Top tips for managing diabetes
As a chronic illness, diabetes is a condition that lasts a lifetime. Managing the condition can be difficult. It demands daily vigilance from not only the person with diabetes, but from their friends, family and colleagues too. The consequences may appear daunting but living with diabetes is more manageable – and a lot less restricting – than you might think. You shouldn’t fear the changes to your daily life, instead, find out what the condition requires from you and how you can tailor your lifestyle around it.
Type 1 and type 2
Diagnosis for diabetes usually means you’ll fit into one of two categories: type 1 or type 2.
Type 1 diabetes is an autoimmune condition. This means that, for reasons currently unknown, the body’s immune system attacks and destroys the cells that produce insulin. Type 1 diabetes is not caused by any lifestyle choices.
Type 2 diabetes is far more common than type 1 – accounting for around 90% of people with diabetes. For people with type 2 diabetes, the body doesn’t produce enough insulin, or the body’s cells improperly react to it. Type 2 can be managed effectively through diet, exercise and medications to begin with. The condition is progressive however, meaning treatments will change as time goes by.
Type 1: Type 1 diabetes’ sole medication is insulin. Insulin is an essential hormone created in the pancreas. It breaks up glucose to be used as energy. People with type 1 diabetes have very little or no insulin produced by the pancreas. Insulin comes in different variations: long-acting, background, or basal insulin; or fast-acting, mealtime or bolus insulin.
Long-acting, background, or basal insulin is taken once or twice a day. Its fundamental role is to balance blood sugar levels overnight and between meals.
Fast-acting, mealtime or bolus insulin is taken with food and drink. When we eat and drink, the amount of sugar in our blood increases – especially with substances high in carbohydrate.
Type 2: Medicines provided for type 2 diabetes aim to reduce the quantity of sugar in your blood. You may be offered many medicines but, usually, a medicine called metformin is prescribed for the first three months. If no change to your blood sugar occurs during this period, your doctor may provide you with a different medicine. Initially insulin is not given as a treatment to type 2. It’s only offered once a variety – and combination – of medicines ceases to work. You’re entitled to free prescriptions for all of these. Ask your GP for an exemption certificate and you’ll be good to go after filling in a form.
To understand how to inject insulin safely, check out this video from Diabetes UK.
Diet & Alcohol
Successfully maintaining a balanced and healthy diet is something we should all aspire to achieve. Keeping a keen eye on the food you’re eating is really important if you have diabetes. You should aim for foods that are low in sugar, fat and salt, and target a variety of foods from different food groups. Ensure that you’re eating high quantities of fruit and vegetables as well as some starchy foods, like pasta. Insulin takers should consider paying attention to carb counting. Carb counting can help you to match your insulin dose to the amount of carbs in your meals and snacks. By effectively carb counting, you won’t have to worry about injecting and eating at the same time every day; you can be more flexible.
For a large majority of us, a night drinking alcohol is seen as no big deal . People with diabetes have to be a bit more careful. If you use insulin or medications such as sulphonylureas, you are at greater risk of suffering a hypo as a result of drinking alcohol. This is due to its effects causing blood sugar levels to spike and drop. If managed properly, drinking alcohol can be a pleasurable experience for people with diabetes. Stick to these guidelines to keep yourself safe while you drink:
- Eat carbs before drinking – never drink on an empty stomach.
- Check blood sugars frequently – especially if you’re dancing.
- Make sure your friends or family with you know how to spot and treat a hypo – it can look like you’re drunk.
- You must check your blood sugar levels before bed and in the morning – low blood sugar can feel like a hangover.
We all need exercise; it’s essential to our health. In addition to all of exercises usual benefits, people with diabetes may also experience positive changes through:
- Lower blood sugar levels as glucose is used by the muscles for energy
- Improved efficiency of insulin – regular physical activity can reduce how much insulin you have to take on a daily basis.
Before exercising, it’s crucial that you check your blood sugar levels. If they are low, eat or drink something containing carbs. However, you may be exercising to lose weight and are cutting out carbs wherever possible. Speak to a doctor, or your diabetes team about lowering the amount of insulin you’re taking, rather than increasing carbs. If your blood sugars are high, consider taking insulin as your blood sugar levels may also rise during exercise.
Exercise can help overweight or obese people to lose weight. Recently, the Labour Party’s deputy leader, Tom Watson, has spoken about how he ‘reversed’ type-2 diabetes through diet and exercise. Tom’s dramatic transition to a healthy lifestyle helped him to lose seven stone in weight. As a result, he no longer takes medication for type 2 diabetes.
Long journeys and holidays
It’s important to stay on top of all your medications and blood tests whenever you plan to go on holiday or embark on a long journey.
Driving can be a frightening concept for people with diabetes. It is a common catalyst for hypo anxiety – the fear of experiencing hypoglycaemia. If you are anxious about driving with diabetes, fear not! Ensure that you follow these steps before you hit the road and you’ll be safe and ready to go:
- Check that your blood sugar levels are good before you leave.
- Have easy access food and drink in the car with you.
- Stop for breaks to check your bloods (every two hours) and grab a quick bite or drink should you need it.
- Have the appropriate hypo medications accessible to you or a passenger.
If your blood sugar levels do drop whilst you’re driving, don’t panic. Stop the car as soon as it’s safe, turn the car off and remove the keys from the ignition. Check your blood glucose and take the necessary treatment for your hypo. Once you start to feel better, wait 45 minutes before carrying on your drive.
If you’ve planned a holiday, make sure you’ve planned your meds. Speak to your diabetes doctor or nurse about how much extra medication you should take with you. Always keep your medication on your person or as close to you as you can, such as in your hand luggage. If a checked-in suitcase gets lost or damaged, you may risk losing your meds. Also, if you take insulin by means of injection, speak to your doctor about a written consent form before you board an aeroplane.
For advice on what to eat when living with diabetes, consult dietitian Ms Claire Fudge. Claire has 15 years of experience across a wide variety of clinical specialities and industries including: diabetes, weight management, bariatric surgery, eating disorders, gastroenterology, IBS, oncology, sports medicine and nutrition support.