Your Type 2 Diabetes Toolkit

Self-management is key to tight glucose control

Woman exercising
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If you have been diagnosed with type 2 diabetes, then you know how overwhelming it can feel at first. There is a lot to do and just as much to learn to manage your disease properly. And that's what makes diabetes so unique. Almost from day one, you are tasked with your own care and are largely responsible for how well or poorly you do.

Luckily, there are tools that can help.

With a little practice and time, you can begin to normalize diabetes in your life and regain consistent control of your blood sugar over the long term.

Blood Glucose Monitoring

Checking your blood glucose levels several times a day helps you understand how your body responds to medications, exercise, and the foods you eat. When first starting out, keeping your glucose within a tight margin can often feel like hitting a moving target. It can suddenly spike with no reason or plummet the next day despite total adherence to your treatment.

But, over time, you will begin to get an intuitive sense of what causes these changes, whether it be stress, a certain type of carb, or excessive physical activity.

To help you in your quest, keep daily records of your glucose levels including notes about what you ate, when you ate, and the types of activities you engaged in. Within a short period of time, these insights will guide you in making the right choices and avoiding the triggers that can lead to blood glucose fluctuations.

Oral Medications

If you are diagnosed with type 2 diabetes, your doctor will usually prescribe an oral medication to help lower your blood glucose. There are currently seven classes of oral diabetes drug licensed for use:

  • Biguanides, which include metformin, the most widely prescribed drug to treat type 2 diabetes
  • Sulfonylureas which stimulate your pancreas to make more insulin
  • Alpha-glucosidase inhibitors which slow the digestion of foods high in carbohydrates
  • Thiazolidinediones which increase your sensitivity to insulin
  • Meglitinides which increase insulin output but are shorter-acting than sulfonylureas
  • DPP4 inhibitors which are typically used in second-line therapy to lower after-meal sugar
  • SLGT-2 Inhibitors which remove excess glucose from your body when you urinate
  • GLP-1 agonists which stimulate the production of insulin in response to the presence of glucose

There are also more than a dozen combination drugs which pair two different medications, most often with metformin as the backbone.

Insulin Therapy

Insulin is a hormone produced by the body which processes the glucose from the foods you eat. Without it, glucose can accumulate and cause trouble. Since you are less able to produce insulin on your own, you must get it from another source.

The insulin used in therapy is injected and closely replicates the type your body would normally produce. You would typically need at least two injections per day and may require four or more depending on your doctor’s recommendations.

There are four different insulin formulations used in therapy:

  • Rapid-acting insulin which starts to work in five minutes and lasts for up to four hours
  • Short-acting insulin which begins to work in 30 minutes, reaches its peak in two to three hours, and continues working for up to six hours
  • Intermediate-acting insulin which begins to work in two to four hours and continues working for up to six hours
  • Long-acting insulin which begins to work in six to 10 hours and continues working for up to 24 hours

There are also pre-mixed formulations which combine an intermediate-acting insulin with either a rapid-acting or short-acting insulin.

Nutrition and Exercise

Most people think that if you have diabetes, you can no longer eat foods with sugar.

That's not entirely true as an occasional dessert or sweet can still be part of a healthy diet.

What type 2 diabetes does typically require is weight loss. To this end, your diet will be primarily focused on the increased intake of lean protein, vegetables, fruits, fiber, and healthy fats to help lose weight and keep it off.

Regular exercise is an equally important part. Not only can it help you maintain your ​ideal body weight, it can have a direct impact on your blood glucose control. This is because insulin resistance is closely linked to increased fat and decreased muscle mass. Muscle cells use insulin far more efficiently than fat, so​ by building muscle and burning fat, you can help lower and better control your blood glucose levels.

To start, aim for 30 minutes of moderate activity five days a week, which may include walking, biking, swimming, pilates, yoga, tai chi, aerobics, cross-training, and team sports. Always design a fitness program with input from your doctor, neither undertraining or overtraining.

By using these tools correctly, you can improve your long-term quality of life with minimal stress or impact on your lifestyle.

View Article Sources
  • Powers, M.; Bardsley, J.; Cypress, M. et al. "Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics." Diabetes Educator. 2017; 43(1):40-53. DOI: 10.1177/0145721716689694.