When David Chu reached his mid-60s, he started to notice that he felt tired throughout the day -- sometimes totally exhausted. So he mentioned it to his doctor, and after a round of blood tests, he found out the reason: He had diabetes.

Chu’s mother had also had the disease, so he knew the stakes right away. “It was like investing in the stock market,” Chu says. “I was motivated by greed and fear. Greed to maintain a better quality of life. Fear of the consequences -- blindness, kidney dialysis, amputation, or worse -- if I did not keep the condition under control.”

From watching his mother, Chu also knew that making good on his investment meant more than just taking medication. He braced for a complete lifestyle makeover, including changes to his diet and exercise habits, to handle the disease.

Experts say that kind of broad approach is the best bet for managing diabetes. The most effective care plans look at all aspects of a person’s life to see where healthy changes can help.  

“Today we don’t just hand out medication and hope for the best. We look at the whole system and take a comprehensive approach,” says Margaret Powers, PhD, president of health care and education for the American Diabetes Association.

It’s Up to You

“Ninety-nine percent of diabetes care is self-management,” Powers says. “It’s the patient who has to take their meds, check their blood sugar, buy the right food, and decide when to exercise.”

She says there are four times when you need to take a look at how well your diabetes management plan works:

  1. When you’re diagnosed
  2. Every year after that
  3. When other things come up, such as another health problem or new medication
  4. During times of transition, like when you check out of the hospital, move to a nursing home, or when a child leaves home for college

You have to think about a number of things when you’re deciding how you’ll take charge of the condition. But along with medicine, Powers says there are two parts of life that everyone with diabetes should focus on: nutrition and exercise.

Diet Is Crucial

What you eat and when you eat it affect every other part of your diabetes care.

That's why your medication and your diet need to be in harmony, Powers says. For instance, many people take insulin to lower their blood sugar. But if they’re not eating at the right time, their levels could dip dangerously.

A balanced diet can also delay the need to take more medication or the need for some meds altogether.

That has been Chu’s motivation. “It’s a fear factor,” he says. “I don’t want to have to take insulin shots.”

But as a Chinese-American raised on a high-carb diet of rice and noodles, adjusting his diet was hard. Chu says he compromised by front-loading his pasta, toast, and rice into breakfast and lunch before tapering off with meat and stir-fried veggies at dinner.

Work It Out

Chu had always been an active adult. He liked playing basketball and going for walks. But his diabetes diagnosis motivated him to make his program more structured. He takes a brisk walk, no faster than a 15-minute mile, every morning. He even joined a health club. And he still shoots hoops when he can.

Exercise is key because it can have a direct impact on your disease. For people with type 2, activity can put off the need for medication. It can also improve the way the body uses insulin. And it can help you slim down, which always helps when it comes to diabetes. Powers says she has seen people improve by losing just 7% to 10% of their body weight.

A 360-Degree Approach

While medication, diet, and exercise are the basis of any sound diabetes management plan, you've got many other ways to keep yourself healthy, too:

  • Skin care. Up to one-third of people with diabetes will have an infection, itching, or blisters. Keep your skin clean and dry, avoid very hot baths and showers, treat cuts right away, and talk to your doctor if you see changes in your skin.
  • Eye care. The disease also makes vision problems like glaucoma and cataracts more likely. Wear sunglasses outdoors, and have regular eye exams to protect your sight.
  • Foot care. High blood sugar can damage nerves in the feet and cause calluses, foot ulcers, and poor blood flow. Check your feet every day and see a doctor about any problems.
  • Stress. Anxiety can raise your blood sugar. So try to find ways to relax as much as possible. Get plenty of rest. Do things you enjoy. And remember that exercise is also a great stress-buster.

Chu makes sure he gets 7 hours of sleep every night, and he keeps a close eye on his blood sugar after a particularly stressful day at work. With his 360-degree approach, he acknowledges that diabetes is now a central part of his life. 

“I have to live with it,” he says. “But as long as it doesn’t get worse, it’s acceptable. Just like getting old.”

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