Type 2 diabetes - self-care
Type 2 diabetes is a chronic (lifelong) disease. If you have type 2 diabetes, your body has trouble using the insulin it normally makes. Insulin is a hormone made by the pancreas to control blood sugar. When your body's insulin is not used correctly, the sugar from food stays in the blood and the level can get too high. Over time, people with type 2 diabetes may not have enough insulin.
Most people with type 2 diabetes are overweight when they are diagnosed. Type 2 diabetes usually happens slowly.
Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your healthcare provider about seeing a diabetes educator.
Symptoms of Type 2 Diabetes
You may not have any symptoms. If you do have symptoms, they may include:
- Urinating a lot, getting up more often than usual at night to urinate
- Blurry vision
- Trouble having an erection
- Red skin rashes in parts of your body
Take Control of Your Diabetes
You should have good control of your blood sugar. If your blood sugar is not controlled, serious problems called complications can happen to your body after many years.
Learn the basic steps for managing diabetes to stay as healthy as possible. Doing so will help keep the complications of diabetes away. Steps include:
- Checking your blood sugar at home
- Keeping a healthy diet
- Being physically active
Also, be sure to take any medicine or insulin as instructed.
Your doctor will also help you by ordering blood tests and other tests. These help make sure your blood sugar and cholesterol levels are each in a healthy range. Also, follow your doctor's instructions about keeping your blood pressure in a healthy range.
Your doctor will likely ask you to visit other health care providers to help you control your diabetes. These providers include a:
- Diabetes pharmacist
- Diabetes educator
Eat Healthy Foods and Manage Your Weight
Foods with sugar and carbohydrates can raise your blood sugar too high. Alcohol and other drinks with sugar can also raise your blood sugar. A nurse or dietitian can teach you about good food choices.
Make sure you know how to have a balanced meal with protein and fiber. Try to eat at the same times each day. Eat healthy, fresh foods as much as possible. DO NOT eat too much food at one sitting. This helps keep your blood sugar in a good range.
Managing your weight and keeping a well-balanced diet are important. Some people with type 2 diabetes can stop taking medicines after losing weight (even though they still have diabetes). Your doctor can let you know a good weight range for you.
Weight-loss surgery may be an option if you are obese (very overweight) and your diabetes is not under control. Your doctor can tell you more about this.
Regular exercise is good for people with diabetes. It lowers blood sugar. Exercise also:
- Improves blood flow
- Lowers blood pressure
It helps burn extra fat so that you can keep your weight down. Exercise can even help you handle stress.
Try walking, jogging, or biking for 30 to 60 minutes every day. Pick an activity that you enjoy and you are more likely to stick with. Bring food or juice with you in case your blood sugar gets too low. Drink extra water.
Wear a diabetes ID bracelet. In case of an emergency, people know you have diabetes and can help you get the right medical attention.
Always check with your doctor before beginning an exercise program. Your doctor can help you choose an exercise program that is safe for you.
Check Your Blood Sugar
You may be asked to check your blood sugar at home. This will tell you and your doctor how well your diet, exercise, and medicines are working. A device called a glucose meter can provide an accurate blood sugar reading.
A doctor, nurse, or diabetes educator will help set up a home testing schedule for you. Your doctor will help you set your blood sugar goals.
- Many people with type 2 diabetes need to check their blood sugar only once or twice a day. Some people need to check more often.
- If your blood sugar is in control, you may need to check your blood sugar only a few times a week.
You May Need Medicines
If diet and exercise are not enough, you may need to take medicine. It will help keep your blood sugar in a healthy range.
There are many diabetes medicines that do different things in your body. Many people with type 2 diabetes need to take more than one medicine to control their blood sugar. You may take medicines by mouth or as a shot (injection). Diabetes medicines may not be safe if you are pregnant. So, talk to your doctor about your medicines if you are thinking of becoming pregnant.
If medicines do not help you control your blood sugar, you may need to take insulin. Insulin must be injected under the skin. You will receive special training to learn how to give yourself injections. But it is not as hard as people think it is.
Learn to Prevent Long-term Problems of Diabetes
People with diabetes have a high chance of getting high blood pressure and high cholesterol. These health problems can cause a stroke or heart attack. You may be asked to take medicine to prevent or treat these conditions.
- Your doctor may ask you to take a medicine called an ACE inhibitor or another medicine called an ARB for high blood pressure or kidney problems.
- Your doctor may ask you to take a special medicine called a statin to keep your cholesterol low.
- Your doctor may ask you to take aspirin to keep your heart healthy. Ask your doctor if aspirin is right for you.
DO NOT smoke. Smoking makes diabetes worse. If you do smoke, work with your doctor to find a way to quit.
Diabetes can cause foot problems. You may get sores or infections. To keep your feet healthy:
- Check and care for your feet every day
- Make sure you are wearing the right kind of socks and shoes
See Your Doctor Regularly
If you have diabetes, you should see your health care provider every 3 months, or as often as instructed. At these visits, your provider may:
- Ask about your blood sugar level
- Check your blood pressure
- Check the feeling in your feet
- Check the skin and bones of your feet and legs
- Examine the back of your eyes
Your doctor will also order blood and urine tests to make sure your:
- Kidneys are working well (every year)
- Cholesterol and triglyceride levels are healthy (every year)
- A1C level is in a good range for you (every 6 months if your diabetes is well controlled or every 3 months if it is not)
Talk to your doctor about any vaccines you may need, such as the yearly flu shot and the hepatitis B and pneumonia shots.
Visit the dentist every 6 months. Also, see your eye doctor once a year, or as often as instructed.
American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014;37 Suppl 1:S14-S80. PMID: 24357209 www.ncbi.nlm.nih.gov/pubmed/24357209.
Brownlee M, Aiello LP, Cooper ME, et al. Complications of diabetes mellitus. In: Mehmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 33.
Buse JB, Polonsky KS, Burant C. Type 2 diabetes mellitus. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2011;chap 31.
Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.