Monday, November 2, 2015

How is Diabetes Managed?


Diabetes is managed by keeping blood sugar under control and as close to normal as possible. For most people with diabetes, a healthy range is between 90 and 130 mg/dl before meals and less than 180 mg/dl at one to two hours after a meal. This is the key to avoiding complications and discomfort. Here are some ways to manage diabetes:

Exercise. Work up to at least 30 minutes a day, most days of the week. Regular physical activity helps to manage diabetes. People with diabetes should talk to their doctor or health care provider before starting any exercise plan. Some good ways to get exercise are to:

Take a brisk walk (outside or inside on a treadmill).
Go dancing.
Take a low-impact aerobics class.
Swim or do water aerobic exercises.
Ice-skate or roller-skate.
Play tennis.
Ride a stationary bicycle indoors.

  • Park the car farther away from your destination.
  • Get on or off the bus several blocks away from your stop.
  • Take the stairs instead of the elevator or escalator.
  • Exercise while watching TV.
  • Walk around while you talk on the phone.
  • Play with the kids.
  • Take the dog for a walk.
  • Take the stairs instead of the elevator or escalator.
  • Get up to change the TV channel instead of using the remote control.
  • Work in the garden or rake leaves.
  • Clean the house.
  • Wash the car.
  • Stretch out your chores. For example, make two trips to take the laundry downstairs instead of one.
  • Park at the far end of the grocery store lot and walk to the store.
  • At work, walk over to see a co-worker instead of calling or emailing.
  • Stretch or walk around instead of taking a coffee break and eating.
  • During your lunch break, walk to the post office or do other errands.

Choose Healthy Food. Good nutrition is a very important part of diabetes management. People with diabetes should work with their diabetes healthcare team to develop an eating plan that meets their personal food preferences while keeping blood glucose in a healthy range. By choosing nutritious foods and balancing what and how much you eat with activity level, blood sugar levels can be kept as close to normal as possible. Here are a few tips on making healthy food choices for the entire family.

Eat lots of vegetables and fruits. Try picking from the rainbow of colors available to add variety to your meals. Choose more non-starchy vegetables that have lots of vitamins and minerals such as spinach, carrots, broccoli or green beans with meals.
Choose whole grain foods instead of processed grain products like white bread, white rice or regular pasta. Try brown rice with your stir-fry or whole wheat spaghetti with your favorite pasta sauce.
Include fish in your meals two to three times a week and choose lean meats like chicken and turkey without the skin. To prepare meats and fish with less fat, trim any visible fat and use low-fat cooking methods such as broiling, grilling, roasting, poaching or stir-frying.
Include dried beans (like kidney or pinto beans) and lentils in your meals.
Choose low fat dairy products such as milk, yogurt and cheese (1 percent fat or less).
Choose liquid oils such as canola, olive or peanut oil for cooking, instead of solid fats such as butter, lard and shortening. Remember that all fats are high in calories. If you're trying to lose weight, cut back on portion sizes of added fats.
Choose fruit that is in-season for dessert – you'll get more flavor and pay less too! Try to cut back on high-calorie dessert and snack foods such as chips, cookies, cakes and ice cream that give you and your family little nutrition.
Choose water and calorie-free "diet" drinks instead of regular soda, fruit punch, sweet tea and other sugar-sweetened drinks.
Control your portion sizes. Remember that the amount of food you eat is important in getting to and staying at a healthy weight. Even eating too much healthy food can lead to weight gain.

Take Your Medicine. It is important for people with diabetes to know what medicines they are taking, why they are taking them and how to take them. People with diabetes should tell their doctor or health care provider if they are taking any herbs or other supplements.

Check Blood Sugar. A doctor or health care provider can explain how to test blood sugar and how often it should be checked.

Quit Smoking. The NYS Smoker's Quitline (1-866-697-8487) provides help to people who want to stop smoking.

A1C Blood Test. This blood test measures the average blood sugar over the last three months. It should be done two to four times a year. An A1C measure of less than 7 percent is the goal. (More information on A1C testing for diabetes control).

Blood Pressure. This should be checked at each visit to a doctor or health care provider. A blood pressure reading of less than 130/80 mmHg is the goal.

Cholesterol. A lipid profile blood test should be checked once a year. This includes total cholesterol, triglycerides, LDL and HDL. The total cholesterol should be less than 200 mg/dL, the LDL (known as the bad cholesterol) should be less than 100 mg/dL and the HDL (known as the good cholesterol) should be greater than 40 mg/dL for men and greater than 50 mg/dL for women.

Eye Exam. A dilated eye exam should be done every year by an optometrist or ophthalmologist (an eye doctor who specializes in eye diseases). During a dilated eye exam, eye drops are used to make the pupil (the black part of the eye) bigger. This allows the eye doctor to see the back of the eye. Finding eye problems early and getting treatment right away will help prevent more serious problems later on.

Foot Exam. It is important that people with diabetes take off their shoes and socks at every doctor's visit and learn how to check their feet daily for cuts, breaks in the skin, or ingrown toenails. The doctor also needs to know if there are any changes in the color or shape of the feet, or if there is any pain or lack of sensation.

Kidney Test. People with diabetes need to have a blood or urine test ordered by their doctor every year to check how well their kidneys are working.

Flu Shot. A flu shot should be given once every year. A doctor or health care provider may also order a pneumonia shot.

Dental Exam. It is important that people with diabetes have their teeth and gums checked every six months.

Coping Skills. People with diabetes may need to talk to their health care team about any feelings, problems or questions they may have. People with diabetes are at higher risk for depression.