Type 2 diabetes - self-care
Type 2 diabetes is a life-long (chronic) disease. If you have type 2 diabetes, the insulin your body normally makes has trouble transmitting a signal to muscle and fat cells. Insulin is a hormone made by the pancreas to control blood sugar. When your body's insulin isn't able to signal correctly, the sugar from food stays in the blood and the sugar (glucose) level can get too high.
Most people with type 2 diabetes are overweight when they're diagnosed. The changes in the way the body handles blood sugar that lead to type 2 diabetes usually happens slowly.
Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your health care provider about seeing a certified diabetes care and education specialist.
Type II diabetes - Animation
Over the past several years, our collective diets have grown unhealthier, and our waistlines have expanded as a result. Doing so, we're putting ourselves at risk for a number of diseases, including type 2 diabetes. Diabetes is serious stuff, if it's not treated, it can lead to some pretty dangerous complications, including nerve and kidney damage. The good news is you can often avoid type 2 diabetes and its complications. You need sugar, or glucose, to keep your body running. Normally when you eat, your pancreas releases a hormone called insulin, which moves the sugar from food out of your blood and into your cells, where it can either be used for energy, or stored. But if you have type 2 diabetes, this system doesn't work as well as it should, in part because your cells have a harder time responding to insulin. As a result, sugar builds up in your blood. Why is that a problem? Well, that excess sugar can damage organs like your eyes and kidneys, and it can lead to complications like nerve damage and heart disease. Diabetes complications could leave you blind, lead to amputation of your toes or feet, and maybe even kill you. You can help prevent diabetes complications by keeping good control over your blood sugar, but first you need to know that you have type 2 diabetes. Sometimes it can be hard to tell because you may not have any symptoms at first. Being very thirsty, tired, or having to go to the bathroom a lot may be pretty good clues that you might have developed diabetes. Blurry vision might also be a clue. Your doctor can confirm it with a blood test. Once you know that you have diabetes, it's your job to keep it under control. You'll need to check your blood sugar at home and talk to your doctor about how to lower it with diet, exercise, and possibly medicine. To avoid serious complications, you'll need to see not just one doctor, but a team of health care professionals. That includes a podiatrist to check your feet, an ophthalmologist to check your eyes, and a dentist for cleanings and exams. Because type 2 diabetes increases your risk for heart disease, you'll also need to see your primary care doctor regularly to have your blood pressure, cholesterol, and triglycerides checked, and to make sure your kidneys are working as well as they should. Like any other disease, it's better to avoid getting type 2 diabetes then to have to treat it. If you're at risk because you're overweight or over age 45, ask your doctor for a blood sugar test at your next check-up. If you have already developed diabetes, you can help avoid complications by staying on top of your health, checking your blood sugars, eating a healthy diet, exercising, and seeing all of your specialists on schedule. Make your doctor a partner in your care. Call right away if you have any problems, like numbness or tingling in your legs or feet, blurry vision, extreme thirst, weakness, or fatigue.
Symptoms of Type 2 Diabetes
You may not have any symptoms. If you do have symptoms, they may include:
- Urinating a lot, getting up more often than usual at night to urinate
- Blurry vision
- More frequent or long lasting infections
- Trouble having an erection
- Trouble healing cuts on your skin
- Red skin rashes in parts of your body
- Tingling or loss of sensation in your feet
Take Control of Your Diabetes
You should have good control of your blood sugar. If your blood sugar is not controlled, serious problems called complications can happen to your body. Some complications can happen immediately and some after many years.
Learn the basic steps for managing diabetes to stay as healthy as possible. Doing so will help keep the chance of having complications of diabetes as low as possible. Steps include:
Also, be sure to take any medicine or insulin as instructed.
Your provider will also help you by ordering blood tests and other tests. These help make sure your blood sugar and cholesterol levels are each in a healthy range. Also, follow your provider's instructions about keeping your blood pressure in a healthy range.
Your doctor will likely ask you to visit other providers to help you control your diabetes. These providers include a:
- Diabetes pharmacist
- Diabetes educator
Eat Healthy Foods and Manage Your Weight
Foods with sugar and carbohydrates can raise your blood sugar too high. Alcohol and other drinks with sugar can also raise your blood sugar. A nurse or dietitian can teach you about good food choices.
Make sure you know how to have a balanced meal with protein and fiber. Eat healthy, fresh foods as much as possible. Don't eat too much food at one sitting. This helps keep your blood sugar in a good range.
