Tips for Managing Type 2 Diabetes

In the United States, around 90% or more of people affected by diabetes have type 2 diabetes. People affected by this condition cannot use insulin effectively. Cells become resistant to insulin, making them not take in enough sugar. In turn, the pancreas cannot produce enough insulin to keep up with blood glucose (sugar) levels. The high blood glucose levels that result can adversely affect different body systems, such as cardiovascular (heart) or renal (kidney) systems.

Whether you're newly diagnosed or have had type 2 diabetes for years, it's essential to make changes to manage symptoms and maintain healthy blood glucose levels.

This article will offer tips, including diet, exercise, blood sugar monitoring, and more, to help you better manage type 2 diabetes and its symptoms.

Diet

For many years, carbohydrate counting was considered integral to diabetes meal planning, but new information has shown that carbohydrate intake isn't all bad. Instead, the American Diabetes Association (ADA) recommends the Diabetic Plate method. This is a way to balance meals proportionally without calorie counting to maintain a healthy diet.

First, fill half of your plate with non-starchy vegetables, which tend to be lower in carbohydrates and keep blood glucose levels down. These include:

• Broccoli
• Asparagus
• Carrots
• Cauliflower
• Tomatoes
• Beans (e.g., green beans, pea pods)
• Peppers
• Mushrooms
• Eggplant
• Leafy greens (e.g., lettuce, spinach, arugula, endive)

Next, fill one-fourth of your plate with lean proteins, which are lower in fats. Lean protein choices include:

• Chicken, turkey, and eggs
• Lean fish (e.g., salmon, cod, tuna, tilapia, swordfish)
• Shellfish
• Lean beef cuts (e.g., tenderloin, chuck, round, sirloin, flank)
• Cheese/cottage cheese
• Beans, lentils, hummus, or falafel
• Nut or but butter
• Edamame
• Tofu or tempeh

Finally, the last one-fourth of your plate should include carbohydrates. The type of carbohydrates chosen will ideally keep blood glucose levels low rather than making them spike. These include:

• Whole grains (e.g., brown rice, oats/oatmeal, polenta, popcorn, quinoa, whole grain bread, pasta, or tortillas)
• Starchy vegetables (e.g., winter squash, parsnips, potatoes, pumpkin)
• Beans (e.g., black, kidney, pinto, garbanzos)
• Fruits, including dried fruit
• Dairy products, including milk, milk substitutes, or yogurt
  

However, the ADA notes that there is no one-size-fits-all eating plan for managing diabetes. A number of different eating patterns can be helpful, depending on your individual needs. The ADA recommends that people with diabetes work with a dietitian who is knowledgable about diets for controlling diabetes.

Exercise

Staying active is essential to maintaining healthy blood glucose levels. Even starting with something simple, like walking, can help the body use insulin more effectively. If you're not usually physically active, work with your healthcare provider to identify fitness goals.

When starting an exercise regimen, it can be helpful to consider the following:

• Determine how much time you can/need to dedicate to physical activity daily.
• Set fitness goals to help stay motivated.
• Identify where the physical activity will occur, such as at home or at a gym.
• Try different types of exercise to find an activity that is enjoyable and allows for consistency.
• Schedule recovery time.
• Explore ways to keep it fun, such as reading while on a treadmill or working out with a friend.

Weight Control

Achieving a healthy weight can help your body use insulin more effectively, control blood sugar levels, cholesterol, triglycerides, and blood pressure (particularly for those who have obesity), and increase energy levels.

Some things to consider to assist with weight control include:

• Understanding emotional triggers and how they impact eating patterns
• Collaborating with a healthcare provider or registered dietitian to set realistic goals for diet, exercise, and portion control
• Learning positive self-talk to encourage success with managing weight and type 2 diabetes

Blood Sugar Monitoring

An essential component of type 2 diabetes management is monitoring blood glucose levels. This can help indicate patterns or trends, such as foods that affect glucose levels or the effectiveness of medications. Your healthcare provider will explain when and how often to check glucose levels using a blood glucose meter at home.

Keeping your levels in a healthy range can prevent type 2 diabetes complications, such as heart attack, stroke, kidney disease, vision changes, or even amputation.

Your healthcare provider will help identify your blood glucose level targets, depending on your age, health conditions, and diabetes treatment plan. The ADA recommends the following blood glucose level targets:

• Before meals, blood glucose levels should be between 80 to 130 milligrams of sugar per deciliter of blood (mg/dL).
• One to two hours after meals, blood glucose levels should be less than 180 mg/dL.
  

Medication and Therapies

Type 2 diabetes affects each person's blood glucose levels differently. Some people can effectively manage blood glucose levels with proper nutrition and exercise. Others might need medications, such as antihyperglycemic medication, or occasionally, injected insulin, to help keep blood glucose levels in a normal range.

• While there is no optimal antihyperglycemic medication, some of the most commonly used medications include:
• Metformin: Metformin is often the first oral antihyperglycemic prescribed. However, there is a rare risk that blood glucose levels can drop too low, causing hypoglycemia (low blood sugar)
• Glucagon-like peptide-1 receptor agonists (GLP-1 RAs): examples include Ozempic (semaglutide) and Trulicity (dulaglutide)
• Sodium-glucose cotransporter-2 inhibitors (SGLT2i): examples include Brenzavvy (bexagliflozin), Jardiance (empagliflozin), and Farxiga (dapagliflozin)
• Dipeptidyl peptidase 4 inhibitors (DPP-4i): examples include Tradjenta (linagliptin) or Januvia (sitagliptin)
• Sulfonylureas: examples include Amaryl (glimepiride), glyburide, and Glucotrol XL (glipizide)

GLP-1 receptor agonists, SGLT2 inhibitors, Sulfonylureas, or DPP-4 inhibitors can be used along with metformin to help control blood glucose levels without causing hypoglycemia.

Summary

Type 2 diabetes is a chronic disease in which the body does not effectively utilize insulin to maintain healthy blood glucose levels. Over time, uncontrolled diabetes can bring about complications, including heart or kidney disease, vision changes, stroke, or amputation.

Maintaining a healthy weight through nutrition and exercise can help manage type 2 diabetes. Monitoring blood glucose levels using a blood glucose meter can help you and your healthcare provider ensure that your type 2 diabetes treatment plan is effective. If blood glucose levels aren't responding to diet and exercise, your healthcare provider might recommend adding oral antihyperglycemic medication like metformin to your treatment plan.

A Word From Verywell 

Managing a chronic disease like type 2 diabetes can be overwhelming and confusing. Speak with your healthcare provider to determine a treatment plan that includes a healthy diet, exercise, blood glucose monitoring, and medication, if needed.