Tips For Aging Well With Type 2 Diabetes
- Lean on your medical team, which may consist of an endocrinologist, a podiatrist, an RDE and a CDE, and other specialty health professionals. In many cases, your primary care physician will be your main healthcare provider for diabetes care.
- Stick to your medication regimen, and be open to potential medication adjustments.
- Take insulin if your doctor says you need it.
Everyday Health editors attend the AADEs annual meeting to connect with certified diabetes educators, registered dietitians, and people like you, who are looking for ways to better manage blood sugar, diet, medication, and more. Check out information on this years meeting in Houston.
The ADA is considered the leading nonprofit for type 1 and type 2 diabetes education. The ADAs free yearlong program Living With Diabetes offers top-of-the-line resources for anyone new to living with diabetes. Youll get access to their newsletter, expert Q& A session, and online support system, among other perks.
One of our favorite features from the AHA is a go-to resource for preventing heart disease: Know Diabetes by Heart. The ADA-supported initiative lays out a step-by-step guide for keeping your heart healthy while living with diabetes.
For more on the association between diabetes and heart disease, check out our article Heart Disease The Diabetes Connection.
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How To Lower Your A1c Level
When you have diabetes, you probably know you should check your blood sugar regularly. Your doctor will also recommend that you take an A1c blood test a few times a year, with a goal of lowering the results to help protect your health. And thereâs a lot you can do to move toward meeting that goal.
Unlike a regular blood sugar test, the A1c test measures the amount of sugar that clings to a protein, called hemoglobin, in your red blood cells. The test shows your average blood sugar levels over the past few months, so you know how well your diabetes is under control.In general, the goal for your A1c is to be lower than 7%. Exactly how much lower will depend on your individual treatment plan. When you take steps to get your A1c in a healthy range, you lower your risk of complications such as nerve damage, eye problems, and heart disease.
Your doctor will let you know the best target for your A1c. How do you get there? Here are a few tactics to try, in addition to taking any medications your doctor prescribes.
Get some new kitchen gear. Youâll want to get a set of measuring cups and a kitchen scale if you donât already have them. These will help you with your portion sizes. Your blood sugar will go up if you eat more food than your body needs. Keeping servings in check is a good way to reduce your A1c level.
Mayo Clinic: âA1C Test,â âHyperglycemia in Diabetes,â âDiabetes Diet: Create Your Healthy Eating Plan.â
Managing Type 2 Diabetes
Managing type 2 diabetes requires teamwork. Youll need to work closely with your doctor, but a lot of the results depend on your choices.
Your doctor may want to perform periodic blood tests to determine your blood glucose levels. This will help determine how well youre managing the condition. If you take medication, these tests will help gauge how well its working.
Your doctor may also recommend a home monitoring system to test your own blood glucose levels between visits. Theyll explain to you how often you should use it and what your target range should be.
Because diabetes can increase your risk of cardiovascular disease, your doctor may want to monitor your blood pressure and blood cholesterol levels. If you have symptoms of heart disease, you may need additional tests. These tests may include an electrocardiogram or a cardiac stress test.
It may also be helpful to bring your family into the loop. Educating them about the warning signs of blood glucose levels that are too high or too low will allow them to help in an emergency.
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Most Diabetes Medications Effectively Lower Blood Sugar
The blood sugar goal for most adults with diabetes is an A1C of below 7%. In many people, diet and exercise are not enough to reach this goal, and one or more medications may be needed. Metformin is a tried and tested medicine that has been used for many decades to treat type 2 diabetes, and is recommended by most experts as first-line therapy. It is affordable, safe, effective, and well tolerated by most people.
When metformin does not adequately control blood sugar, another medication must be added. It is at this point that doctors and patients must choose among the many drugs and drugs classes available to treat type 2 diabetes. In general, for people who are at low risk of heart disease or have no history of diabetic kidney disease, most diabetes medications that are added to metformin effectively reduce blood sugars and can lower A1C to under 7%.
So, how to choose a medication? Each person with diabetes has their own goals, needs, and preferences. Before choosing a medicine, it is important to ask some relevant questions: Is my blood sugar at goal? Is this medicine affordable? Do I have heart or kidney disease? What are the side effects? Is it a pill or injection, and how often is it taken?
Regardless of which treatment is selected, the American Diabetes Association Standards of Care recommends reassessment of diabetes control every three to six months, followed by modifications to treatment if needed.
Giving Patients A Choice
Doctors stress that patients should be supported in making diabetes management a priorityhowever they choose to do soregardless of whether the aim is remission.
The majority of patients dont achieve remission, but the goal is to keep their blood sugar under good control, says Dr. Gwendolyne Jack, endocrinologist and clinician-educator at Weill Cornell Medicine in New York City. To achieve this, she says, some patients will continue to need lifelong medication, including insulin. Thats OK. That is not a failure on their part, Jack says.
But the impact of a diagnosis on patientsand the desire many patients have to control blood sugar without medication or insulinshouldnt be ignored, Taylor and others emphasize. Survey results published in Diabetic Medicine in February 2018 show this is the No. 1 question patients want researchers to answer about the disease: Can Type 2 diabetes be cured or reversed, what is the best way to achieve this, and is there a point beyond which the condition cant be reversed?
