Diet, exercise are cornerstones of managing diabetes
Diabetes can be a daunting diagnosis, but proper management of blood sugar levels help patients live long, productive lives with minimal complications, especially if we catch it early.
People with diabetes have too much glucose, often called blood sugar, which can lead to problems such as heart disease and stroke, high blood pressure, blindness, nerve and kidney damage and amputations. Early detection and treatment can prevent organ damage and reduce the risk of these complications.
In Type 1 diabetes, the body does not produce insulin, the hormone needed to convert blood sugar into energy. In Type 2, the body does not properly use insulin, leading to the build-up of glucose in the blood. Type 2 diabetes accounts for 95 percent of cases.
Type 2 is almost always preceded by “pre-diabetes,” in which blood glucose levels are higher than normal, but not high enough to be diabetes. In this early stage we can begin preventative treatment to hold blood sugar levels at or near normal.
Diabetes symptoms may include frequent urination, excessive thirst, unusual weight loss and fatigue, but many people with Type 2 diabetes have no symptoms. Family history, obesity and inactivity are among Type 2 risk factors. Blood tests that measure your glucose level help us make a diagnosis.
Once we make the diagnosis, our goal is to control your blood sugar level. Diet and exercise are cornerstones of control.
Diet should follow American Diabetes Association guidelines. Generally speaking, it includes a variety of healthy choices — vegetables, whole grains, fruits, non-fat dairy, beans, lean meats and poultry — in moderate amounts. Your physician may refer you to a dietitian to help you learn how to eat correctly.
Regular exercise helps control weight, lowers blood sugar and mitigates the risk of complication such as heart disease, the incidence of which is four times greater among people with diabetes. Just 30 minutes a day of biking, brisk walking or even treading water in the pool has myriad benefits. Regular physical activity helps everyone.
When diet and exercise are not enough, we may need medication to achieve blood sugar goals. Many people may require only an oral medication for treatment. We have a variety from which to choose. Patients with a Type 2 diagnosis don’t always have to immediately add insulin. The need for medication depends on where we find patients in the disease process and the effect diet and exercise is having.
Most people with Type 2 diabetes need to monitor their blood sugar at home at different periods, typically when they wake in the morning and after they eat their largest meal. Some patients may have to monitor more often. Like many practices, our office offers the equipment and training to help you learn how to do this. Tracking your blood sugar response to food can help teach you what to eat.
A physician with expertise in diabetes management can determine the severity of your condition and outline interventions. Certified diabetes educators, classes and support groups can help you learn about management and cope with its inconvenience. Most physicians have referrals to educational professionals and support groups.
Finally, good management requires a close working relationship with your physician, who may want to see you every couple of weeks at first to evaluate your progress and find the right procedures to follow.
Learning to manage diabetes is a lifelong commitment, but most people are able to become proficient in their home care, fit it into their lifestyle and lead normal lives.
Dr. Robert Gnade is a family physician and active member of the Grady Memorial Hospital medical staff.