Time for Diabetes Tune-up 2023

Type 1 diabetes mellitus is a chronic condition that occurs when the pancreas, an organ in the abdomen, produces very little or no insulin.

Diabetes mellitus is a lifelong condition that can be controlled with lifestyle modifications and medical treatments. Insulin treatment is one component of a treatment plan for people with type 1 diabetes.

Insulin treatment replaces or supplements the body’s insulin to achieve normal or near-normal blood sugar levels and prevent or minimize complications. It also causes other problems with how your body stores and processes other forms of energy, including fat. All cells in your body need sugar to function normally. Sugar gets into cells with the help of a hormone called insulin.

In diabetes type 2, the body stops responding to normal or even high insulin levels. Over time, the pancreas (an organ in the abdomen) no longer produces enough insulin to meet the body’s needs.

Being overweight, especially when extra fat is stored in the liver and abdomen, increases the body’s need for insulin. This causes sugar to build up in the blood, which, if left untreated, can cause problems.

People with type 2 diabetes need regular monitoring and ongoing treatment to maintain target blood sugar levels. Treatment includes lifestyle adjustments, self-care measures, and medications; usually combining these approaches.

Mission is to prevent and cure diabetes, a chronic illness that requires continuous medical care.

There aren’t any significant changes, but there are a few essential things to keep in mind as you manage your diabetes in 2023: 

• New recommendations for people with diabetes regarding their sleep hygiene and physical activity. 
• Cutoffs for diagnosis of hypertension. 
• New lipid management guidelines call for lower LDL targets for high-risk people. 
• Another critical theme is weight loss, given the strong connection between obesity and diabetes. Support for more significant weight loss (up to 15%) is emphasized, with consideration given to the availability of newer medications.

Collaborating on lifestyle change is key

“Most standard lifestyle advice for managing diabetes is the same: Eat your veggies, get outside and exercise, and get enough sleep.”

Doctors can help you make plans and make informed decisions to manage your diabetes better, but you need to play an active role.  

Follow the tips for people with the most common form of the disease, type 2 diabetes. (Some of these tips also apply to people with type 1 diabetes, but these people should consult their doctor for specific advice). 

Five major steps to incorporate into your daily routine for diabetes management:

“ABCs of diabetes” refers to three aspects of your health that should be well monitored to control your diabetes: A1C (a blood investigation test which measures your average blood sugar level over the past few months), blood pressure, and cholesterol. Keeping your blood sugar at or near your target reduces the risk of complications that can affect your eyes, kidneys, and nerves. In addition, when you control your blood pressure and cholesterol, you reduce your risk of cardiovascular disease, which is a common complication of type 2 diabetes.

Strive for healthy, uninterrupted sleep:

Experts have long recognized a link between poor sleep and obesity.

“Altered sleep patterns can affect blood sugar control.”

“Obstructive sleep apnea (OSA),” a severe condition that causes repeated, brief pauses in breathing throughout the night, is a common cause of trouble sleeping.

Because this is more common in people with diabetes (especially those who are overweight), anyone with the typical symptoms of loud snoring, snorting and wheezing during sleep and daytime sleepiness should be screened for sleep apnea despite a whole night’s sleep. Sleep problems and diagnosed sleep disorders are common in modern society. The most common sleep disorder is insufficient sleep. People need to stay in bed longer. Irregular sleep is also common. Many people do not have a regular daily routine, and their daily sleep pattern is irregular.

Numerous studies have demonstrated that glucose intolerance is exacerbated by frequent nighttime awakenings, insufficient sleep, excessive sleep, and irregular sleep patterns. Sleep deprivation will exacerbate diabetes or prediabetes in people. Sleep issues have a significant impact on glucose tolerance and are linked to diabetes, prediabetes, and insulin resistance.

The point is that irregular sleep patterns have increased diabetes risk factors as a result of modern lifestyle.

Additionally, there is a well-established link between sleep disorders like obstructive sleep apnea (OSA) and insomnia and type 2 diabetes. About two thirds of people with type 2 diabetes suffer from OSA. Diabetics’ glycemic control is impacted by its severity. The insulin sensitivity decreases in proportion to the severity of OSA.

Every patient should be asked some of the following questions in their history.

• What is your schedule for work?
• Do you get enough sleep?
• When do you go to sleep?
• What time do you rise?
• What about the weekend?
• Do you have a regular bedtime?

There are short, simple sleep questionnaires that healthcare professionals can give  their patients. Diagnosing sleep apnea is less complicated than many people realize. “Today, about 60% to 70% of sleep studies for suspected sleep apnea are done using home-based tests. For the test, you’ll get a small, lightweight monitor, a belt you slip around your midsection, a small finger clip that monitors your oxygen, and an airflow sensor to place under your nose. These sensors and devices measure your oxygen saturation, heart rate, and airflow, as well as the movements of your chest and abdomen and your position while you sleep.

Don’t “diet”:

Popular diets like keto, paleo, intermittent fasting, and others can help people lose weight. But most people regain lost weight once they stop following the diet. Instead, it’s far more effective to gradually move toward a healthy eating pattern that you can stick to. It is significant for people with diabetes to avoid sodas and other sugary drinks. You should also cut back on desserts, sweets, and fatty foods and eat more high-fiber carbohydrates like whole wheat bread and brown rice. Maintaining regular mealtimes is very important.

