American College Of Physicians Guidance Statement
According to a 2018 guidance statement by the American College of Physicians , Clinicians should aim to achieve an HbA1c level between 7% and 8% in most patients with type 2 diabetes. The ACP said that this higher target is aimed at helping patients benefit from glycemic control while avoiding the adverse effectsassociated with low blood sugar, medication burden, and costsof stricter targets. The ACP stated that evidence does not indicate that medication therapy to reduce the HbA1c level to 7% or less results in reduced mortality or in decreased macrovascular complications, such as heart attack or stroke, compared with a reduction to about 8%.
However, experts from the American Diabetes Association and the American Association of Clinical Endocrinologists have expressed skepticism about the higher target, noting that the guidance statement does not take into account the cardiovascular disease benefits of newer drugs, which themselves frequently reduce HbA1c levels. In response, a coauthor of the ACP statement observed that other guidelines have also not specifically accounted for these newer medications in their recommended HbA1c levels and that research on such drugs has primarily been in patients either with cardiovascular disease or at high risk of developing it.
Tip #2 Cut Way Back On The Number Of Carbs That You Eat
Carbohydrates are the enemy of diabetics. They are one of the main causes of blood sugar spikes. Yes, other things can cause a spike like stress and illnesses, but carbs are the biggy and its an easy fix. I say easy because all you have to do is stop eating so many carbs. I know that can be easier said than done because sugar/carbs are addictive and its tough to quit cold turkey.;
When I first found out that I was diabetic, I immediately stopped drinking sugary sodas and switched to Diet Coke. That made a huge difference for me. But, I stopped drinking Diet Cokes a few years ago due to the artificial sweeteners that are in them. These days, I drink Bubly, Waterloo, and LaCroix flavored seltzer water which have 0 calories or sweeteners in them. I add a few drops of liquid stevia sweetener to them and they taste awesome and I dont miss regular sodas at all.
I have also stopped eating potato chips with my sandwiches. This was a tough one because I enjoy salty crunchy chips with my lunches. But I found that pork rinds are a great alternative. I didnt care for pork rinds at first, but now I love them and enjoy trying different brands and flavors. Pork rinds have zero carbs, so you can have salty crunchy chips without glucose spikes that go with them. My current favorites are the generic store brands of plain pork rinds. I like them better than the popular Macs brand.
Who Gets Type 2 Diabetes
There are people who are healthy and get type 2 diabetes and there are people who are unhealthy and get type 2 diabetes, says Dr. Christofides. Its a bit like lung cancer in that not everyone who smokes gets lung cancer, and some people get lung cancer who have never smoked.
Type 2 diabetes is multifactorial, explains Sharon Bergquist MD, meaning that a persons genes, environment, and lifestyle work together to lead to the disease. Some of the increased risk may be attributed to genetic susceptibility, but a higher percentage is likely due to environment and lifestyle, which can be influenced by culture and socioeconomics.
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How Can I Treat High Blood Sugar
Talk to your doctor about how to keep your blood sugar levels within your target range. Your doctor may suggest the following:
- Be more active. Regular exercise can help keep your blood sugar levels on track. Important: dont exercise if ketones are present in your urine. This can make your blood sugar go even higher.
- Take medicine as instructed. If your blood sugar is often high, your doctor may change how much medicine you take or when you take it.
- Follow your diabetes meal plan. Ask your doctor or dietitian for help if youre having trouble sticking to it.
- Check your blood sugar as directed by your doctor. Check more often if youre sick or if youre concerned about high or low blood sugar.
- Talk to your doctor about adjusting how much insulin you take and what types of insulin to use.
Statistics About Type 2 Diabetes
The report the following statistics about diabetes in the United States:
- Over 30 million people have diabetes. Thats around 10 percent of the population.
- One in four people have no idea they have diabetes.
- Prediabetes affects 84.1 million adults, and 90 percent of them are unaware of it.
- Non-Hispanic black, Hispanic, and Native American adults are to have diabetes as non-Hispanic white adults.
The ADA reports the following statistics:
- In 2017, diabetes cost the United States $327 billion in direct medical costs and reduced productivity.
- The average medical expenses for people with diabetes are about 2.3 times higher than they would be in the absence of diabetes.
- Diabetes is the seventh leading cause of death in the United States, either as the underlying cause of death or as a contributing cause of death.
Diabetes impact is widespread. It touches the lives of nearly half-a-billion of people around the world. View some infographics that shine a light on other diabetes statistics you should know.
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What Are The Symptoms Of Type 2 Diabetes
Symptoms of Type 2 diabetes tend to develop slowly over time. They can include:
- Urinary tract infections and bladder infections.
Rarely, Type 2 diabetes leads to a condition called diabetic ketoacidosis . DKA is a life-threatening condition that causes your blood to become acidic. People with Type 1 diabetes are more likely to have DKA.
