In discussing self management with the person with diabetes I focus on how healthy lifestyle behaviors can change the treatment plan. Introducing healthy lifestyle behaviors by providing consistent and predictable meals, daily activity, healthy coping and consistent medication management can improve overall glucose control and may change the overall treatment plan for managing diabetes.
Type 2 diabetes is a condition that is characterised by chronically elevated blood sugar levels. However, the main cause as well as the driver for this condition is something called Insulin Resistance. When you eat certain foods, particularly refined carbohydrates, that food is converted to sugar inside your body. Your body’s way of dealing with this sugar is to produce a hormone called insulin. Insulin moves the sugar inside your cells so that it can be used for energy. Sounds great, right?
Yes. The combination of insulin and an oral medication, when taken as directed by your doctor, is very safe and effective in controlling blood sugar. A typical combination therapy consists of taking an oral medication during the day and insulin at night. Once you begin taking insulin, you will need to monitor your blood sugar more often to reduce the risk of low blood sugar reactions.Combination therapies are often helpful for people who have Type 2 diabetes (adult onset diabetes). If you have been taking an oral medication, your doctor may change your treatment plan to include insulin injections. This change is often made to help people with Type 2 diabetes gain better control of their blood sugar.
Foods high in fiber: Research shows that 90 percent of the U.S. population doesn’t consume enough fiber on a daily basis. High-fiber foods help slow down glucose absorption, regulate your blood sugar levels and support detoxification. Aim to eat at least 30 grams of fiber per day, which can come from vegetables (like Brussels sprouts, peas and artichokes), avocados, berries, nuts and seeds, especially chia seeds and flaxseeds. (9)
Get Your Fats in Good Balance– Overabundance of Omega-6 fats in the diet is a contributing factor in diabetes. Pay attention to your intake of Omega-3 and Omega-6 fats and try to get them closer to a 1:1 ratio. For many people, supplementing with a good quality Omega-3 oil can help while dietary adjustments are being made. Avoid Omega-6 seed oils and their sources (these are used at almost every restaurant). Eat fatty fish like salmon and sardines for the Omega-3s.
Refined sugar: Refined sugar rapidly spikes blood glucose, and soda, fruit juice and other sugary beverages are the worst culprits. These forms of sugar enter the bloodstream rapidly and can cause extreme elevations in blood glucose. (7) Even though natural sweeteners like raw honey and maple syrup are better options, they can still affect blood sugar levels, so only use these foods on occasion. Your best option is to switch to stevia, a natural sweetener that won’t have as much of an impact.
Normally, the process goes like this: The carbohydrates from your food are converted into a form of sugar called glucose. Glucose is the preferred fuel for your body's cells, and it's the only food your brain can use. The glucose floats along in the bloodstream until the pancreas, a large gland located behind the stomach, goes into action. The pancreas produces insulin, a hormone that signals body cells to take in the glucose. Once inside the cell, the glucose is either used as fuel to produce heat or energy or is stored as fat.
In Type 2 diabetes, the insulin that is produced does not work effectively. This is referred to as “insulin resistance.” Previously referred to as “adult-onset diabetes,” Type 2 diabetes is the most common form and occurs most frequently in inactive, overweight adults. With rising rates of childhood obesity, we are now seeing Type 2 diabetes diagnosed in more children and teens. Type 2 diabetes is usually treated with a diet that promotes weight loss, exercise and oral medications. Over time, most with Type 2 diabetes produce less insulin. Because of this,insulin may also be required to treat Type 2 diabetes.
To prevent further diabetic complications as well as serious oral problems, diabetic persons must keep their blood sugar levels under control and have a proper oral hygiene. A study in the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease than well-controlled diabetics are. At the same time, diabetic patients are recommended to have regular checkups with a dental care provider at least once in three to four months. Diabetics who receive good dental care and have good insulin control typically have a better chance at avoiding gum disease to help prevent tooth loss.
Many manufacturers offer pen delivery systems. Such systems resemble the ink cartridge in a fountain pen. A small, pen-sized device holds an insulin cartridge (usually containing 300 units). Cartridges are available for the most widely used insulin formulations. The amount of insulin to be injected is dialed in, by turning the bottom of the pen until the required number of units is seen in the dose-viewing window. The tip of the pen consists of a needle that is replaced with each injection. A release mechanism allows the needle to penetrate just under the skin and deliver the required amount of insulin.
Foods high in chromium: Chromium is a nutrient that’s involved in normal carbohydrate and lipid metabolism. Foods high in chromium can improve the glucose tolerance factor in your body and naturally balance out blood glucose levels. It plays a role in insulin pathways, helping bring glucose into our cells so it can be used for bodily energy. Broccoli has the highest amounts of chromium, but you can also find it in raw cheese, green beans, brewer’s yeast and grass-fed beef. (10)
Recently, a small clinical trial in England studied the effects of a strict liquid diet on 30 people who had lived with Type 2 diabetes for up to 23 years. Nearly half of those studied had a remission that lasted six months after the diet was over. While the study was small, the finding offers hope to millions who have been told they must live with the intractable disease.
High doses of magnesium may cause diarrhea, nausea, loss of appetite, muscle weakness, difficulty breathing, low blood pressure, irregular heart rate, and confusion. It can interact with certain medications, such as those for osteoporosis, high blood pressure (calcium channel blockers), as well as some antibiotics, muscle relaxants, and diuretics.
He emphasizes lifestyle changes and weight loss as a first step. "We give them a 3-month trial of diet and lifestyle [modification] before starting medications," he says. "A lot of times, for many patients newly diagnosed, we will see the sugars melt back into the normal range" after the weight loss and other changes. He has seen it happen after a weight loss of 7% to 10% of their starting weight.
When the insulin levels are unable to keep up with the increasing resistance, blood sugars rise and your doctor diagnoses you with type 2 diabetes and starts you on a pill, such as metformin. But metformin does not get rid of the sugar. Instead, it simply takes the sugar from the blood and rams it back into the liver. The liver doesn’t want it either, so it ships it out to all the other organs — the kidneys, the nerves, the eyes, the heart. Much of this extra sugar will also just get turned into fat.
Mr. Tutty, who weighed about 213 pounds before the trial, lost a little more than 30 pounds, the average weight loss in the trial. The people in the study most likely to respond to the treatment were in their early 50s on average and younger than the nonresponders, and they had had diabetes for fewer years. The responders were also healthier before the trial: They had been taking fewer medications than nonresponders, had lower fasting glucose and hemoglobin A1c before the trial, and had higher baseline serum insulin levels. Three of those who went into remission had lived with diabetes for more than eight years.
“Our findings suggest that even if you have had type 2 diabetes for six years, putting the disease into remission is feasible”, says Prof Michael Lean from the University of Glasgow who co-led the study. “In contrast to other approaches, we focus on the need for long-term maintenance of weight loss through diet and exercise and encourage flexibility to optimise individual results.”
Keeping close tabs on your diet is a major way to help manage type 2 diabetes. A healthy diet for people with type 2 diabetes includes fresh or frozen fruit and vegetables, whole grains, beans, lean meats, and low-fat or fat-free dairy. Focus on eating fruit and non-starchy vegetables, like broccoli, carrots, and lettuce, and having smaller portions of starchy foods, meats, and dairy products. Be especially careful about loading up on foods that are high on the glycemic index (GI) and especially the glycemic load (GL), systems that rank foods according to how they affect glucose levels.
Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas. This release of insulin promotes the uptake of glucose into body cells. In patients with diabetes, the absence of insufficient production of or lack of response to insulin causes hyperglycemia. Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime.