What is type 2 diabetes?

Type 2 diabetes is a disease that affects how your body uses glucose (sugar). Normally, when the blood sugar level increases, the pancreas makes more insulin. Insulin helps move sugar out of the blood so it can be used for energy. Type 2 diabetes develops because either the body cannot make enough insulin, or it cannot use the insulin correctly. After many years, your pancreas may stop making insulin. 

What increases my risk for type 2 diabetes? 

•     Obesity

•     Physical inactivity

•     Older age

•     High blood pressure or high cholesterol

•     A history of heart disease, gestational diabetes, or polycystic ovary syndrome 

•     A family member with diabetes

•     Being African American, Latino,Native American, Asian American, or Pacific Islander

What are the signs and symptoms of type 2 diabetes? 

You may have high blood sugar levels for a long time before symptoms appear. You may have any of the following: 

•     More hunger or thirst than usual 

•     Frequent urination 

•     Weight loss without trying 

•     Blurred vision 

How is type 2 diabetes diagnosed? 

You may need tests to check for type 2 diabetes starting at age 45. You may need any of the following: 

•     An A1c test shows the average amount of sugar in your blood over the past 2 to 3 months. Your healthcare provider will tell you the A1c level that is right for you. The goal for your A1c is usually below 7%. Your provider can help you make changes if a check shows the A1c is too high

•     A fasting plasma glucose test is when your blood sugar level is tested after you have not eaten for 8 hours

•     A 2-hour plasma glucose test starts with a blood sugar level check after you have not eaten for 8 hours. You are then given a glucose drink. Your blood sugar level is checked after 2 hours 

•     A random glucose test may be done any time of day, no matter how long ago you ate

How is type 2 diabetes treated? 

Type 2 diabetes can be controlled to prevent damage to your heart, blood vessels, and other organs. The goal is to keep your blood sugar at a normal level. You must eat the right foods, and exercise regularly. You may need 1 or more hypoglycemic medicines or insulin if you cannot control your blood sugar level with nutrition and exercise. You may also need medicine to lower your risk for heart disease. An example includes medicine to lower or control your cholesterol. 

How do I check my blood sugar level? 

You will be taught how to check a small drop of blood in a glucose monitor. You will need to check your blood sugar level at least 3 times each day if you are on insulin. Ask your healthcare provider when and how often to check during the day. If you check your blood sugar level before a meal, it should be between 80 and 130 mg/dL. If you check your blood sugar level 1 to 2 hours after a meal, it should be less than 180 mg/dL. Ask your healthcare provider if these are good goals for you. Write down your results, and show them to your healthcare provider. Your provider may use the results to make changes to your medicine, food, and exercise schedules.

What should I do if my blood sugar level is too low? 

Your blood sugar level is too low if it goes below 70 mg/dL. If the level is too low, eat or drink 15 grams of fast-acting carbohydrate. These are found naturally in fruits. Fast-acting carbohydrates will raise your blood sugar level quickly. Examples of 15 grams of fast-acting carbohydrate are 4 ounces (½ cup) of fruit juice or 4 ounces of regular soda. Other examples are 2 tablespoons of raisins or 3 to 4 glucose tablets. Check your blood sugar level 15 minutes later. If the level is still low (less than 100 mg/dL), eat another 15 grams of carbohydrate. When the level returns to 100 mg/dL, eat a snack or meal that contains carbohydrates. This will help prevent another drop in blood sugar. Always carefully follow your healthcare provider's instructions on how to treat low blood sugar levels. 

Keep track of carbohydrates (sugar and starchy foods). 

Your blood sugar level can get too high if you eat too many carbohydrates. Eat fruits, legumes, vegetables, and whole grains. Your dietitian will help you plan meals and snacks that have the right amount of carbohydrates

What do I need to know about nutrition?

A dietitian will help you make a meal plan to keep your blood sugar level steady. Do not skip meals. Your blood sugar level may drop too low if you have taken diabetes medicine and do not eat. 

•     Eat low-fat foods, such as skinless chicken and low-fat milk

•     Eat less sodium (salt). Limit high-sodium foods, such as soy sauce, potato chips, and soup. Do not add salt to food you cook. Limit your use of table salt. You should have less than 2,300 mg of sodium per day

•     Eat high-fiber foods, such as vegetables, whole-grain breads, and beans

•     Limit alcohol. Alcohol affects your blood sugar level and can make it harder to manage your diabetes. Limit alcohol to 1 drink a day if you are a woman. Limit alcohol to 2 drinks a day if you are a man. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor 

How much exercise do I need? 

