Lifestyle Changes to Manage Type 2 Diabetes
by Karen Schroeder Kassel, MS, RD, MEd
Losing weight and beginning a regular exercise program can help bring your blood glucose (sugar) levels to within the normal range. However, this does not mean that your diabetes has been cured. Rather, you must maintain these lifestyle habits, including eating healthy foods, to keep your blood glucose in control and to minimize the chances of complications.
Diet and exercise alone may not be enough to maintain blood glucose levels within a normal range. You may need to take anti-diabetes medicines, including insulin, to control glucose levels.
Weight loss is the first step you can take to help lower your blood glucose level. As you lose weight, your body's cells will be more responsive to insulin. This can lead to improved blood glucose control.
The safest and most effective way to lose weight is by eating fewer calories, eating healthy food, and exercising regularly. You should strive for gradual and continual weight loss until you reach your ideal weight. If you are overweight, losing just 5%-10% of your body weight can make a difference in your blood glucose control.
The nutrition guidelines for managing diabetes can seem complicated. However, you will see that the guidelines are similar as those for general good health. A registered dietitian can help you develop healthy eating patterns that will work for you. Ask your doctor for a referral to a registered dietitian.
The basic eating guidelines for people with type 2 diabetes are:
Planning Meals and Snacks
Eat three meals per day, and do not skip meals. Each meal should be at about the same time each day and contain about the same amount of carbohydrate, protein, and fat as the same meal the day before. Your blood glucose rises and falls in response to your eating patterns. Therefore, by eating about the same amounts and types of food at the same times each day, you can more easily predict when your blood glucose level will rise.
Snacks are also important. Eat 2-3 snacks per day, and keep them with you at all times in case a meal is delayed. Just before bedtime, have a snack that contains both protein and starch. Eating at this time can help control the changes in blood glucose that may occur while you sleep.
Filling Your Plate
To make sure that you are getting the nutrients that you need, follow the United States Department of Agriculture’s http://www.choosemyplate.gov/ guidelines. MyPlate encourages you to:
In addition, the American Diabetes Association (ADA) offers these tips for creating a healthy plate:
Focusing on Carbohydrates
Sugar and starch are both carbohydrates. Your body reacts to any type of carbohydrate in the same way, so the total amount of carbohydrate you eat is more important for blood glucose control than the source.
A dietitian can help you determine how many grams of carbohydrate you should eat per day. This amount should be dispersed evenly throughout your meals and snacks, and you may need to avoid foods that are high in sugar. Many foods contain carbohydrates. Grain products, fruits, and milk products contain the most. Soda has a lot of sugars and should be avoided.
Keeping a Record
Keep a record of your meals, include the time you ate, what you ate, and how much you ate. Include this information with your blood glucose levels and insulin dosages. This information is very helpful when you discuss how to modify your medicine and/or diet with your doctor.
The ADA recommends exercising for at least 150 minutes/week. This should be moderate-intensity aerobic exercise, like brisk walking, riding a bicycle, playing tennis, or doing water aerobics. In addition, strength training should be done at least twice a week. Examples of strength training include using free weights, weight machines, or resistance bands.
Talk with your doctor about an exercise program that is safe for you. Since exercise causes your blood glucose to drop, you may need to make some modifications in your medicine dose and schedule, as well as your eating plan. Also, when you exercise, remember to wear your diabetes identification bracelet.
When to Contact Your Doctor
Contact your doctor if you:
ChooseMyPlate.gov. United States Department of Agriculture website. Available at: http://www.choosemyplate.gov/ . Accessed August 7, 2012.
Create your plate. American Diabetes Association website. Available at: http://www.diabete... . Accessed August 7, 2012.
Diabetes mellitus type 2. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated August 2, 2012. Accessed August 6, 2012.
9/19/06 DynaMed's Systematic Literature Surveillance http://www.dynamicmedical.com/what.php : Thomas DE, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus. Cochrane Database of Systematic Reviews 2006; Issue 3.
2/28/2008 DynaMed's Systematic Literature Surveillance http://www.dynamicmedical.com/what.php : Davies MJ, Heller S, Skinner TC, et al. Effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cluster randomised controlled trial. BMJ . 2008 Feb 14. [Epub ahead of print]
2/28/2008 DynaMed's Systematic Literature Surveillance http://www.dynamicmedical.com/what.php : Christian JG, Bessesen DH, Byers TE, Christian KK, Goldstein MG, Bock BC. Clinic-based support to help overweight patients with type 2 diabetes increase physical activity and lose weight. Arch Intern Med . 2008;168:141-146.
5/11/2009 DynaMed Systematic Literature Surveillance http://www.dynamicmedical.com/what.php : Loimaala A, Groundstroem K, Rinne M, et al. Effect of long-term endurance and strength training on metabolic control and arterial elasticity in patients with type 2 diabetes mellitus. Am J Cardiol . 2009;103:972-977.
8/19/2009 DynaMed Systematic Literature Surveillance http://www.dynamicmedical.com/what.php : Li TY, Brennan AM, Wedick NM, Mantzoros C, Rifai N, Hu FB. Regular consumption of nuts is associated with a lower risk of cardiovascular disease in women with type 2 diabetes. J Nutr . 2009;139:1333-1338.
Last reviewed September 2012 by Brian Randall
Last Updated: 09/30/2012