Type 2 Diabetes: Living With the Disease
Treatment Overview
Your treatment for type 2 diabetes will change over time to meet your individual needs. But the focus of your treatment will always be to keep your blood sugar levels within a normal or near-normal range to prevent complications from diabetes, such as eye, kidney, heart, blood vessel, and nerve disease. You play an important role in managing your condition. By learning about diabetes and working with your health professional to create a plan for treatment, you can improve your health and quality of life.
How can you manage your diabetes?
Follow your diet
It is important to follow a healthy, balanced diet that includes whole grains, lean meat, fish, and vegetables. To help control your blood sugar and reduce your risk for complications from diabetes, limit alcohol. And reduce calories if you need to lose weight.
Of the three major nutrients (carbohydrate, protein, and fat), carbohydrate has the greatest effect on blood sugar. Because you have diabetes, it's important that you include the proper amount of carbohydrate in your daily diet and that you space carbohydrate evenly throughout the day. You can use one of the following approaches:
Carbohydrate counting for people with diabetes who do not use insulin (preferred)
Planning meals to manage diabetes often means looking at food in a new way. Some people may have trouble accepting the changes they need to make in their lifestyle. You may find it helpful to read about how emotions influence what we eat, when we eat, and how much we eat:
Take an ASA daily
If you are 21 or older, talk to your health professional about taking a low-dose ASA daily to help prevent heart attack, stroke, and other large blood vessel disease (macrovascular disease). People with diabetes are 2 to 4 times more likely than people who don't have diabetes to die from heart and blood vessel diseases.16
Exercise regularly
Exercise helps control your blood sugar, because you use glucose for energy during and after activity. It also helps you stay at a healthy weight; lower high cholesterol; raise high-density lipoprotein (HDL), or "good," cholesterol; and lower high blood pressure. These benefits help prevent cardiovascular disease. Try to do activities that raise your heart rate. Each week, exercise for at least 150 minutes spread over at least 3 days that are not in a row. Or, if you can, get more than 4 hours each week. The Canadian Diabetes Association suggests that you include resistance exercises in your program.2 Resistance exercises can include activities like weight lifting or even yard work. See the topic Fitness for ideas on how to add daily activity to your life. Work with your health professional to develop a safe exercise program.
Maintain blood sugar control
Lower high blood pressure and high cholesterol
It's important to keep your blood pressure and cholesterol at recommended levels to reduce your risk of heart disease and large blood vessel disease.
- Blood pressure should be less than 130/80 millimetres of mercury (mm Hg) in people with diabetes. Moderate exercise, such as 30 to 45 minutes of brisk walking most days of the week, can help lower blood pressure. But you may need to take one or more medicines, such as angiotensin-converting enzyme (ACE) inhibitors or thiazide diuretics, to achieve your goal.9
- A low-fat diet, including eating oily fish 2 or 3 times a week;exercise; and weight loss can lower your cholesterol.10 Your body needs insulin to process fats, as it does with carbohydrate. If your diabetes is poorly controlled, the fats in your blood (particularly triglycerides) can rise significantly. You should strive for a goal of less than 2.0 millimoles per litre (mmol/L) (80 milligrams per decilitre [mg/dL]) for low-density lipoprotein (LDL), or "bad," cholesterol. HDL should be more than 1.03 mmol/L (40 mg/dL) for men and more than 1.3 mmol/L (50 mg/dL) for women. Triglycerides should be less than 1.5 mmol/L (130 mg/dL). Statins reduce LDL levels and the risk of heart disease in people with diabetes.7 They also have been shown to reduce the risk of heart attack and stroke by one-third in people with diabetes, even those who do not have high LDL levels or existing heart disease.11
Take care of yourself in other ways
- Don't smoke.
- Take care of your skin and your teeth and gums.
- Know what to do when you are sick.
- Grieve the things you feel you have lost because of diabetes.
- Wear identification to let medical personnel know that you have diabetes so they can give you appropriate care. You can buy medical identification in bracelets
, necklaces, or other forms of jewellery at your local drugstore.
- Know why foot care is important, and take care of your feet daily. For information, see:
- Limit your alcohol intake to no more than 1 drink a day
- See your health professional regularly. For more information, see the Examinations and Tests section of this topic.
If you take oral diabetes medicine
Take your medicine as directed. If you take one of the medicines with low blood sugar as a side effect, learn to:
If you need to take insulin
If you become severely ill, have surgery, become pregnant, or breast-feed, you may need insulin injections temporarily even though you normally take only oral medicine. You should be able to return to your usual treatment after the situation is over.
As type 2 diabetes progresses, your pancreas may produce less and less insulin. This means that you have to take insulin, usually by giving yourself a shot several times a day for the rest of your life.
If you take insulin, learn how to:
Also, learn how to:
- Take precautions when you are driving. Do not drive if your blood sugar is below 4 millimoles per litre (mmol/L).
- Take precautions to prevent problems while travelling.
Other issues
Talk with your health professional if you want to know about:
- Treatment changes to prepare for pregnancy.
- Finding a support group.
- Immunizations. See the topic Immunizations for the recommended immunization schedule.
More information
What to Think About
The United Kingdom Prospective Diabetes Study (UKPDS) showed that keeping blood sugar levels within a normal or near-normal range helps decrease a person's chances of developing complications from diabetes. Every effort you make to get your blood sugar level closer to a normal or near-normal range leads to some lowering of your risk for complications.
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| Author: | Alison Allen Caroline Rea, RN, BS, MS | Last Updated: November 14, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Caroline S. Rhoads, MD - Internal Medicine Matthew I. Kim, MD - Endocrinology & Metabolism David C.W. Lau, MD, PhD, FRCPC - Endocrinology & Metabolism | |
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