You Can Eat Many Types Of Foods
There’s nothing you cannot eat if you have type 2 diabetes, but you’ll have to limit certain foods.
You should:
- eat a wide range of foods including fruit, vegetables and some starchy foods like pasta
- keep sugar, fat and salt to a minimum
- eat breakfast, lunch and dinner every day do not skip meals
If you need to change your diet, it might be easier to make small changes every week.
Information about food can be found on these diabetes sites:
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How To Learn More About Diabetes
- Take classes to learn more about living with diabetes. To find a class, check with your health care team, hospital, or area health clinic. You can also search online.
- Join a support group in-person or online to get peer support with managing your diabetes.
- Read about diabetes online. Go toNational Diabetes Education Program.
Diet And Diabetes: How To Manage Type 2 Diabetes Through Your Diet
With more people being diagnosed with type 2 diabetes, it’s important to raise awareness and empower people to manage their diabetes to prevent or delay the onset of any complications. As a dietician, one of the areas that people often get confused about is their diet.
Reviewed byDr Sarah Jarvis MBE
21-Apr-21·6 mins read
Research has evolved so much in the past decade and so has the dietary advice. So what should you eat to manage your type 2 diabetes?
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Ask Your Doctor If Losing Weight Might Help Your Condition
Not everyone with type 2 diabetes would benefit from losing weight. This really varies from person to person, which is why you should always talk to your doctor before trying to lose weight in an attempt to control your type 2 diabetes.
With that in mind, its important to know that being overweight or obese has been associated with the onset or exacerbation of type 2 diabetes because it is linked with insulin resistance. Insulin resistance happens when your body cant properly use the hormone insulin to regulate your blood glucose levels. It can lead to excessively high blood sugar, prompting diabetes.
So, losing weight may help to lower your blood sugar levels by decreasing your insulin resistance. The exact amount of weight loss it takes to bring about this effect is different for different people . However, according to the Mayo Clinic, losing 5 to 10 percent body weight has made a difference for some people.
Tell Them About The Symptoms Of Low Blood Sugar
Like most people with type 2, I was immediately put on metformin, the most common type 2 diabetes medication, to help lower my blood sugar. Foolishly, I thought this medicine and my new eating habits would completely eliminate my past sugar swings, which could make me light-headed or even panicky, both common symptoms of hypoglycemia. But these episodes didnt completely disappear.
For example, on some days, my work schedule made it really hard to stick to my meal plan, so I asked everyone around me to be on the outlook for any sudden mood change and alert me. That way, I could eat a hard candy, a piece of fruit, or even a small protein-based meal to get my blood sugar under control until I could eat a proper meal. . Sure, its not always fun when other people are grabbing a doughnut or cupcake at 4 p.m., but I always remember the word stat ringing in my ear and remind myself how lucky I am to be alive.
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Set Goals That Promote Healthy Habits
Keeping your blood sugar within a target range helps to lower your risk of complications from type 2 diabetes. Adopting healthy habits can help you achieve and maintain that target range.
Consider taking some time to reflect on your current lifestyle habits and the changes you could make to manage your condition.
For example, you might benefit from:
- adjusting your eating habits
- testing your blood sugar levels more often
- taking your prescribed medications more consistently
Even small changes to your habits might make a positive difference to your blood sugar levels or overall health.
When Should I Call My Doctor
Its important to monitor diabetes very closely if youre sick. Even a common cold can be dangerous if it interferes with your insulin and blood sugar levels. Make a sick day plan with your healthcare provider so you know how often to check your blood sugar and what medications to take.
Contact your provider right away if you experience:
- Confusion or memory loss.
- Nausea and vomiting for more than four hours.
- Problems with balance or coordination.
- Severe pain anywhere in your body.
- Trouble moving your arms or legs.
A note from Cleveland Clinic
Type 2 diabetes is a disease where your body doesnt make enough insulin and cant use sugar the way it should. Sugar, or glucose, builds up in your blood. High blood sugar can lead to serious health complications. But Type 2 diabetes is manageable. Regular exercise and a healthy diet can help you manage your blood sugar. You may also need medication or insulin. If you have Type 2 diabetes, you should monitor your blood sugar at home regularly and stay in close communication with your healthcare provider.
Last reviewed by a Cleveland Clinic medical professional on 03/25/2021.
References
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What Should A Type 2 Diabetes Meal Plan Include
Ask your healthcare provider or a nutritionist to recommend a meal plan thats right for you. In general, a Type 2 diabetes meal plans should include:
- Lean proteins: Proteins low in saturated fats include chicken, eggs and seafood. Plant-based proteins include tofu, nuts and beans.