Taylor acknowledges that many people with the chronic condition see it as something the doctor will deal with patients often get help with controlling blood sugar, but their goal isnt remission. However, at least 40% of people with Type 2 diabetes hate their condition and would go to lengths to get rid of it, he says. They describe the moment of diagnosis as a hammer blow. Many doctors do not understand that.
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Bonus 1 Is The 30 Day Food & Drink Plan
The first free bonus is your 30-day diabetes-reversing meal and drink plan.
Simply follow the plan to the letter to reverse your type 2 diabetes without even thinking about anything else.
We know some people prefer to skip right to the food and drink plan.
And you can take this plan with you anywhere. While you travel, to work, on vacation or just to use at home. Itll always be there for you.
Exceptions To The Rule
Professor Taylor caveats that all of this research is relevant for individuals with the usual form of type 2 diabetes. Rare forms of diabetes exist that can easily be mistaken for type 2 diabetes, including:
A) Pancreatic diabetesThis occurs after several cases of pancreatitis and is likely to be caused by pancreas damage.
B) Monogenic diabetesThis genetic form of diabetes is commonly found in slim individuals diagnosed in early adulthood who have a very strong family history of diabetes.
C) Slow onset type 1 diabetesSometimes type 1 diabetes develops slowly, appearing in adulthood, and these individuals usually need insulin therapy soon after being diagnosed.
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Healthy Eating For Type 2 Diabetes
A dietitian or your doctor will be able to advise you on what to eat to meet your nutritional needs and control your blood sugar. Your doctor should be able to refer you to a registered dietitian for personalised advice.
Eating healthy foods with a low glycaemic index can help to optimise your blood sugar levels. This includes wholegrain breads, minimally processed breakfast cereals like rolled or steel cut oats, legumes, fruit, pasta and dairy products.
Avoid high-carbohydrate, low-nutrient foods such as cakes, lollies and soft drinks, and eat a diet low in saturated fat.
You should eat at regular times of the day and may also need snacks. Try to match the amount of food you eat with the amount of activity you do, so that you dont put on weight.
If you are overweight or obese, losing even 5-10 per cent of your body weight can significantly improve blood sugar control.
Why Surgery Works So Fast On T2d Symptoms
Most people considering bariatric/metabolic surgery, for whatever reason, initially have a very simplistic view of the process, says Dr. Aragon. They believe the surgery, which will either reduce the size of their stomach or bypass it completely depending on the procedure3, will ultimately cause them to eat less and the result will be to lose weight. The reality is that the smaller stomach is the least of the factors that cause the weight loss. The surgery causes a massive metabolic and hormonal change. Its no different from when a woman has her ovaries removed. Without ovaries, she is likely to have hot flashes, night sweats, mood swings, sleeplessness, fatigue, anxiety, and even loss of sex drive. Our stomachs and intestines are not just reservoirs for food. Like ovaries, they secrete substances that influence our appetite, sense of fullness, the way our bodies manage sugar, store fat, and more. The surgery removes or bypasses the source of these hormones. That is why we see almost immediate results for diabetics, whether weight has been part of the equation or not their blood sugar comes under control without insulin. An overweight patient does lose weight, but whats interesting is that patients who are not obese do not seem to lose weight. They maintain their current weight and just enjoy the metabolic results of the surgery.
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Attacking The Origin With Immunotherapy
In type 1 diabetes, insulin-producing cells are progressively destroyed by the immune system. Stopping this process early enough could preserve the cells and provide a cure.
That is the goal of Imcyse, a Belgian company running a phase I/II clinical trial with an immunotherapy designed to stop type 1 diabetes by specifically killing the immune cells that destroy the pancreas. A phase I trial showed there were no major safety issues related to the immunotherapy and some clinical benefits were also revealed.
Early after diagnosis, between three to six months, it is estimated that around 10% of the insulin-producing cells are still alive and producing insulin. After stopping the autoimmune process, the remaining beta cells would be protected and could continue producing insulin, explained Pierre Vandepapelière, CEO of Imcyse.
Belgian company ActoBio Therapeutics, a subsidiary of the US firm Precigen, is now running a phase I/II clinical trial with an unusual approach to stop the progression of type 1 diabetes. The company uses cheese-producing bacteria to deliver two drugs that stimulate regulatory T cells to instruct the immune system not to attack insulin-producing cells.
It is potentially a safe oral treatment that will be given for a limited period of time and could lead to patients who develop type 1 diabetes not needing to use insulin, or delay the need for insulin after diagnosis, said Pieter Rottiers, CEO of Precigen ActoBio.
How Close Are We To A Cure For Type 2 Diabetes
Type 2 diabetes is one of the worlds greatest health problems. It affects about 400 million people globally. If its uncontrolled, it can lead to dangerous complications like kidney failure, blindness, heart attack, and stroke. But while there are over 30 different drugs on the market to help manage this disease and prevent these problems, none provide an actual cure.
