Author: Amna Paracha, PharmD Candidate, Class of 2021 University of Maryland Eastern Shore School of Pharmacy and Health Professions

Diabetes is a disorder caused by a defect in the secretion of and/or the action of insulin. Insulin, a hormone made by our pancreas, helps control blood glucose levels by signaling different cells to take in glucose (sugar) as our body’s primary source of energy. When this system is disrupted, the glucose stays in our bloodstream and can lead to numerous chronic health conditions.

There are two types of diabetes:

  • Type 1 diabetes is an autoimmune disorder and is characterized by our own immune system attacking and destroying the insulin producing cells in our pancreas.1
  • Type 2 diabetes is attributed to genetics, obesity, hypertension, high cholesterol, and other unknown factors. Type 2 diabetes occurs when our body becomes resistant to insulin or when our body is unable to produce enough insulin to adequately lower our blood glucose levels.1

Whether you are diagnosed with type 1 or type 2 diabetes, the management of either is imperative to your health. Your doctor may ask you to self-monitor your blood glucose levels by testing your own sugar multiple times a day and documenting your readings. When documenting, it is essential to keep an accurate log by including information about the time of the reading, whether it was before or after a meal, and general comments about the day including dietary changes, physical activity, or illness. Printable glucose logs can be found here.

Self-monitoring blood glucose allows practitioners to get a better understanding of a patient’s glucose levels throughout the day. With this patient specific information, providers can help guide physical activity and nutrition recommendations and appropriately titrate medication dosages which empowers patients to better manage their health.2 Studies have shown that frequent monitoring of sugar levels can prevent a hypoglycemic (low blood sugar) or hyperglycemic (high blood sugar) episode and reduce the likelihood of adverse side effects.2

The American Diabetes Association (ADA) and Center for Disease Control (CDC) recommend multiple lifestyle changes to enhance diabetes care.3,4

  • Eat Healthy:
    • Managing your diet helps blood sugars stay in range and prevents the risk of a hyperglycemic or hypoglycemic attack.
    • The Plate Method:
      • Fill half of the plate with non-starchy vegetables (salad, broccoli, cauliflower)
      • Fill one quarter of the plate with a lean protein (chicken, turkey, beans, tofu)
      • Fill one quarter of the plate with a grain or starchy food (potatoes, rice, pasta)
    • Alcohol Consumption:
      • Alcohol consumption can lead to risks including hypoglycemia (especially with insulin therapy), hyperglycemia (if consumed in high amounts), and weight gain.
      • Limit alcohol consumption to no more than one drink per day for women, and for men, no more than two drinks per day.
        • One drink is equal to a 12-oz beer or a 5-oz glass of wine.
      • Quit Smoking:
        • Smokers with diabetes have a heightened risk of cardiovascular disease and premature death.
        • Speak to your doctor to formulate a plan and discuss tools to help you quit smoking.
      • Be Active
        • Exercise has been shown to improve blood glucose control, reduce cardiovascular risk factors, contribute to weight loss, and improve well-being.
        • Most adults with type 1 or type 2 diabetes should engage in 30 minutes or more of moderate to vigorous intensity aerobic exercise five times a week.
          • Aerobic exercise includes walking, swimming, running, or biking.
          • Yoga and tai chi may be included based on individual preferences to increase flexibility, muscular strength, and balance.
        • Get Support
          • Your doctor may include routine psychosocial assessments to address emotional and mental well-being which is an important part of diabetes care and self-management.
          • Incorporate daily meditation or yoga to help you relax or consider joining a diabetes support group to share your thoughts and learn from people who have similar concerns.
        • Prevent Complications
          • Take medications as directed even if you feel fine.
          • Manage your blood pressure and cholesterol by taking prescribed medications, eating a healthy diet, and staying physically active.
          • High blood sugar can lead to nerve damage commonly in the feet. Prevent nerve damage by quitting smoking, eating healthy, and taking medicines as prescribed. Wash and check your feet daily.
          • Follow up with a podiatrist (for your feet) and optometrist (for your eyes) annually to assess the risk of nerve damage.
          • Follow up with your primary care physician regularly.

Diabetes can affect almost every part of your body. Managing your blood sugar helps prevent complications and leads to improved health outcomes.

References:

  1. Diabetes Overview. American Diabetes Association. https://www.diabetes.org/diabetes. Accessed September 23, 2020.
  2. Dailey G. Assessing Glycemic Control With Self-monitoring of Blood Glucose and Hemoglobin A1c Measurements. Mayo Clinic Proceedings. 2007;82(2):229-236. doi:10.4065/82.2.229
  3. Lifestyle Management: Standards of Medical Care in Diabetes—2019. Diabetes Care. 2018;42(Supplement 1). doi:10.2337/dc19-s005
  4. Living with Diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/managing/index.html. Published June 27, 2019. Accessed September 24, 2020.