The approach to treating or ‘managing’ diabetes depends on the individual person and the type of diabetes. The aim is to keep blood glucose and other things (“clinical indicators”) as close to healthy ranges as possible.
Why is Diabetes Management important?
If diabetes is not managed optimally, high blood sugar levels can cause serious damage to all of our major body organs. The approach to diabetes management will depend on the type and duration of your diabetes. The main thing is to find out as much as you can about your diabetes, so that you can make sure treatment is appropriate to you and your life.
Managing diabetes is an ongoing task that demands time and attention each day. It pays off in the long run though – keeping blood glucose levels close to normal for much of the time can significantly reduce the risk of developing or worsening more serious long term complications.
Don’t let diabetes get the better of you! Learn about your blood glucose levels and the factors that affect them; develop your own self-management skills and stay healthy.
Educate your family and whanau about diabetes and the potential complications of diabetes, and develop a support system that will help you to achieve your goals.
Diabetes management involves:
- Making informed healthy food choices
- Treatment – prescribed by your doctor
- Blood glucose monitoring – performed by you
- Continual adjustment – of treatment and/or daily activities in order to maintain control of blood glucose levels
- Avoiding dangerously high or low blood glucose levels
- Setting and achieving targets
- Reducing other risk factors for complications – e.g. blood pressure and levels of blood fats and cholesterol
- Detecting and treating complications early
Essential tools for diabetes management
- Diabetes knowledge
- Blood glucose monitoring
- Your health care team
Keys to your success
- Learn as much as you can about diabetes – about the day-to-day management and the risks of long-term complications. This will help you to make informed choices about your diabetes management
- Use your blood glucose monitoring – your healthcare team will give you individual guidance on making adjustments to your treatment plan based on the results of your home blood glucose tests
- Take a look at your lifestyle – are there any simple changes that you could make to improve your general health and well-being?
- Don’t try to make major lasting changes overnight; set yourself realistic short-term and long-term goals
- Involve your family and friends. Develop a support network and consider including other people with diabetes in this – join a local group or an e-mail based one, such as Diabetes Support NZ.
Healthy Living
Much of diabetes management is based upon the concept of leading a ‘healthy lifestyle’. It’s easy to describe how we should live our lives – but it is not so easy to make changes, and putting ‘healthy living’ into practice is not always as easy as it sounds.
Here, we outline the basic principles behind the different management approaches. There is more detailed information on the different aspects of diabetes treatment in the various “Deep Dives” pages.
Managing Type 1 Diabetes (T1DM)
If you have Type 1 diabetes then your body will not be producing any insulin. Insulin is necessary for survival, so the only option is to provide the body with insulin from an outside source. Because it is a protein hormone, if it is taken by mouth (e.g. as a tablet) it is destroyed by the digestive system before it has chance to be absorbed. Insulin is therefore injected into the layer of fat that lies just beneath the skin. Alternatively, insulin can be supplied continuously by a pump; it is fed into the body through a long thin tube with a needle or plastic cannula that is inserted under the skin.
The amount of insulin that is given must closely match the body’s requirements in order to keep the blood glucose level in the right range. Too much insulin causes it to fall too low (hypoglycaemia) and too little causes it to rise too high (hyperglycaemia). Both of these conditions are unpleasant and can be dangerous if they are not corrected.
So, insulin needs to be closely matched with food intake (amount and timing) and exercise levels. This continual juggling act forms the crux of diabetes management and is only made possible with regular monitoring of blood glucose levels.
Managing Type 2 Diabetes (T2DM)
If you have Type 2 diabetes, your management plan will depend on a number of factors, including:
- Your body weight
- Your current eating habits
- Your current level of physical activity
- The severity of your symptoms
- Your blood glucose levels
- How long you have had diabetes for
You may at first be advised to make changes in your lifestyle – lose some weight and increase your level of physical activity, for example. Weight loss and exercise can be very successful in getting blood glucose levels back down to the normal range. Although it can be very difficult to change habits of a lifetime, the threat of your health deteriorating further may signify that now is the time to stop and take stock of things.
In some people, the ‘healthy lifestyle’ approach is simply not enough to bring blood glucose levels into line and extra help is needed. Usually the next step is tablets – known as oral hypoglycaemics – that either help you to produce more insulin, or help your body to use the insulin more effectively. These tablets, however, are only effective if your body is able to produce some insulin. You may be prescribed more than one type of tablet. You should remember that diet, weight loss and exercise are still crucial to the diabetes management plan even when tablets are prescribed.
Some people with Type 2 diabetes need insulin injections. This might be temporary – if your body is under a lot of stress, you have an infection or you have been admitted to hospital for surgery, for example. However, in many cases, Type 2 diabetes is a progressive condition in which insulin production declines slowly over the years. Eventually, if not enough insulin is produced on a regular day-to-day basis, then there is no alternative but to start on injections of insulin. If this happens to you then you must remember that this is not a failing on your part – it is just the natural progression of things.
Regardless of the management approach, people with Type 2 diabetes should ideally monitor blood glucose levels on a day-to-day basis. It is only with this information that you can assess the effects of your daily activities on your blood glucose level.
Managing Gestational Diabetes (GDM)
The aim of diabetes management in Gestational diabetes is to bring blood glucose levels into the healthy range in order to prevent complications of the pregnancy.
Dietary therapy is usually the first line of treatment. Refined foods and simple sugars should be replaced with more complex carbohydrates and fat intake should be reduced. A moderate restriction in calorie intake and increased exercise are generally recommended in overweight women.
In some women, modifying the diet is not sufficient to bring blood glucose levels down. In such cases, insulin injections are required.
