Introduction

Managing Diabetes: The Essentials

Diabetes cannot be cured, but maintaining an ideal lifestyle will help to manage diabetes effectively, preventing complications and maintaining a good quality of life.

Stewardship of diabetes includes aspects of lifestyle change, use of oral medications, insulin delivery, and the use of a variety of technology to assist in self-management. The purpose of diabetes stewardship is to maintain good glucose (blood sugar) control while engaging in activities to promote a healthy lifestyle.

Lifestyle: The Basics of Good Stewardship

No treatments of diabetes can be effective without consistent healthy regulation of daily activities and habits:

Healthy eating: Be sure to include high-fiber foods, lean meats and proteins, whole grains, vegetables and healthy fats, and limit foods with added sugars, processed foods and refined carbohydrates.

Exercise: Here it is important to exercise at least 150 minutes of activity per week. Other activities of walking, biking and swimming can count towards some of this relatively moderate activity time.

Weight Management: Weight management is important. If managing or trying to lose weight while dieting, diet-related studies have shown that managing weight can help reduce blood sugar regulation by as little as 5–10%.

It may also be suggested to manage stressors and to get good sleep. Sleep and stress are also important factors in balancing glucose levels.

Lifestyle is always first, and ultimately, the most powerful tool in managing type 2 diabetes, and it can assist in controlling type 1 diabetes too.

Oral Medications for Type 2 diabetes

If lifestyle and diet alone are not effective by themselves, or with reasonable means, one option may be supplementing lifestyle choices or dietary adjustments with oral medications are available or prescriptive in reducing blood glucose levels:

Metformin - First-line medication that lowers glucose output from the liver and secondary improves insulin sensitivity.

Sulfonylureas - Work by causing the pancreas to release more insulin.

DPP-4 Inhibitors - Improve insulin release and reduce blood glucose after eating.

SGLT2 inhibitors - Assisting glucose elimination to urine through the kidneys excretion, and are intended to assist the kidneys in function as well as lowering blood glucose.

Thiazolidinediones (TZDs) - Help improve muscle and fat cells insulin sensitivity.

GLP-1 receptor agonists (either injectable or oral) - Harm digestion, decrease appetite, and improve insulin release.

When seeing a physician, often a combination of medications may be prescribed, or they may monitor them for secondary effect.

Insulin Therapy

Insulin is required for type 1 diabetes because the body does not produce it. Furthermore, it is not uncommon for individuals with advanced type 2 diabetes to use insulin at some point.

Denoting insulin therapy are:

Rapid Acting - Allows insulin duration beyond eating duration, usually insulin is taken before eating.

Short Acting - Insulin is prescribed approximately around eating time, and the duration is approximately 4–6 hours.

Intermediate Acting - Insulin duration for half days worth of needs.

Long-Acting - Insulin duration to provide and ensure glucose will be stable throughout the day and the night.

Modern delivery allows insulin for injection to occur with insulin pens, and can be delivered via insulin pumps or patch pumps, making it more accurate for healthy living.

New-age Diabetes Technology

New-age technology for tracking managing diabetes:

Continuous Glucose Monitor (CGM) - Small wearable sensors applied to track and access blood glucose twenty-four-seven.

Smart insulin pumps: Smart insulin pumps will deliver doses at a precise interval and adjust to the readings of a CGM reader sensor for delivered doses.

Mobile health apps: Mobile health apps measure meals, activity, and glucose levels to measure for better decision making.

Even with all these newer healthcare management ways of limiting stress, these healthy options make the days even more manageable for keeping upper blood glucose levels even more manageable.

The Importance of Regular Monitoring

Even if the active effort of diabetes stewardship is exercised, it is always important to see physicians for check-ups. The physician will always check:

HbA1c labs every 3-6 months

Kidney and eye health

Blood pressure and cholesterol

Diabetes stewardship is equally working as a team effort involving you, your physician, and your daily habits.

Key Takeaway

Stewardship for diabetes requires diligence, staying focused for consistency, support, and systems of managing blood glucose. Even if it is stressful, with the newer provisions for disease management, it is possible for us to have a fulfilling and being active in taking care of ourselves and managing blood glucose levels at the same time.

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