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How to manage type 2 diabetes

Staying at a healthy weight helps your body respond better to insulin and keeps blood pressure and cholesterol in check. © iStockphoto.com/Mark Hatfield Staying at a healthy weight helps your body respond better to insulin and keeps blood pressure and cholesterol in check. © iStockphoto.com/Mark Hatfield

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By Jenilee Matz, M.P.H., Staff Writer, myOptumHealth

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If you have type 2 diabetes, your body doesn't make enough insulin or it can't properly use the insulin it makes.

Insulin is needed to move glucose (sugar) from the blood to the cells, so the body can use it for energy. Without insulin, sugar stays in the blood. High blood sugar levels raise the risk of serious health problems such as heart and kidney disease and blindness.

Your targets

The goal of treating type 2 diabetes is to lower the risk of complications from the disease. This is achieved by keeping blood sugar levels within target range. Your doctor can tell you what your target is. You will need to test your blood sugar regularly - maybe several times a day - to make sure you're meeting your goal.

Keeping your "diabetes ABCs" close to targets will also cut the risk of health problems. The American Diabetes Association (ADA) suggests aiming for these targets. Your doctor will let you know if your personal goals are more specific:

  • A for A1C: below 7 percent. The hemoglobin A1C (HbA1C) test shows what your average blood sugar levels have been for the past two or three months.
  • B for blood pressure: below 130/80 mm Hg. Blood pressure is the force of blood that travels through your arteries.
  • C for cholesterol: LDL below 100 mg/dL. Cholesterol is a fatty substance (lipids) in your blood.

How to meet your goals

There is no cure for diabetes, but there are ways to manage it. Everyone's treatment strategy is different. For some, a nutritious diet, exercise and weight loss is all that's needed to control blood sugar. Others will also need to take medication.

Your doctor will tailor a care plan to meet your needs, and monitor you to make sure the plan is working. Follow your treatment plan exactly as prescribed by your doctor:

Have a healthy diet. Your diet should focus on the same foods as any other healthy diet: fruits, vegetables, whole grains, lean protein, low-fat and nonfat dairy. Limit foods high in saturated and trans fat, sodium and added sugars.

Figuring out what - and when - to eat can be tricky. For example, some people with diabetes may need to count carbohydrates. The ADA suggests that all people with diabetes seek nutritional counseling. A dietitian can work with you to create a meal plan that will help keep your blood sugar in check and appetite satisfied.

Exercise regularly. Exercise helps your body respond better to insulin, lowers blood pressure and cholesterol and aids in weight loss.

Experts suggest most people with diabetes aim for 30 minutes of moderate exercise, five days a week, for a total of 150 minutes each week. Start slowly and gradually increase the amount of activity you do as you get in better shape.

Check with your doctor before you start or increase your activity level.

Reach or maintain a healthy weight. Staying at a healthy weight helps your body respond better to insulin and keeps blood pressure and cholesterol in check. Even losing as little as 5 percent of your body weight - 10 pounds if you weigh 200 pounds - can help.

Take medications and insulin as prescribed. You may need medication to help control your diabetes. Your doctor may prescribe:

  • Biguanides. Metformin (Glucophage). This drug works by decreasing the amount of glucose produced by the liver and by making muscle tissues more sensitive to insulin.
  • Sulfonylureas. Chlorpropamide (Diabinese), glipizide (Glucotrol), glyburide (Micronase, Glynase and Diabeta) and glimepiride (Amaryl).These medicines make the pancreas release more insulin.
  • Alpha-glucosidase inhibitors. Acarbose (Precose) and meglitol (Glyset). These drugs block the breakdown of some carbohydrates, which stops blood sugar levels from rising.
  • Dipeptidyl Peptidase-4 (DPP-4) inhibitors. Sitagliptin (Januvia).Glucagon-like peptide 1 (GLP-1) is a naturally occurring compound in the body that lowers blood sugar levels. DPP-4 inhibitors stop GLP-1 from breaking down as quickly, so blood sugar levels stay low.
  • GLP-1 agonist. Byetta (exenatide). This medication works along with the GLP-1 your body makes naturally to lower blood sugar levels.
  • Meglitinides. Repaglinide (Prandin) and nateglinide (Starlix). Meglitinidesstimulate the pancreas to release more insulin.
  • Thiazolidinediones. Rosiglitazone (Avandia) and pioglitazone (ACTOS). These drugs reduce the amount of glucose the liver makes and help insulin work better.
  • Insulin. You may need to take insulin if your body cannot make enough for your needs.

Your doctor may also prescribe medicine to help control blood pressure or cholesterol. Take all drugs exactly as directed.

For success

Know that taking medication doesn't mean you can forget about good nutrition and exercise. All parts of your care plan work together to help you meet your diabetes goals. Not smoking, limiting alcohol and reducing stress are all important parts of a healthy lifestyle as well.

View the original How to manage type 2 diabetes article on myOptumHealth.com 

SOURCES:

  • National Guideline Clearinghouse. Diagnosis and management of type 2 diabetes mellitus in adults. Accessed: 03/03/2010
  • American Diabetes Association. What are my options? Accessed: 03/03/2010
  • American Diabetes Association. Executive summary - standards of medical care in diabetes - 2010. Diabetes Care. 2010;33(Suppl 1):S4-S10.

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These Web sites are for your informational use only. It is not a substitute for professional medical advice. It may not represent your true individual medical situation. Do not use this information to diagnose or treat a health problem or disease without consulting a qualified health care provider. Also consult your healthcare provider before starting any medications or supplements or beginning or modifying any exercise program.

© 2012 OptumHealth, Inc. All rights reserved. No part of information on this page may be reproduced or transmitted in any form or by any means, without the written permission of OptumHealth, Inc.

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