Contact your doctor immediately if you experience symptoms of low blood sugar (hypoglycemia) Table 03. Some diabetes medications, such as insulin, the sulfonylureas, and the meglitinides may cause excessively low blood sugar (hypoglycemia). Likewise, skipping meals and intense workouts can cause blood sugar levels to drop to dangerous levels. Symptoms of hypoglycemia include trembling, hunger, sweating, dizziness, and confusion. If measures are not taken to counteract hypoglycemia, seizures, coma, and even death can result.
Certain foods and drinks can boost glucose quickly. Pure forms of sugar, such as juice or hard candies, are best. Avoid foods that contain fat, as they will not be digested as rapidly. Specific recommendations for treating hypoglycemia should be discussed with your doctor. It is advised that diabetics, especially the elderly and those diabetics on insulin who are at high risk for hypoglycemia, wear medical identification.
Table 3. Warning Signs of Hypoglycemia
Sweating Heart palpitations Hunger Faintness Weakness Confusion Headache Numbness or tingling of the mouth and lips
Lose weight if you are overweight. Leading a sedentary lifestyle and eating a nutrient-poor diet high in sugar, calories, and fat contributes to obesity, which is a major risk factor for diabetes. Getting exercise and eating a balanced diet can help you lose weight and prevent diabetes.
Follow a careful diet. Diet should be geared towards achieving goals for blood sugar control, cholesterol/lipid levels, and blood pressure, as well a maintaining a reasonable weight and adequate nutrition.
Follow a diet in which 50% to 60% of your daily calories come from carbohydrates, and no more than 30% of your calories come from fat. Because diabetics sometimes have high cholesterol as well, limit your intake of saturated fats, which are found in animal products like butter and red meat. Eat at regular intervals to help maintain safe blood sugar levels and prevent hypoglycemia. If you are overweight, you need to cut down on portions and restrict total calories. Consistent calorie restriction of 300-500 calories daily will result in gradual weight loss. No matter what your starting weight is, a moderate weight loss of 10-20 pounds has been shown to lower blood sugar, cholesterol levels, and blood pressure. If you have high blood pressure, you should limit your salt intake.
Maintain an exercise regimen. Exercise is an important part of diabetes treatment because it lowers blood sugar. During exercise, your body uses glucose circulating in the blood before it taps into its starch (glycogen) stores. When the starch stores are depleted, the body turns to fat cells for glucose. Lowering your body fat may be another way exercise helps improve insulin sensitivity. Exercise is also an important part of any weight loss program.
A minimum of 30 minutes of moderate-intensity activity (walking, jogging, cycling or other aerobic activity) three to four times a week, supplemented by an increase in daily lifestyle activities (such as walking breaks at work, using the stairs instead of the elevator, doing housework, or gardening) is recommended. You should check with your doctor before starting any exercise program.
Check your feet for sores and avoid foot infections. Like other parts of the body, the feet undergo wear and tear (blisters, cuts, etc.). If you have diabetes, you are prone to poor circulation and nerve damage. Because of this nerve damage and corresponding loss of sensation, you may not notice foot pain. Repeated trauma can cause the skin on your foot to breakdown. Furthermore, poor circulation will hinder healing, and unnoticed sores can become infected and ulcerated. If left untreated, the tissue on your foot will die and have to be removed.
You can avoid this complication by checking your feet daily. Be sure to tend to even the most minor cut by cleansing it thoroughly with soap and warm water and disinfecting it with a mild antiseptic. Afterwards, cover the sore with a dry sterile bandage. If you discover ulcers or have a cut or sore on your foot that is not healing or looks infected, tell your doctor right away. Trim your toenails regularly and have your doctor examine your feet at every visit (at least twice a year). Your doctor can refer you to a podiatrist to help you with regular foot care.
Get your eyes checked yearly. Poor circulation, which is characteristic of diabetes, can damage your retinas and lead to blurry vision or a complication that can lead to blindness (retinopathy). Get your eyes checked by an ophthalmologist at least yearly to help detect these complications before they become debilitating.
If you smoke, quit. Cigarette smoking is a major risk factor for cardiovascular disease.
Drink alcohol only in moderation. Alcohol contains excess calories and contributes to weight gain. If you drink on an empty stomach and take medication for your diabetes, you are at increased risk for hypoglycemia. Alcohol is broken down by your liver, and this extra stress on your liver may interfere with the functioning and clearance of medications you take for controlling diabetes and cholesterol.
Get an annual flu vaccine and get the pneumonia vaccine once before age 65. The pneumonia vaccine should be repeated after age 65 once.
Monitoring your blood sugar is an essential part of diabetes self-care. Monitoring your blood sugar will help to detect changes in the blood glucose levels caused by diet, activity, stress, illnesses, and medications. Tracking your blood glucose over time will help you achieve better blood glucose control.
Your doctor will tell you how often and when you need to monitor your blood sugar, which can be done at home with relative ease. You will have to prick your finger using a special device to obtain a small drop of blood. The drop can be placed on a reagent strip, which will change color. Judging from the changes, you can determine your blood sugar level, or you can place the strip into a blood glucose meter that provides a readout. There is a variety of meters available that range in price, features (including memory, the ability to download results to your computer, and voice applications for the visually impaired), and ease of use. It is important to consider what your health insurance covers in the way of meters and supplies (especially test strips), as these can be expensive. Your doctor or diabetes educator can help you decide which meter is best for you.
Your doctor is the best source of information on the drug treatment choices available to you.
Some people use unproven alternative remedies and nutritional supplements to lower glucose levels. Some naturalists suggest taking the mineral chromium to lower blood sugar and cholesterol levels. Others say the Indian herb Gymnema sylvestre can help improve glucose control and reduce the need for medications. However, there is little evidence that these measures are as effective as insulin or hypoglycemic agents in controlling blood sugar and preventing complications. Talk with your doctor if you wish to try these alternatives.
Although type 2 diabetes is a serious condition that can have long-term complications, controlling your blood glucose can reduce or delay the development of long-term complications.
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