Meal timing:

Following a consistent time of eating pattern is essential for some people, especially those taking long-acting insulin or oral medications that lower blood sugar levels. If a meal is missed or delayed during these therapies, you are at risk of developing low blood sugar. High-fat, high-protein meals break down more slowly than low-fat, low-protein meals. If you use fast-acting insulin before a meal, your blood sugar levels may drop shortly after eating a high-fat meal and rise again hours later. If you eat meals that contain more protein or fat than usual, you may need to adjust your mealtime insulin dose to manage this delayed rise in blood sugar.

Exercise safely:

Walking is ideal for most people, provided you start slowly and gradually increase your distance and speed. However, people with diabetes need to be extra careful in choosing a well-fitting pair of shoes and regularly check their feet for redness, blisters, or sores. That’s because diabetes can cause neuropathy (numbness due to nerve damage), which makes you unable to perceive minor trauma and injuries to your toes and feet. These can lead to more severe foot problems.

Working towards a healthier weight:

Although many people with obesity require medication to lose significant weight, the three aforementioned tips can assist in weight loss. A healthy weight is associated with a low risk of diseases and health issues related to weight. Chronic stress, chronic poor sleep, an excessive intake of calories, and a lack of exercise are some of the multiple factors that contribute to weight gain. Other factors include taking certain medications (such as insulin, corticosteroids, antidepressants, beta-blockers, antipsychotics, and corticosteroids). It is beneficial to control excess weight gain over time and to maintain a stable weight, both of which are strongly linked to health risks.

Maintain, Don’t Gain:

Maintaining a healthy weight can reduce your risk of heart disease, stroke, diabetes, high blood pressure, and cancer.

Know your treatment targets:

As in the past, most diabetics should aim for an HBA1C level lower than 7%. It can detect prediabetes, which increases your risk of diabetes. It can be used to diagnose diabetes. And it’s used to monitor how well your diabetes treatment is working overtime. It is also critical to create your diabetes management plan with your diabetes care team. Even if you don’t lose weight, achieving this goal reduces your risk of serious diabetes complications, such as vision and kidney problems and neuropathy.

Diabetes also increases your risk of heart disease. Target blood pressure is less than 130/80 mm Hg. Target LDL cholesterol is at least a 50% reduction (or reaching 70 mg/dL or less). If you already have heart disease, the doctor may lower the LDL target to 55 mg/dL. Many people are recommended to take cholesterol-lowering statins to help them reach a lower goal. Sometimes, a combination of cholesterol-lowering drugs can help lower stubbornly high LDL levels.

GET THE UPPER HAND WITH DIABETES FOR OVERALL WELL-BEING!

For people with diabetes, regular monitoring of their blood sugar levels is a critical way to control their diabetes. In addition, monitoring your blood sugar levels is most important. 

Blood glucose test results can help you decide your diet, physical activity, and medications. 

A blood test might reveal a lot about your sugar health. The test results show our average blood sugar level during the previous two to three months. The greater the values, the more likely you are to experience complications from diabetes.

Your doctor will tell you how often the A1C test is needed, but if your treatment goals are met, it should be done at least twice a year. On the other hand, if you are not meeting your goals or changing treatments, you may need an A1C test more frequently. 

In addition to your annual physical examination and routine eye exams, schedule two to four diabetes screenings every year.

During the physical exam, your doctor will question you about your diet and activity level and look for complications related to diabetes, including signs of kidney damage, nerve damage, heart disease, and other medical problems. They will also examine your feet for any problems that need treatment. In addition, your eye doctor will check for signs of retinal damage, cataracts, and glaucoma.

Take care of your feet: 

High blood sugar levels might harm your feet’s nerves and limit blood flow. Cuts and blisters can cause serious illnesses if left untreated. In addition, your feet may experience discomfort, tingling, or lack of feeling if you have diabetes. 

Take care of your teeth, as diabetes can make you prone to gingivitis.

Depending on how much you drink and eat at the same time, alcohol can result in high or low blood sugar. If you decide to drink, do so sparingly.

If you smoke, try to cut back or stop. Smoking raises your risk of developing type 2 diabetes and puts you at risk for other problems. 

Living with diabetes frequently results in tension, sadness, or rage. Stress can raise your blood sugar levels, but you can learn how to lower your pressure. For example, try deep breathing, gardening, walking, yoga, meditation, a hobby, or listening to your favorite music. Consider joining a diabetes awareness program or a support group that teaches stress management techniques. Your attempts to manage your diabetes may suffer if you are depressed. 

When you’re feeling low, ask for assistance. You may feel better if you talk to a mental health professional, a support group, a workmate, a friend, or a family member who will listen to your feelings. Try to sleep for 7 to 8 hours each night. Getting enough sleep can also help improve your mood and energy levels and maintain sugar levels. In addition, a team of healthcare professionals can help you improve your diabetes self-care. So remember, you are an essential member of your healthcare team.