Managing your weight and keeping a well-balanced diet are important. Some people with type 2 diabetes can stop taking medicines after losing weight (even though they still have diabetes). Your provider can let you know a good weight range for you.
Weight-loss surgery may be an option if you are obese and your diabetes is not under control. Your doctor can tell you more about this.
Regular exercise is good for people with diabetes. It lowers blood sugar. Exercise also:
- Improves blood flow
- Lowers blood pressure
It helps burn extra fat so that you can keep your weight down. Exercise can even help you handle stress and improves your mood.
Try walking, jogging, or biking for 30 to 60 minutes every day. Pick an activity that you enjoy and you are more likely to stick with. Bring food or juice with you in case your blood sugar gets too low. Drink extra water. Try to avoid sitting for more than 30 minutes at any one time.
Wear a diabetes ID bracelet. In case of an emergency, people know you have diabetes and can help you get the right medical attention.
Always check with your provider before beginning an exercise program. Your provider can help you choose an exercise program that is safe for you.
Check Your Blood Sugar
You may be asked to check your blood sugar at home. This will tell you and your provider how well your diet, exercise, and medicines are working. A device called a glucose meter can provide a blood sugar reading from just a drop of blood.
A doctor, nurse, or diabetes educator will help set up a home testing schedule for you. Your doctor will help you set your blood sugar goals.
- Many people with type 2 diabetes need to check their blood sugar only once or twice a day. Some people need to check more often.
- If your blood sugar is in control, you may need to check your blood sugar only a few times a week.
The most important reasons to check your blood sugar are to:
- Monitor if the diabetes medicines you're taking have a risk of causing low blood sugar (hypoglycemia).
- Use the blood sugar number to adjust the dose of insulin or other medicine you are taking.
- Use the blood sugar number to help you make good nutrition and activity choices to regulate your blood sugar.
You May Need Medicines
If diet and exercise are not enough, you may need to take medicine. It will help keep your blood sugar in a healthy range.
There are many diabetes medicines that work in different ways to help control your blood sugar. Many people with type 2 diabetes need to take more than one medicine to control their blood sugar. You may take medicines by mouth or as a shot (injection). Certain diabetes medicines may not be safe if you are pregnant. So, talk to your doctor about your medicines if you're thinking of becoming pregnant.
If medicines don't help you control your blood sugar, you may need to take insulin. Insulin must be injected under the skin. You'll receive special training to learn how to give yourself injections. Most people find that insulin injections are easier than they thought.
Learn to Prevent Long-term Problems of Diabetes
People with diabetes have a high chance of getting high blood pressure and high cholesterol. You may be asked to take medicine to prevent or treat these conditions. Medicines may include:
- An ACE inhibitor or another medicine called an ARB for high blood pressure or kidney problems.
- A medicine called a statin to keep your cholesterol low.
- Aspirin to keep your heart healthy.
Do not smoke or use e-cigarettes. Smoking makes diabetes worse. If you do smoke, work with your provider to find a way to quit.
Diabetes can cause foot problems. You may get sores or infections. To keep your feet healthy:
- Check and care for your feet every day.
- Make sure you're wearing the right kind of socks and shoes. Check your shoes and socks daily for any worn spots, which could lead to sores or ulcerations.
See Your Doctor Regularly
If you have diabetes, you should see your provider every 3 months, or as often as instructed. At these visits, your provider may:
- Ask about your blood sugar level (always bring your meter if you are checking blood sugar at home)
- Check your blood pressure
- Check the feeling in your feet
- Check the skin and bones of your feet and legs
- Examine the back of your eyes
Your provider will also order blood and urine tests to make sure your:
- Kidneys are working well (every year)
- Cholesterol and triglyceride levels are healthy (every year)
- A1C level is in a good range for you (every 6 months if your diabetes is well controlled or every 3 months if it is not)
Talk to your provider about any vaccines you may need, such as the yearly flu shot and the hepatitis B and pneumonia shots.
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Visit the dentist every 6 months. Also, see your eye doctor once a year, or as often as instructed.
Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
American Diabetes Association Professional Practice Committee. 5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S60-S82. PMID: 34964866 pubmed.ncbi.nlm.nih.gov/34964866/.
American Diabetes Association Professional Practice Committee. 12. Retinopathy, Neuropathy, and Foot Care: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S185-S194. PMID: 34964887 pubmed.ncbi.nlm.nih.gov/34964887/.
Brownlee M, Aiello LP, Sun JK, et al. Complications of diabetes mellitus. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ , eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 37.
Riddle MC, Ahmann AJ. Therapeutics of type 2 diabetes. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ , eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 35.