One reason is that until recently, we didnt quite understand the full scope of the problem. Two decades ago, if you asked a diabetes specialist to explain the cause of type 2 diabetes, they would say insulin resistance. Insulin is a hormone made by the pancreas that helps the glucose in your blood enter cells in your muscle, fat, and liver, where its used for energy. But when you have insulin resistance, these muscle, fat, and liver cells dont respond well to it. As a result, your pancreas has to make more and more insulin to compensate. Over time, this can lead to type 2 diabetes.
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How Can Diabetes Be Permanently Cured
Although there is no treatment for type 2 diabetes, research indicate that it is reversible in certain cases. By altering your diet and losing weight, you may be able to achieve and maintain normal blood sugar levels without medication. This may not indicate total recovery. Type 2 diabetes is a chronic condition.
What About Islet Cell Transplantation As A Cure For Diabetes
A successful islet cell transplant can improve the quality of life for a person with diabetes. It’s an evolving technology that’s still being researched.
Islet cells sense blood sugar levels and make insulin. The cells come from a donor.
Once transplanted successfully, the donor cells begin to make and release insulin in response to blood sugar levels. This procedure can provide more flexibility with meal planning and help protect against serious long-term diabetes complications such as heart disease, stroke, kidney disease, and nerve and eye damage.
The person receiving the transplant must take medicine for the rest of their life to prevent their body from rejecting the donor’s cells.
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Can Walking Cure Diabetes
Studies have shown that walking may be effective for lowering blood glucose levels and improving diabetes management. In a research involving individuals with type 1 diabetes, participants were randomly allocated to either take a 30-minute walk after a meal or have the same meal while remaining sedentary.
Newer Diabetes Medications: Weighing Benefits And Risks
Lately, newer treatment options for type 2 diabetes glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors have been heavily advertised. These newer drug classes lower blood sugar and also have cardiovascular and kidney benefits.
GLP-1 receptor agonists are drugs that lower blood sugar after eating by helping your bodys insulin work more efficiently. All drugs in this group except one are self-injected under the skin, either daily or weekly. Several of them, such as liraglutide , semaglutide , and dulaglutide , have been shown to lower the risk of cardiovascular disease in people who are at high risk for it, or who have pre-existing heart disease. They also promote weight loss. Some people who take GLP-1 receptor agonists may have side effects such as nausea and vomiting, and in very rare cases pancreatitis.
While these diabetes medications certainly have more to offer than just improvements in blood sugar, they remain costly and inaccessible to many individuals. This is why it is essential to have an open and honest conversation with your doctor about what is most important to you and what aligns with your goals and preferences. Management of a complex disease like diabetes takes an entire team, with you being the key team member.
About the Author
Samar Hafida, MD, Contributor
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Replacing Missing Cells With Cell Therapy
Although still in the very early stages of development, cell therapy is one of the biggest hopes towards developing a cure for diabetes, especially for type 1 diabetes. Replacing the missing insulin-producing cells could potentially recover normal insulin production and cure patients.
However, early attempts to transplant pancreatic cells have largely failed, mostly due to immune reactions that reject and destroy the implanted cells. The lack of donors is also a limitation.
One of the most advanced alternatives comes from the Diabetes Research Institute in the US, which is developing a bioengineered mini-organ where insulin-producing cells are encapsulated within a protective barrier. This mini-pancreas is then implanted into the omentum, a part of the abdominal lining. A phase I/II trial is ongoing, but the DRI announced its first successful results in 2016, revealing that the first patient in Europe treated with this approach no longer requires insulin therapy.
This can be the beginning of a new era in islet transplantation. Our ultimate goal is to prevent the need for lifelong anti-rejection therapy, stated Camillo Ricordi, Director of the DRI.
A similar device is being developed by the US company ViaCyte, in collaboration with the nonprofit organization JDRF. A phase I/II trial is ongoing and has already proved the device is safe. The company is now working on improving the engraftment of insulin-producing cells.
What Is A Liquid Diet
As the name suggests, a liquid diet means you’re getting all, or at least most, of your calories from drinks. There are different kinds.
A clear liquid diet is something a doctor may put you on for a short while. Youâre often asked to follow one before a medical procedure or if you’re having some digestive issues. You wonât get the calories and nutrients you need with one of thesediets, so you canât be on them for long and shouldnât do them without medical supervision.
People choose to go on other types of liquid diets for weight loss. Typically, theyâre limited to fruit or vegetable juices, or shakes. These drinks may replace all of your meals or just one or two meals . You also get snacks on some of these plans.
These diets can cut the calories you take in and can help you lose weight, but you shouldnât stay on them for very long. Talk to your doctor before you go on a liquid diet. Youâll need to make sure you get enough important nutrients, like fiber and protein.
Do liquid diets work for weight loss?
Liquid diets can work, like any diet that gives you fewer calories than you use. These diets can help by taking the guesswork out of portion control. Theyâre also beneficial if you have trouble chewing food.
But the results may not last. When you drastically cut calories, your metabolism slows to save energy. Unless you change your eating habits, you’re likely to regain the weight you lost after you go off the liquid diet.
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