11 Diabetes Dos: Your Type 2 Checklist

By Erin O’Donnell

young man sleeping in bed

Living well with type 2 diabetes requires adopting healthy routines. We spoke with endocrinologist and diabetes educator Anthony Pick, MD, of Northwestern Medicine Lake Forest Hospital in Illinois, to find out which regular habits he recommends for his patients.

Daily Habits

Aim for smart food choices. To keep blood sugar levels in a healthy range, Pick recommends eating slowly, savoring your food, being attentive to signs of fullness, and choosing nutritious foods. He recommends that patients newly diagnosed with type 2 work closely with a registered dietitian and diabetes educator to create an eating plan designed just for them.

Make sleep a priority. Pick encourages patients with type 2 diabetes to get 7 to 8 hours of sleep each night, and to seek treatment for possible sleep apnea if they snore. “What’s underappreciated is that sleep deprivation and sleep apnea aggravate diabetes,” Pick says. “It leads to cravings for unhealthy food and increased insulin resistance.” It also makes weight loss harder, he adds.

Record blood sugar levels. Testing and recording your blood sugar allows you to see patterns, such as how certain foods or activities affect your blood sugar levels. Your doctor or diabetes educator will tell you how often you should test daily.

Many people use traditional blood sugar meters, which involve testing a drop of blood from your fingertip. But Pick says a growing number of his patients use continuous glucose monitors (CGMs), in which a small sensor placed on the skin of the upper arm measures blood sugar every few minutes and some send the results to your smartphone. This makes it easier to see trends and share information with your doctor.

Avoid sitting for long spells. If you have a desk job that involves sitting all day or you like to binge-watch TV, Pick urges you to get up and move regularly. Research suggests that long periods of sitting are harmful for the heart. “There’s that saying that ‘sitting is the new smoking,’” Pick says. Current exercise guidelines recommend 150 minutes of moderately intense exercise a week, or at least 30 minutes of physical activity 5 days a week. Choose physical activities that you enjoy enough to do regularly.

Peek at your feet. Diabetes can cause nerve damage in your feet, so you might injure your foot but not feel it, causing potentially serious wounds that won’t heal on their own. Examine your feet daily to spot problems.

Several Times a Year

Have your A1c tested. The A1c blood test reveals your average blood sugar level over the last 2 to 3 months. Most people with type 2 diabetes need an A1C test twice a year, although some need it more frequently.

Visit the dentist. Diabetes weakens your body’s ability to fight bacteria, increasing your risk of gingivitis, a condition in which the gums swell and bleed. Left untreated, this inflammation can develop into gum disease and increase your risk of losing teeth. It also worsens glucose control. See your dentist at least twice a year.

Annual Habits

See a diabetes educator. Make this appointment soon after you’re diagnosed with type 2 diabetes, and return at least once a year. “Study after study shows that when people meet with diabetes educators, they have lower A1c, less diabetes distress, a better understanding of their medications, and better self-management,” Pick says. Certified diabetes educators previously used the initials “CDE” after their names, but beginning this year this is changing to “CDCES,” which stands for certified diabetes care and education specialist.

Get your feet checked. Because type 2 diabetes can impair your ability to sense foot injuries and put you at risk for severe infection, ask your doctor to examine your feet at least once a year.

Visit the eye doctor. Diabetes increases your risk of eye diseases such as retinopathy, glaucoma, and cataracts. The American Diabetes Association recommends that you have a dilated eye exam soon after being diagnosed with type 2 diabetes, because 1 in 5 people already have an eye problem when diabetes is diagnosed. Pick encourages patients to repeat this exam annually.

Get a flu shot. Pick recommends that his patients get a flu vaccine every fall; diabetes makes it harder for your body to fight this illness. He also recommends the pneumococcal vaccine to provide protection again pneumonia and related infections.

3 Stress-Busting Habits

Stress raises blood glucose levels and makes it harder to take good care of yourself, says Anthony Pick, MD. He encourages his patients with type 2 diabetes to consider the following habits to reduce stress. 

1. Foster friendships. 

Meeting with pals regularly for tea or a jog keeps you connected and may protect against depression and loneliness, two risk factors for heart disease. 

2. Own a pet. 

Caring for a cat or dog can also keep loneliness at bay. A dog provides the added benefits of getting you outside for walks.

3. Take time in nature. 

Research shows that walks in the woods can decrease stress hormone levels, pulse rate, and blood pressure. They can also boost your mood.

Better Visits

Anthony Pick, MD, suggests 3 ways to improve your next doctor appointment.

1. Set a visiting goal.

Tell the doctor right away what you’d like to accomplish during your appointment. For example, are you having any medication side effects, or do you need help with weight loss?

2. Bring a list of medications. 

Write down what you take, the dose you take, and when you take it. 

3. Write your history.

Pick suggests writing, in your own words, the story of your diabetes and your general health history. Bring a copy for your doctor. 

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