Complications

Good blood sugar control can reduce your risk of serious health problems, like:

• Heart disease and stroke. Adults with diabetes are more likely to have heart disease or a stroke. Heart disease is the leading cause of death in people with diabetes.
  
• High blood pressure. Many adults with diabetes have high blood pressure or take prescription medicine(s) for high blood pressure.
  
• Eye problems. People with diabetes are at risk for cataracts, glaucoma, and problems with the retina (retinopathy), which can reduce vision or cause blindness. Diabetes is the leading cause of new cases of blindness in adults ages 20 to 74.
  
• Kidney damage. Diabetes is the leading cause of severe kidney disease.
  
• Nerve damage. Many people with diabetes have some nerve damage. This shows up as numbness or tingling in the feet or hands. You may not feel pain well, so sores can get worse and get infected. Severe nerve damage in people with diabetes is a major cause of leg and foot amputations.
  
• Infections. People with diabetes may be at greater risk for infection and death from infections. High blood sugar may make it harder for your body to fight infections. People with diabetes may be at a greater risk for getting many other illnesses. Once they get these illnesses, they have more trouble getting better.
  
• Gum disease. Because infections are harder to fight, you’re more likely to develop gum disease.
  
• Problems in pregnancy. Diabetes that isn’t managed well, before pregnancy and during pregnancy, can cause birth defects and miscarriages. During the later parts of pregnancy, poorly controlled diabetes can lead to very large babies, which is risky for both mother and child.
  

There’s good news, though. When you manage your diabetes well, you can reduce the risk of these health problems.

Who Gets Diabetes?

Millions of Americans have been diagnosed with type 2 diabetes. Many others have it and don’t know it. Millions more have a condition called pre-diabetes, which means that they are at risk for developing type 2 diabetes.

Several things put you at risk for type 2 diabetes. You can control some of these factors, such as:

• Your weight. Too much body fat is a main risk factor for type 2 diabetes.
  
• Smoking. This makes it harder for you to control your blood sugar.
  
• Lack of being active. Being inactive can lead to excess body fat, high blood sugar, and high blood pressure.
  
• High blood pressure and/or high cholesterol. These conditions are linked to type 2 diabetes and heart disease.
  

Risk factors you can’t control:

• Family history. Your risk is higher, if you have a close relative (parent, brother, sister) with diabetes.
  
• Gestational diabetes, or having a baby who weighs more than 9 pounds. Women who have diabetes during pregnancy or have a large baby are at greater risk for diabetes later in life, usually type 2 diabetes.
  
• Age. Type 2 diabetes is more common in people age 40 and older, but it is rising among young people who are overweight and inactive.
  
• Ethnic group. African Americans, Latinos, Hispanics, Native Americans, Asian Americans, and Pacific Islanders are more likely to develop diabetes.
  

The more risk factors you have, the more likely you will get type 2 diabetes.

Make An Action Plan

Managing diabetes

Good health begins with your personal plan to manage diabetes. You and your doctor will come up with a plan, possibly with the help of a diabetes teacher or a dietitian.

The goal of treatment is to keep your blood sugar level as close to normal as you can. Changing your eating habits and being more active are very important first steps. But healthy eating and exercise don’t always lower blood sugar enough. You may need to take one or more medicines to keep your blood sugar under control. Many people with type 2 diabetes take medicines. Some take a combination of medicines that work in different ways to help control blood sugar.

Managing type 2 diabetes can be hard work. With support, information, and the help of your doctor, you can do it!

Download the Diabetes.com Type 2 Diabetes Action Plan (PDF Format).

Hang in There

Don’t be surprised if you sometimes feel like there’s lots to do to manage type 2 diabetes. Here are some tips to help you keep on track:

Stay motivated

• If you’re having trouble staying with your diabetes plan, think about what the problem may be.
  
• Ask yourself what you need to do to get on track. Find one step that could get you started. Choose something fairly easy.
  
• Find things you can do to keep the problem from happening again.
  
• Focus on your successes, not your slip-ups. Don’t beat yourself up for backsliding.
  
• It’s normal to feel overwhelmed with the demands of managing diabetes. Accepting that you have diabetes doesn’t mean that you have to like it.
  
• The more you know about diabetes, the easier it is to manage. Visit this program, whenever you need a refresher. Read books and visit respected Web sites about diabetes. Or, take a class in your community. See a diabetes educator at least once a year for more tips on living with diabetes.
  

Get diabetes support

• Decide what type of support you need from your family, friends, co-workers, or healthcare team. Then tell them. Odds are, they’ll be happy to help and flattered that you asked them.
  
• Some of the areas you might need help with are setting goals, getting through hard times, and solving problems.
  
• Teach your family and friends about type 2 diabetes. Ask them to listen to what you think and feel, and support you in making some healthy changes. For instance, they may want to exercise with you.
  
• Stay in touch with your doctors between appointments. You may want to talk on the phone or fax your blood sugar records. This will help you and your doctor spot any problems early.
  
• Join a support group for people with type 2 diabetes. It always helps to talk with people who’ve been there.
  

