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How to manage type 2 diabetes

October 02, 2018 | UCI Health
woman with type 2 diabetes exercising

Diabetes is a chronic condition that affects more than 30 million Americans and is the seventh leading cause of U.S. deaths. Most people with the disease — about 90% — have type 2 diabetes.

"This progressive condition can affect every major organ in the body, and those complications are what make the disease so devastating," says UCI Health endocrinologist Dr. Ping H. Wang.

"About 80% of diabetics die not from diabetes, itself, but from heart disease or stroke associated with diabetes."

It can also result in kidney damage, requiring dialysis or transplant, nerve destruction that can make amputation necessary, as well as eye problems, including blindness.

What is diabetes?

In type 1 diabetes, which affects about 1.25 million U.S. adults and children, the pancreas can’t or stops producing insulin, the hormone that allows the body to metabolize blood sugar and keep levels within a normal range.

Without insulin, blood sugar levels can spike and cause long-term damage. Type 1 diabetes is treated with insulin replacement, a healthy diet and close monitoring of blood sugar levels.

More than 90% of diabetics have type 2 diabetes. Their bodies develop insulin resistance and a progressive rise in blood sugar levels over time. Type 2 diabetes usually occurs in people over age 45 or 50. But increasingly, we are seeing younger adults and even teens and children with the condition.

Type 2 diabetes can be managed

Type 2 diabetes is a serious disease, but the good news is that it can be managed, Wang says.

If you are diagnosed with type 2 diabetes, it’s important to make some lifestyle modifications:

  • Increase your exercise levels to at least three times a week, and work out enough to sweat.
  • Bring your body weight down to normal levels for your height and body type.
  • Eat a balanced diet, avoid concentrated sweets (foods with a lot of sugar like desserts), and moderate your intake of carbohydrates (pasta, bread, rice and grains).
  • Get regular sleep because disruption of circadian rhythms has been shown to affect blood glucose metabolism. Getting a good night’s sleep is of special concern for people with sleep apnea.

Caring for diabetes

Next, you will need to learn to take care of diabetes yourself.

"Beyond the lifestyle changes, you’ll need to learn how to monitor your sugar levels — once a day in mild cases and up to five times a day in severe cases," Wang says. "Newer monitoring devices don’t require a finger stick."

To control your diabetes, you:

  • May need to take one or a combination of oral medications, or to inject insulin, depending on the severity of your diabetes.
  • Must examine your feet every night before bed to check for any skin breakdowns, which could result in potentially serious infections later on that you might not feel if diabetes has damaged your nerves.
  • See your doctor twice a year to have your average blood sugar, or A1C, levels tested.

More than blood sugar

But managing diabetes is more than just checking blood sugar levels. The focus must be on helping people to live longer and healthier in every way.

About 80% of people diagnosed with diabetes suffer from anxiety or depression. There are also other complications to watch out for. Make sure that the physician managing your diabetes is screening for these complications.

In some cases, it might be possible to actually reverse type 2 diabetes. For other patients, we can put the brakes on disease progression and manage the condition.

"Someday, we hope to find a cure for this disease," Wang says.

Not knowing can be harmful

Unfortunately, Wang says about 25% of people with diabetes don’t know they have it. See your doctor to check your blood sugar levels if you are experiencing these symptoms:

  • Fatigue
  • Unusual thirst
  • Frequent urination
  • Feeling hungry often
  • Blurred vision
  • Numbness in hands and feet
  • Unexplained weight loss

"Getting appropriate treatment early is the key to managing — and possibly reversing — this debilitating disease," he says.

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