Type 2 diabetes is a lifelong condition. “For most people, it’s a companion that’s not going to go away,” says Zeb I. Saeed, MD, an endocrinologist with Indiana University Health.
So when you have it, you need to learn to manage your condition. Or, as Saeed puts it, you “make room for diabetes.” You might need to change the foods you eat, get more active, or take medicine.
But there are pitfalls that can get in the way of your health. To avoid some common mistakes with your diabetes management, ask yourself these questions:
1. Are You Taking Your Medicine Incorrectly?
John Morton, MD, a bariatric surgeon with Yale Medicine, says around 60% of people with diabetes don’t take their medications exactly as prescribed. “This is a bigger problem than we think,” he says. If you’re not sure about how you should be taking your meds, Morton says to talk to your doctor, a nurse educator, or your pharmacist.
Never skip or change your dose. “The medication that you’re on for diabetes isn’t an option,” says Jorge Moreno, MD, an obesity medicine specialist with Yale Medicine.
Go over your work schedule with your doctor. If you work an overnight shift, Moreno says you might need to take your medicine at a different time than the drug label says.
2. Do You Choose the Wrong Drinks?
It’s easier to get dehydrated when you have diabetes. On top of that, your blood sugar can go up if you don’t have enough fluid in your body. But certain beverages can spike your glucose levels. “People with diabetes are told to hydrate,” Moreno says. “So they go ahead and hydrate with 100% juice. Unfortunately, that’s loaded with sugar.”
Limit these liquids:
- Fruit and vegetable juices
- Sports drinks
Drink water when you’re thirsty. If that’s too boring, try:
- Sparkling or seltzer water
- Water flavored with lemon, mint, or cucumber
- Sugar-free flavored waters
Ask your doctor if artificially sweetened drinks are OK. We need more research into how they affect blood sugar. But Moreno says diet or “zero” drinks can be an option if you really don’t like water.
3. Do You Think Some Carbs Don't Count?
Your body breaks down carbohydrates into simple sugars, also called glucose. It doesn't matter where these carbs came from. You need to look at total grams of carbs in your food, not just the sugar content.
“Pasta, rice, tortillas, they have a lot of glucose,” Moreno says. “They will increase your sugar levels, sometimes even more than candy.”
Natural sugars also count. It’s true that you should swap cookies for fruits. “But that doesn’t mean you can have loads of them,” Saeed says. “Moderation is key.”
Gail Nunlee-Bland, MD, chief of endocrinology at Howard University Hospital, recommends eating no more than two servings of fruit a day. And try to add more non-starchy vegetables to your meals. “The green leafy ones are better,” she says.
There’s a handy measurement to give you a better idea of which foods, including fruits and veggies, are best for your diabetes. It’s called the glycemic index (GI). The ratings tell you how likely a food is to boost your blood sugar. For example, berries are lower on the GI scale -- and lower in natural sugars -- than bananas, raisins, or grapes, Saeed says.
Labels on most packaged foods in the U.S. don't list glycemic index ratings. But you can easily find GI calculators online.
Still confused about carbs? Moreno suggests you go over your typical breakfasts, lunches, and dinners with your doctor. Tell them exactly what you eat. That gives them a clue about where you need to cut back, he says. Or ask your doctor to refer you to a dietitian who works with people who have diabetes.
4. Do You Get Too Little Exercise?
Regular aerobic exercise can lower your blood sugar and help your body respond to insulin better. And don’t forget about strength training. Think about muscle tissue like a sponge, Moreno says. “It absorbs glucose.”
To fit more activity into your day:
- Take a walk, especially 15 minutes after a meal.
- Ride a bike.
- Use resistance bands.
- Do bodyweight exercises.
- Lift weights.
No matter how you choose to get your heart pumping, do it for at least 20-30 minutes a day. It’s OK to break up your activity into several 5- to 10-minute blocks if that’s all the time you have.
Include at least 2 days of strength training each week. “The more muscle you build, the more energy you burn, the less sugar is available" in your blood, Morton says.
5. Do You Think You Can't Afford Healthy Food?
“The No. 1 thing I often hear is it’s just too costly to eat healthy with diabetes,” Nunlee-Bland says. But she says there are ways to follow a balanced diet on a budget.
- Eat dried beans for protein and fiber
- Choose frozen or canned fruits and vegetables (with no added sugar or salt)
- Buy in-season produce
- Plan your meals ahead of time
Prep meals on the weekends, Nunlee-Brand suggests. That helps keep you on track for the week ahead.
You don’t have to give up all your favorite foods. Ask a dietitian for tips. “They can help you plan your meals so you can enjoy some of the things that you like to eat,” she says.
6. Do You Skip Checkups?
When you have diabetes, you can develop other health issues even if you eat right, take your medicine, and get enough exercise. You may not be able to tell when something starts to go wrong. “Don’t assume everything is OK,” Morton says. “Make sure that you do your testing on a routine basis.”
You might need certain tests each time you see your doctor. Others might come up once or twice a year. Ask your doctor what’s right for you. They’ll want to keep an eye on your:
- Blood pressure
- Foot health
- Eyes, teeth, and gums
- Vaccinations and boosters
7. Do You Expect Too Much Too Soon?
It can take time for your diabetes medicine to work. Don't necessarily expect to see major results within the first couple of days or weeks. The same goes for healthy lifestyle changes.
“It can take months for the scale to move,” Saeed says. “But you should start feeling better sooner.”
8. Do You Skimp on Sleep?
Too little sleep -- less than 7 to 9 hours a night -- raises your odds of certain medical issues. For starters, it makes it harder to control your blood sugar and blood pressure. “You want a good night’s sleep,” Moreno says. “It can affect multiple things.”
Tell your doctor if you have trouble sleeping. They can suggest behavior changes to help you rest. And they’ll check for other health problems, such as insomnia or obstructive sleep apnea.
9. Do You Ignore Your Mental Health?
Mental health care should be a part of your diabetes care plan. Depression or stress can affect your blood sugar in several ways. For one thing, “you may not remember to take your medicine,” Moreno says.
Stress hormones also prep your body for action. When stressful situations pop up, your body sends out extra energy so you can fight or run. “It says … 'let’s get all of our resources together here,' and that means sugar,” Morton says.
You can’t get rid of stress. But you can learn to handle it better. If you’re not sure where to start, ask your doctor to refer you to a mental health counselor.
Some do-it-yourself techniques Morton suggests include:
- Learn yoga.
- Pray or try mindfulness meditation.
- Read a book.
- Go for a walk.
- Spend time with people who care about you.
What works for someone else might not be right for you. But whatever you do to wind down, make it an everyday thing.
“The one big thing is to set the time aside,” Morton says. “You’ve got to do it almost like a schedule. From 6 to 7, that’s my time where I’m going to go do something for me.”