Managing Diabetes

Diabetes mellitus affects more than 16 million Americans. It damages blood vessels, including the coronary arteries of the heart. Up to 75 percent of those with diabetes develop heart and blood vessel diseases. Diabetes also can lead to stroke, kidney failure, and other problems.

Diabetes occurs when the body is not able to use sugar as it should for growth and energy. The body gets sugar when it changes food into glucose (a form of sugar). A hormone called insulin is needed for the glucose to be taken up and used by the body.

Symptoms of diabetes include: increased thirst and urination, weight loss, and blurred vision, hunger, fatigue, frequent infections, and slow healing of wounds or sores.

There are two main types of diabetes: insulin-dependent, or type 1, and noninsulin-dependent, or type 2. Type 1 usually appears suddenly and most commonly in those under age 30. Type 2 diabetes occurs gradually and most often in those over age 40. Up to 95 percent of those with diabetes have type 2. You’re more likely to develop type 2 if you are overweight or obese, especially with extra weight around the middle, over age 40, have high blood pressure, or have a family history of diabetes. Diabetes is particularly prevalent among African Americans, Asians, and Native Americans.

Because of the link with heart disease, it’s important for those with diabetes to prevent or control heart disease and its risk factors. Besides diabetes, major risk factors for heart disease include smoking, high blood pressure, high blood cholesterol, physical inactivity, and overweight and obesity.

Fortunately, new research shows that the same steps that reduce the risk of heart disease also lower the chance of developing type 2 diabetes. And, for those who already have diabetes, those steps, along with taking any prescribed medication, also can delay or prevent the development of complications of diabetes, such as eye disease and nerve damage.

According to the research, a 7 percent loss of body weight and 150 minutes of moderate-intensity physical activity a week can reduce the chance of developing diabetes by 58 percent in those who are at high risk. The lifestyle changes cut the risk of developing type 2 diabetes regardless of age, ethnicity, gender, or weight.

To reduce the risk of developing diabetes, as well as heart disease, you should:

  • Follow a heart healthy eating plan, which is low in saturated fat and cholesterol, and moderate in total fat.
  • Aim for a healthy weight.
  • Be physically active each day – try to do 30 minutes of moderate-intensity physical activity such as brisk walking on most and, preferably, all days of the week.
  • Don’t smoke.
  • Prevent or control high blood pressure
  • Prevent or control high cholesterol
  • Check your feet every day for cuts, blisters, sores, swelling, redness or sore toenails.
  • Brush and floss your teeth and gums everday.
  • Take any prescribed medication for other sonditions such as coronary heart disease.
  • Check with your doctor about taking aspirin if you have heart disease.
Preventing Diabetes: Questions for the doctor 

Diabetes is a disease. When you have diabetes, there is too much sugar (called glucose) in your blood.

There is more than one type of diabetes, but type 2 diabetes is the most common form of the disease. People who are overweight and inactive are more likely to get type 2 diabetes. Talk to your doctor about how you can prevent type 2 diabetes.

What do I ask the doctor

Visiting the doctor can be stressful. It helps to have questions written down before your appointment. Print out this list of questions, and take it with you the next time you visit the doctor.

  • Am I at risk for type 2 diabetes?
  • Does my weight put me at risk for diabetes?
  • Are there any warning signs of diabetes I should look out for?
  • How can I find out if I have diabetes?
  • What should I eat to prevent or delay diabetes?
  • How much physical activity should I do to prevent or delay diabetes?
  • If I’m overweight, how many pounds do I have to lose to prevent or delay diabetes?
  • What are healthy ways to lose weight and keep it off?
  • What are my blood pressure numbers and cholesterol levels? What should they be?
  • Do my blood pressure and cholesterol numbers put me at risk for diabetes?
  • Can you give me information about preventing diabetes to take home?

If you already have diabetes, you can delay its progression, or prevent or slow the development of heart, blood vessel, and other complications by following the steps given above and these:

  • Eat your meals and snacks at around the same times each day
  • Check with your doctor about physical activities that are best for you
  • Take your diabetes medicine at the same times each day
  • Check your blood sugar every day. Each time you check your blood sugar, write the number in your record book. Call your doctor if your numers are too high or too low for 2 to 3 days.

What are some good types of physical activity for people with diabetes

Walking vigorously, hiking, climbing stairs, swimming, aerobics, dancing, bicycling, skating, skiing, tennis, basketball, volleyball, or other sports are just some examples of physical activity that will work your large muscles, increase your heart rate, and make you breathe harder – important goals for fitness.

In addition, strength training exercises with hand weights, elastic bands, or weight machines can help you build muscle. Stretching helps to make you flexible and prevent soreness after other types of exercise.

Do physical activities you really like. The more fun you have, the more likely you will do it each day. It can be helpful to exercise with a family member or friend.

Are there any safety considerations for people with diabetes when they exercise

Exercise is very important for people with diabetes to stay healthy, but there are a few things to watch out for.

You should avoid some kinds of physical activity if you have certain diabetes complications. Exercise involving heavy weights may be bad for people with blood pressure, blood vessel, or eye problems. Diabetes-related nerve damage can make it hard to tell if you’ve injured your feet during exercise, which can lead to more serious problems. If you do have diabetes complications, your health care provider can tell you which kinds of physical activity would be best for you. Fortunately, there are many different ways to get exercise.

Physical activity can lower your blood glucose too much, causing hypoglycemia, especially in people who take insulin or certain oral medications. Hypoglycemia can happen at the time you’re exercising, just afterward, or even up to a day later. You can get shaky, weak, confused, irritable, anxious, hungry, tired, or sweaty. You can get a headache, or even lose consciousness.

To help prevent hypoglycemia during physical activity, check your blood glucose before you exercise. If it’s below 100, have a small snack. In addition, bring food or glucose tablets with you when you exercise just in case. It is not good for people with diabetes to skip meals at all, but especially not prior to exercise. After you exercise, check to see how it has affected your blood glucose level. If you take insulin, ask your health care provider if there is a preferable time of day for you to exercise, or whether you should change your dosage before physical activity, before beginning an exercise regimen.

On the other hand, you should not exercise when your blood glucose is very high because your level could go even higher. Do not exercise if your blood glucose is above 300, or your fasting blood glucose is above 250 and you have ketones in your urine.

When you exercise, wear cotton socks and athletic shoes that fit well and are comfortable. After you exercise, check your feet for sores, blisters, irritation, cuts, or other injuries.

Drink plenty of fluids during physical activity, since your blood glucose can be affected by dehydration.

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