Managing and Controlling Type 2 Diabetes

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Managing and Controlling Type 2 Diabetes

Young hispanic diabetic man measuring glucose sitting on the sofa at home.

Getting a type 2 diabetes diagnosis may feel like a life sentence. Diabetes can require major lifestyle changes and often comes with a prescription for daily injections or medications with no end date in sight.

But Dr. Umar Mohammed, a primary care provider at WWMG’s Marysville Family Medicine, says, “Diabetes doesn’t have to affect your ability to do what you want to do. You can live just as long and fulfilling a life with diabetes as without it.”

What is Diabetes?

Diabetes is a chronic endocrine disease that affects around 10% of Americans. There are two types of diabetes:

  • Type 1, in which the pancreas fails to produce insulin, makes up 5-10% of all diabetes cases. Type 1 has a strong genetic component and must be managed with insulin every day.
  • Type 2 diabetes is much more common, affecting up to 95% of all diabetes patients. While family history plays a part, type 2 can be managed and even prevented with the right lifestyle choices.

What is Pre-Diabetes?

“The major risk factors for type 2 diabetes are obesity, sedentary lifestyle, and poor diet,” said Dr. Mohammed.

With the onset of type 2 diabetes (also called pre-diabetes), the body produces insulin, but is unable to utilize it, resulting in chronic high blood sugar.

As the body becomes increasingly resistant to insulin through weight gain and aging, insulin production continues to increase until the overworked pancreas begins to fail, and symptoms of type 2 diabetes develop.

Knowledge is Power in Controlling Diabetes

“The burden of managing diabetes, more than a lot of other diseases, falls on the patient. As health providers, we try to give our patients the information and tools that they need to manage those daily decisions,” said Dr. Mohammed.

The first line of defense against type 2 diabetes is not medicine, but education. A primary care provider can advise each patient on the individual lifestyle changes they will need to make and can even help with the mental health aspects of being diagnosed with a serious chronic illness.

“Dealing with the fact that they will have to make these lifestyle changes and possibly be on medication for the rest of their lives can be hard for a lot of people,” said Dr. Mohammed. “Patients can gain positivity from the fact that they are in control of this disease process. They can get results from the effort they put in to fight it,” he said. “But for some people it’s harder to deal with than others.”

In those cases, additional support from an endocrinologist or mental health counselor may be beneficial. A primary care provider can refer out to a specialist if needed.

The Importance of Exercise

“Exercise plays just as much a role as diet,” said Dr. Mohammed. Regular exercise can positively contribute to weight loss, but it also benefits metabolism. While at rest, muscles need insulin to help metabolize sugars. But during exercise, active muscles use sugars without the need for insulin.

Despite the benefits, Dr. Mohammed says patients are often resistant to the recommendation to exercise because they think it means hours at the gym. But aerobic exercise like a brisk 30-minute walk 5 times a week is enough to reap the benefits of the activity. Even minimal exercise is better than none at all.

Weight and Diet

“Weight is a very big component with type 2 diabetes,” Dr. Mohammed explains, because fat cells increase insulin resistance. Insulin is important in the digestion of carbs, especially simple carbs. “We encourage patients who are overweight to lose some of that weight which will give us better glycemic control.”

For diabetics, making smart choices about carbohydrates is more important than counting calories. Patients need to limit items like white bread and sugary foods like desserts and alcohol, whose empty calories throw off metabolism. But it’s not as straightforward as simply avoiding carbohydrates.

“We don’t want to demonize carbs because they are the best source of energy for the brain,” said Dr. Mohammed. Learning how to find simple carbs hidden in common foods and replace them with more complex carbohydrates and protein to avoid blood sugar spikes can take some study, which is one reason that support from a primary care provider is so helpful.

Medical Treatment for Diabetes

Diabetes requires close medical supervision to help patients control blood sugar and avoid long-term problems.

By checking A1C levels (which measure average blood sugar) quarterly, health care providers can catch changes early and intervene before organ damage or other complications occur.

The complications from diabetes can be harder to treat and may impact one’s quality of life more than diabetes itself. So annual testing for common complications like eye disease, neuropathy, and kidney damage allows for early diagnosis. Then, lifestyle and prescription changes can be made before the complication progresses to a dangerous level.

WWMG has brought diabetic eye exams (which are different from a regular vision exam) in-house at our primary care locations, to make screening easier and support long-term patient health.

Medications for Diabetes

When possible, Dr. Mohammed wants to help newly-diagnosed type 2 diabetics avoid the need for daily medications and self-injections of insulin, which can be a challenge to manage. For these patients, being consistent in making lifestyle changes and taking medication can often eliminate the need for insulin. But when A1C levels are regularly too high, insulin is necessary to bring them down quickly and avoid long-term organ damage.

Type 2 diabetes can be a lot to manage, including changing your diet, taking up exercise, learning to inject insulin, taking daily medications, controlling blood sugar, and attending regular medical appointments.

But it doesn’t have to be overwhelming if you remember that each of these steps is a tool for building better health. As Dr. Mohammed says, “You are fighting against this disease, but you have all the tools that you need to win.”

If you or a loved one are pre-diabetic, or are looking for a healthcare partner to help you manage type 2 diabetes, request an appointment with a WWMG family medicine provider. We’re here to support you at all ages and stages of health.