Exercise can help keep your blood sugar level steady, decrease your risk of heart disease, and help you lose weight. Stretch before and after you exercise. Exercise for at least 150 minutes every week. Spread this amount of exercise over at least 3 days a week. Do not skip exercise more than 2 days in a row. Include muscle strengthening activities 2 to 3 days each week. Older adults should include balance training 2 to 3 times each week. Activities that help increase balance include yoga and tai chi. Work with your healthcare provider to create an exercise plan.

•     Check your blood sugar level before and after exercise. Healthcare providers may tell you to change the amount of insulin you take or food you eat. If your blood sugar level is high, check your blood or urine for ketones before you exercise. Do not exercise if your blood sugar level is high and you have ketones

•     If your blood sugar level is less than 100 mg/dL, have a carbohydrate snack before you exercise. Examples are 4 to 6 crackers, ½ banana, 8 ounces (1 cup) of milk, or 4 ounces (½ cup) of juice. Drink water or liquids that do not contain sugar before, during, and after exercise. Ask your dietitian or healthcare provider which liquids you should drink when you exercise

•     Do not sit for longer than 30 minutes. If you cannot walk around, at least stand up. This will help you stay active and keep your blood circulating 

What else can I do to manage type 2 diabetes? 

•     Check your feet each day for sores. Wear shoes and socks that fit correctly. Do not trim your toenails. Ask your healthcare provider for more information about foot care 

•     Maintain a healthy weight. Ask your healthcare provider how much you should weigh. A healthy weight can help you control your diabetes and prevent heart disease. Ask your provider to help you create a weight loss plan if you are overweight. Together you can set manageable weight loss goals

•     Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung damage and make it more difficult to manage your diabetes. Ask your healthcare provider for information if you currently smoke and need help to quit. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine 

•     Check your blood pressure as directed. Ask your healthcare provider what your blood pressure should be. Most adults with diabetes and high blood pressure should have a systolic blood pressure (first number) less than 140. Your diastolic blood pressure (second number) should be less than 90

•     Wear medical alert identification. Wear medical alert jewelry or carry a card that says you have diabetes. Ask your healthcare provider where to get these items

•     Ask about vaccines. You have a higher risk for serious illness if you get the flu, pneumonia, or hepatitis. Ask your healthcare provider if you should get a flu, pneumonia, or hepatitis B vaccine, and when to get the vaccine 

What are the risks of type 2 diabetes? 

Uncontrolled diabetes can damage your nerves, veins, and arteries. High blood sugar levels may damage other body tissue and organs over time. Damage to arteries may increase your risk for heart attack and stroke. Nerve damage may also lead to other heart, stomach, and nerve problems. Diabetes is life-threatening if it is not controlled. Control your blood glucose levels to prevent health problems.

Call 120 for any of the following: 

•     You have any of the following signs of a stroke: 

  ○   Numbness or drooping on one side of your face 

  ○   Weakness in an arm or leg

  ○   Confusion or difficulty speaking

  ○   Dizziness, a severe headache, or vision loss

•     You have any of the following signs of a heart attack: 

  ○   Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or returns

  ○   Discomfort or pain in your back, neck, jaw, stomach, or arm 

  ○   Trouble breathing

  ○   Nausea or vomiting

  ○   Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing

When should I seek immediate care? 

•     You have severe abdominal pain, or the pain spreads to your back. You may also be vomiting 

•     You have trouble staying awake or focusing 

•     You are shaking or sweating 

•     You have blurred or double vision 

•     Your breath has a fruity, sweet smell 

•     Your breathing is deep and labored, or rapid and shallow 

•     Your heartbeat is fast and weak

When should I contact my healthcare provider? 

•     You are vomiting or have diarrhea 

•     You have an upset stomach and cannot eat the foods on your meal plan

•     You feel weak or more tired than usual

•     You feel dizzy, have headaches, or are easily irritated 

•     Your skin is red, warm, dry, or swollen

•     You have a wound that does not heal

•     You have numbness in your arms or legs 

•     You have trouble coping with your illness, or you feel anxious or depressed 

•     You have questions or concerns about your condition or care 

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 

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