- Minimally processed carbohydrates: Refined carbs like white bread, pasta and potatoes can cause your blood sugar to increase quickly. Choose carbs that cause a more gradual blood sugar increase such as whole grains like oatmeal, brown rice and whole-grain pasta.
- No added salt: Too much sodium, or salt, can increase your blood pressure. Lower your sodium by avoiding processed foods like those that come in cans or packages. Choose salt-free spices and use healthy oils instead of salad dressing.
- No added sugars: Avoid sugary foods and drinks, such as pies, cakes and soda. Choose water or unsweetened tea to drink.
- Non-starchy vegetables: These vegetables are lower in carbohydrates, so they dont cause blood sugar spikes. Examples include broccoli, carrots and cauliflower.
Faq: Frequently Asked Questions
Is type 2 diabetes genetic?
Over 75% of kids with type 2 diabetes also have a relative with the condition. But this could be due to similar lifestyles in the family rather than genetic factors. Like any condition, some people have a genetic predisposition towards both insulin insensitivity and type 2 diabetes, but the primary factor governing type 2 diabetes is lifestyle.
How often do I need to monitor my blood sugar if I have type 2 diabetes?
You and your healthcare provider should decide when and how often you need to check your blood sugar. You can keep a record in a smart phone app or on paper so you can easily chart your variations. Doctors recommend that diabetes patients get an A1C test at least two times a year.
How has type 2 diabetes changed over time?
Type 2 diabetes used to be called adult-onset diabetes or non-insulin dependent diabetes because it was diagnosed mainly in adults who did not require insulin to manage their condition. However, because more children are starting to be diagnosed with T2D, and insulin is used more frequently to help manage type 2 diabetes, referring to the condition as adult-onset or non-insulin dependent is no longer accurate or used.
Can type 2 diabetes be cured?
Yes! Your greatest opportunity to reverse type 2 diabetes is early detection and intervention.
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Putting It All Together
Treating and managing diabetes can seem complicated at times. But your diabetes health care team is there for you. Your diabetes management plan should be easy to understand, detailed, and written down for you so that you can refer to it whenever you need to.
The good news about type 2 diabetes is that if you do the diabetes treatment steps listed above, your blood sugar levels can return to a healthier range. For some people with type 2 diabetes, that can mean not even needing to take diabetes medicines anymore.
You also might hear about alternative treatments for diabetes, such as herbal remedies and vitamin or mineral supplements. These practices can be risky, especially when people stop following the treatment plan their doctor has given them. So get the facts by talking to your diabetes health care team. They keep track of the latest research developments, and will introduce new products as they become available.
Consider The Glycemic Index
The Glycemic Index ranks carbohydrate-containing foods according to how they affect BGLs. Foods with a low GI raise BGLs more slowly and steadily than foods with a high GI.
Low-GI foods include heavy grain bread, rolled oats and muesli, pasta, corn, orange sweet potato, most legumes, low-fat milk and yogurt, as well as some fruits.
Tips: You dont need to cut out higher-GI foods completely the trick is to combine them in a meal with low-GI options to help balance them out.
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Together We Can Make The Difference
Supporting People with Diabetes
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Do I Have To Give Up Sugar Forever
The simple answer is no but it is advisable to cut down on refined sugars, foods with added sugars and highly sweetened foods like soft drinks, chocolate, cakes and biscuits, especially if your current intake is high. With or without diabetes, we should all be eating less refined sugars which can contribute to weight gain and obesity, heart disease and dental issues.
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Appreciate Your Body Daily
Your body does amazing things every day. Notice them and be grateful.
Create a gratitude journal and implement this practice every day. List two or three things you appreciate about your body.
For example: Im grateful for my legs that carry me through the day. Im grateful for my arms that hug my children every night.
Take Medicines As Prescribed
Several medicines are available for people with type 2 diabetes. They work in different ways to help the body make or respond to insulin better.
Sometimes pills for diabetes even when combined with diet and exercise aren’t enough to keep blood sugar levels under control. Some people with type 2 diabetes also have to take insulin. The only way to get insulin into the body now is by injection with a needle or with an insulin pump. If someone tried to take insulin as a pill, the acids and digestive juices in the stomach and intestines would break down the medicine, and it wouldn’t work.
Getting insulin injections today is nearly painless, thanks to smaller needles. Insulin pumps cut down on the number of injections needed.
Different kinds of insulin are used for different purposes. The types of insulin you use and how you take it each day will depend on what’s best for you and your daily schedule.
If you take an insulin shot but forget to eat, your blood sugar levels can get too low. So try to avoid skipping meals or snacks. If your parents remind you to eat when you take your insulin, it’s probably because they worry about you, not because they’re trying to nag you!
Your diabetes health care team will teach you how and when to give yourself insulin.
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