes, the more likely you are to need insulin as part of your regimen; however, it is becoming more common for doctors to prescribe insulin use earlier in treatment for Type 2 diabetics, because they have found that starting insulin sooner, can, in some cases, keep Type 2 diabetics healthier longer.1
Check out the Type 2 Management Tools section for detailed information about different types of medication and how they work.
Test your blood sugar…a lot!
We can’t stress this one enough. Testing is one of the most important tools you have at your disposal for managing your blood sugar. I test 5-8 times a day. Testing helps you understand the impact different activities have on your blood sugar levels. In addition, you will start to recognize the body language associated with the intangibles for a “feeling” of where your blood sugar is at. This is very, very helpful. It also lets you know flat out where you’re at and how you need to respond.
Getting Low
You’re a diabetic…low blood sugar (hypoglycemia) is going to happen and you want to be able to respond immediately and effectively. A few things come to mind:
- Test often – it not only gives you an immediate reading of where you’re at, but it also helps you develop a good sense of what your body is telling you. Am I dehydrated or is my blood sugar high? My body feels fine but I’m not clicking mentally. Is it because I’m tired or am I low? Test and learn what all these wonderful indicators are telling you. They give you an advantage!
- Know this – when you’re low you will not be hitting on all cylinders mentally. You’ve got to make recovery easy and have a plan rehearsed in advance. Know what you are going to do!
- Don’t leave home without it…and I’m not talking about American Express. I’m talking about some form of a relatively high glycemic carbohydrate that can bump you up fast. It has to be easy and accessible. My favorites are Gu, cookies, or orange juice because they’re quick, easy,…and tasty. Glucose tablets work great too.
- Don’t be afraid to ask for help – you’re knowledgeable, you’ve planned accordingly but it’s one of those days where, who knows why, you’re out for a walk and you’re about 15 minutes from home, and whoa baby, your blood sugar is dropping like a rock. There is nothing except an eternity between you and your personally controlled recovery at home. Can you make it…………get it in your mind now; don’t risk it! Ask for help at the closest house or opportunity.
A couple of scenarios to consider that the above will help with:
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You’re a single person, and you wake up in the middle of the night from a hard, confusing dream. Things don’t seem to make sense. Then you notice the phone just quit ringing…or was it your imagination? You're tired, so in a dazed condition you lay down to go back to sleep. Wait!!! Not a good thing to do. You just realized when things don’t make sense you’re going to act and grab a couple of cookies. You do and then check your blood sugar and find out it’s around 48.
You’re at the beach with your kids and...maybe it’s the sun, maybe it was all of the splashing around in the water, but, you just don’t feel quite right. You rummage around in the cooler for a fast-acting carbohydrate, but the kids ate all of the snacks. You forgot your tester and you’re leaving soon anyway, so you think, “Maybe I’m not that low…I can probably hang on until I get home; it’s only about a 20 minute drive.” Wait!!!! Not a good thing to do. You just realized your plan is to trust your instincts when you feel low and ask for help. You call your daughter over and give her a couple of dollars to run up to the vending machine and grab a candy bar for you (go ahead and cringe, all you perfectionists, but it’s not a main component of your diet and it works).
You're in a meeting at work that is dragging on for longer than you expected. It was supposed to go from 10:00 to 11:00 but it's now close to 11:45 and you missed one of your planned mid-morning snacks. The boss is in there, the boss's boss is in there, there are about 10 other high profile individuals whose time needs to be considered carefully and...you're crashing. As a personal choice, you have elected not to let people know you're diabetic, and now you need to step out while in the thick of things. You're waiting for the perfect opportunity but it doesn't seem to present itself so you decide to lay low and avoid being a role player because you're not thinking clearly. Wait!!!! Not a good thing to do. You realized your plan is to simply get up and excuse yourself for a moment and get the carbohydrates stored in your office. You do, recover quickly and return to the meeting where it continues for another 45 minutes. Good thing you grabbed that snack.
Getting low is a dangerous condition. Be prepared and know how you are going to act, so when the time comes, you don’t have to think about it.
Check out the Nutrition page for detailed information and tips about how to effectively use carbs to raise low blood sugar.
At Work Or Away From Home
Home, as should be expected, is your comfort zone and there are many reasons why; you own your schedule, no secrets necessary, and if there are people around you, they are people who understand diabetes. You have the ability to respond to highs and lows at will, you can test, make corrections and eat as needed. When you’re away from home, the trick is to have enough knowledge to establish these home advantages wherever you’re at. Six basic principles stand out:
- Supplies Storage: If you are taking medication, whether insulin, oral medication, or another type of injectable medication, you will want to make sure you can store it properly. You will also need to make sure you have all of your testing supplies available. Do not separate yourself from your supplies; have something (e.g. a purse, tote, or backpack) that you can carry your supplies in.
- Meals and Snacks: You probably have an established eating regimen, directed by your doctor. Try to follow this as closely as possible, especially from a carbohydrate and calories standpoint. Try to have a strategy for the entire day that will align your food consumption to your medication and your weight goals. This will ensure you don’t get too high and at the same time prevent you from getting too low.
- Playing It Safe: If you anticipate it will be a very unpredictable day, establish things very conservatively; if you are using insulin (or another injectable medication), be careful of overestimating your dosage needs, choose foods that you know and are predictable, and take advantage of any opportunity that might present itself to help with corrections.
- Testing: You need to know where your blood sugar is at as you start your day and you need to know what opportunities you can create to test during the day and evening. Test more often than you normally would; an unpredictable day will likely lead to less predictable blood sugar levels.
- Accounting for Physical Activity: Know the impact your day’s physical activities might possibly have on the efficiency of insulin and other medications you take. For example, I have found exercise can significantly lessen the amount of insulin I take to maintain good blood glucose control. Testing will help you identify the impact physical activity has on your blood glucose levels.
- Glucose: Always, always have a quick, easy source of glucose available…don’t leave home without it.
Conclusion
Daily management, regardless of where you might be, needs to always consist of:
- Making healthy choices about diet and exercise.
- Understanding your medication regimen.
- Testing your BG often.
- Keeping supplies, including a fast-acting source of glucose, with you at all times.
- Having a plan that allows an immediate response to any low blood sugar situations you might encounter.
Knowledge and discipline will give you the ability to live and do the things you’ve aspired to and enjoy. So be adventurous, learn as much as you can about managing your diabetes and the process will continue to enhance every aspect of your life.
- References1. American Diabetes Association. Complete Guide to Diabetes. Alexandria, VA: American Diabetes Association, Inc., 2011.
