It’s important to work with a health care team and set up healthy
goals. Knowing the ABC’s of diabetes management can help with goal setting:
A1c: Hemoglobin A1c test shows what blood glucose has been over the last 3
months. Controlling blood glucose levels will help prevent complications.
Get this test at least every 3- 6 months. For most people with diabetes,
the A1C goal is below 7%.
Blood pressure: Blood pressure is the force of blood inside the blood vessels.
When blood pressure is high, the heart has to work harder. For most people
with diabetes, the recommended blood pressure target is blood pressure
below 140/80 mm Hg.
Cholesterol: Cholesterol numbers show the amount of fat in the blood. Some
kinds, like HDL cholesterol, helps protect the heart. While others, like
LDL cholesterol, can block blood vessels and result in heart disease.
Triglycerides are another kind of blood fat that increases the risk of
heart attack or stroke.
- LDL (“bad”) cholesterol, under 100 mg/dl
- Triglycerides, under 150 mg/dl
- HDL (“good”) cholesterol for men, above 40 mg/dl
- HDL (“good”) cholesterol for women, above 50 mg/dl
Eating healthy can be a challenge. The best mix of carbohydrates, protein,
and fat depends on the goals and preferences of the individual with diabetes.
The plate method allows for a more flexible diet and for you to continue
eating your favorite foods.
The total amount of carbohydrate consumed has the strongest influence on
blood sugar levels. Most individuals with diabetes in the U.S. report
eating moderate amounts of carbohydrate (about 45% of total energy intake).
Divide your plate into sections
- ½ of non-starchy vegetables (spinach, broccoli, carrots, bok choy, tomatoes)
- ¼ of lean, low-fat protein (tuna, salmon, shrimp, chicken breast,
- ¼ of carbohydrates (whole grain bread, rice, high-fiber cereal,
- Low-calorie drink, such as water, unsweetened tea or coffee
- A serving of fruits, dairy and/or salad (beware of high-calorie dressings)
Here is an example of what your plate might look like:
Most individuals with diabetes can control their blood glucose levels by
following a healthy meal plan and an exercise program and taking oral
medication. Exercise can help maintain a healthy weight and blood glucose
levels, lowering stress and increasing energy.
Maintaining normal blood sugar at rest and during exercise depends mainly
on the body. Contracting muscles increase uptake of blood glucose, even
when blood sugar levels are maintained by glucose production by the liver
and the movement of alternate fuels, such as free fatty acid.
Intensity and duration of exercise are factors that influence exercise
fuel use and are the most important. With increasing exercise intensity,
the body relies heavily on carbohydrates as long as there is enough available
in the muscle or blood. When glycogen stores are short, muscles increase
their uptake and use of circulating blood glucose, along with free fatty
acids from fat tissues. Glucose production moves from the liver to improve
glycogen production as the length of exercise increases.
The best time to exercise is 1 to 1 ½ hour after a meal. Check your
blood sugar before exercising. If your blood sugar is less than 90 mg/dl,
have a snack with starch before starting. If your blood sugar is more
than 300 mg/dl, wait to exercise. Exercise may cause an increase in blood sugar.
Aim for 30-60 minutes a day for 5-6 days a week. Start with 5-10 minutes
and slowly increase the workout minutes. Remember to include a warm-up
and cool-down time.
You should be able to talk while you exercise. Ask your doctor or diabetes
educator before beginning an exercise routine.
First-line treatment for individuals who are newly diagnosed with diabetes
would be to improve their lifestyle by choosing healthier meal options,
exercising and losing weight. Diabetes may be treated with insulin and
oral medications. Insulin may be required if the blood sugar is too high
and diabetes remains uncontrolled.
Insulin is given through shots or can be added into intravenous fluids
during hospitalization. Long-acting insulin (basal insulin) works to control
blood sugar between meals and during sleep. This type of insulin is usually
taken once or twice a day (usually with dinner or at bedtime), which helps
controls blood sugar levels throughout the day.
Rapid or fast-acting (bolus) insulin is taken prior to a meal. This type
works quickly to control the sudden and rapid spike in blood sugar after a meal.
If you think you have hypoglycemia, check your blood glucose. If your blood
sugar reading is 70mg/dl or less, have at least 15 grams of carbohydrates,
such as half a cup (4 oz.) of juice or regular soda, 3-5 hard candies,
glucose tablets or gel (take as instructed). After 15 minutes, recheck
your blood glucose.