How do I manage Type 2 diabetes?

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Q: I am a 48-year old mom recently diagnosed with Type 2 diabetes and am overwhelmed with managing my condition. I do not feel sick, but my blood sugar has remained high. My life is already so full and hectic. Can you help me prioritize what is most important?

Being diagnosed with diabetes is a life-changing event that causes many patients to feel overwhelmed and afraid.

The first step is knowing and understanding your diagnosis, and to remember you are not alone. If you have questions or fears related to your diagnosis, talk to your health care provider to work through and process what you are going through.

If you feel like there is too much to learn and manage, tell your primary provider what you are feeling. Your provider will connect you with resources, such as a diabetic educator, to empower you and teach what you need to know.

Diabetes is increasingly common. In 2012, 9.3 percent of the population had diabetes, which is essentially a disorder that affects the way the body uses sugar. As nurse practitioners, we help many patients manage their diabetes and live full, healthy lives. We do so by educating our patients, coaching them on lifestyle changes and prescribing appropriate medications.

What exactly is diabetes?

The cells in the body need sugar to function, and sugar is able to enter the cell with the help of a hormone called insulin. Diabetes occurs when there is an impairment with the insulin.

Type 1 diabetes occurs when there is not enough insulin being produced. Type 2 diabetes occurs when the body builds resistance to insulin and does not respond to it. Sugar builds up in the blood and is unable to enter the cells when the body does not respond to insulin or when there is not enough insulin.

In the early stages, Type 2 diabetes usually causes no symptoms, so many people do not even realize they have elevated blood sugar. Over time, as sugar builds up in the blood, symptoms may include intense and increased thirst, blurry vision and the need to urinate often. Type 2 diabetes can be life threatening if not treated and can contribute toward heart attacks, strokes, kidney disease, vision problems, infections and nerve pain in the hands and feet.

Diabetes is treated with lifestyle changes, including an increase in exercise and a healthy diet. Sometimes lifestyle changes are not enough and medications are needed. While it is a chronic condition, diabetes can be very effectively managed with healthy changes in day-to-day habits and a medication regimen. People with diabetes can lead a full life, but this involves a lifelong management plan.

If you are a smoker, the single most important thing you can do first, if you are diagnosed with diabetes, is quit smoking for good. Smokers with diabetes have a greatly increased risk of heart attack and stroke. Start here.

To stay as healthy as possible, it is important to control your ABCs.

  • A stands for A1C (hemoglobin A1C), a blood test that shows your average blood sugar over the last few months. A well-controlled hemoglobin A1C means your sugars are stable. Poorly controlled sugar can cause kidney disease, nerve damage and various eye diseases that lead to vision loss or blindness and other health complications.
  • B stands for blood pressure, and controlling your blood pressure decreases your risk for heart attack, stroke and kidney disease.
  • C stands for cholesterol, a waxy substance found in your blood. Controlling you cholesterol decreases your risk for heart attack and stroke. People with diabetes are more than twice as likely to have a heart attack or stroke, so by keeping your ABCs under control, you will lower your risk for health complications.

Exercise is beneficial for everyone, whether you have diabetes or not. Physical activity promotes cardiovascular improvement by lowering blood pressure, improving cholesterol and improving blood sugar, and it can lead to an overall sense of well-being.

Aerobic exercises such as walking, cycling, swimming or rowing help increase the heart rate and will improve your health. Choose an exercise program that is enjoyable so that you are motivated to stick with it over time. Exercise intensity should be gradually increased along with duration, and exercising 30 minutes a day most days of the week is recommended.

To help manage your diabetes, a diet with fruits, vegetables, whole grains and low-fat dairy products is encouraged. A dietitian can help provide education on meal planning, snacks and carbohydrate counting. Carbohydrates impact your blood sugar, and balance, variety and moderation is encouraged with all foods.

In general, high carbohydrate foods should be monitored, and, when given the option, choose whole grains such as brown rice over white rice, wheat pasta over white pasta and wheat bread over white bread. There are many health benefits to having a healthy diet and an active lifestyle even if your weight does not decrease.

Medication can help control blood sugar, blood pressure and cholesterol if they are elevated, and nicotine replacement can help you successfully quit smoking. Talk with your health care provider to discuss your individual goals and options.


Michelle Napral is a nurse practitioner at the University of Minnesota Health Nurse Practitioners Clinic, 3rd Street & Chicago. Send questions to nursenews@umn.edu

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  • David

    Awesome ways. I was diagnosed with type 2 Diabetes and put on Metformin on June 26th, 2016. I started the ADA diet and followed it 100% for a few weeks and could not get my blood sugar to go below 140. Finally i began to panic and called my doctor, he told me to get used to it. He said I would be on metformin my whole life and eventually insulin. At that point i knew something wasn’t right and began to do a lot of research. On August 13th I found Lisa’s diabetes story (google ” HOW EVER I FREED MYSELF FROM THE DIABETES ” ) I read that article from end to end because everything the writer was saying made absolute sense. I started the diet that day and the next morning my blood sugar was down to 100 and now i have a fasting blood sugar between Mid 70’s and the 80’s. My doctor took me off the metformin after just three week of being on this lifestyle change. I have lost over 30 pounds and 6+ inches around my waist in a month. The truth is we can get off the drugs and help myself by trying natural methods

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