Ways To Help Yourself

Maintain a Healthy Blood Sugar Level

There’s a secret to keeping your blood sugar in check: Be prepared.

Diabetes on the job

Talk with your doctor about how to manage diabetes at work. Be sure to:

• Eat meals at about the same time every day. Try not to skip meals or snacks.
  
• Take your medicines and test your blood sugar as directed by your doctor.
  
• Describe the signs of low blood sugar to close co-workers. You may need their help if your blood sugar drops.
  
• Keep sugar snacks or glucose pills in your desk, in case your blood sugar gets too low. Carry some with you.
  
• Tell the company nurse that you have diabetes.
  
• Keep tabs on your stress. Try deep breathing, relaxation, or take a short break from the office.
  

Dealing with sick days

A cold or the flu can make it harder to keep your blood sugar in check. It is recommended that people with diabetes get a flu shot every year. Also, you and your healthcare provider should make a “sick-day” plan. When you’re sick:

• Check your blood sugar four times a day. If it’s higher than 300 mg/dL, use a home test to check your urine for ketones.
  
• Keep taking your diabetes medicines.
  
• Drink plenty of water or sugar-free drinks to stay hydrated.
  
• Try to eat as usual. If your stomach can’t handle it, try clear soups or gelatin.
  
• Check any over-the-counter medicines for sugar. Ask your pharmacist for sugar-free options.
  

Call your doctor if your blood sugar is lower than 70 mg/dL several times a week, or if it stays higher than 240 mg/dL. Also, call if you’ve been vomiting or had diarrhea for several hours, or if your urine has high ketone levels.

Diabetes on the road

To prepare for your vacation, follow these steps:

• See your healthcare provider before your trip to go over your plans.
  
• Plan for changes in meal patterns, time zones, and activity levels.
  
• Take along twice as many medicines and supplies as you think you’ll need.
  
• Always carry medicines and snacks with you, and wear a medical ID bracelet or necklace.
  
• Wear comfortable, closed shoes, change them often, and never go barefoot. Check your feet every day for calluses, bunions, sores, or discolored skin.
  
• Find out how to get healthcare where you’re going. Locate the nearest hospital or Red Cross center in advance.
  
• Get any travel shots you need at least one month before you go.
  
• Tell the airline and cruise-ship staff that you have diabetes. They can give you special meals.
  
• If you’re traveling by car, test your blood sugar before you leave. Stick as close to your regular routine as you can.
  
• Learn important phrases in the local language, such as “I need help” or “I have diabetes.” And words, like “sugar” or “orange juice.”
  

Diabetes Resources

For online diabetes information, news, and community features:

Note: The Diabetes.com Web site contains links to third-party Web sites on the Internet. These links are provided as a service to individuals interested in more information. These sites are not part of the Diabetes.com Web site, a GlaxoSmithKline (GSK) Web site. The content and materials in these third-party Web sites are not produced or endorsed by GSK and may refer to uses of our products that are not recommended by GSK. You should always consult with your doctor before using any GSK prescription product.

The following nonprofit and professional groups can provide you with more information on type 2 diabetes:

American Association of Clinical Endocrinologists (AACE)
1000 Riverside Ave., Suite 205
Jacksonville, FL 32204
Phone: (904) 353-7878
E-mail: info@aace.com
www.aace.com
www.powerofprevention.com

American Association of Diabetes Educators
100 W. Monroe Street, Suite 400
Chicago, Illinois 60603
Phone: (800) 338-3633
www.aadenet.org

American College of Cardiology
Heart House
9111 Old Georgetown Road
Bethesda, MD 20814-1699
Phone: (301) 897-5400
Toll-Free: (800) 253-4636, ext. 694
www.acc.org

American Diabetes Association (ADA)
ATTN: National Call Center
1701 North Beauregard Street
Alexandria, VA 22311
Toll-free: (800) DIABETES (342-2383)
Phone: (703) 549-1500
www.diabetes.org

American Heart Assocation
National Center
7272 Greenville Avenue
Dallas, TX 75231
Toll-Free: (800) AHA-USA (242-8721)
www.americanheart.org

American Kidney Fund
6110 Executive Blvd., Suite 1010
Rockville, MD 20852
Toll-Free: (800) 638-8299
www.akfinc.org/

Association of Black Cardiologists
6849 B2 Peachtree Dunwoody Road, NE
Atlanta, GA 30328
Phone: (678) 302-4ABC (4222)
Toll-Free: (800) 753-9222
www.abcardio.org

Centers for Disease Control and Prevention: Diabetes
1600 Clifton Rd.
Atlanta, GA 30333
Tel: (404) 639-3311
Toll-Free: (800) 311-3435
www.cdc.gov/doc.do/id/0900f3ec802723eb

Joslin Diabetes Center
One Joslin Place
Boston, MA 02215
Phone: (617) 732-2400
www.joslin.org

National Diabetes Education Program
One Diabetes Way
Bethesda, MD 20814-9692
Phone: (301) 496-3583
Email: ndep@info.nih.gov
www.ndep.nih.gov/diabetes/diabetes.htm

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892-3560
Phone: (301) 654-3327
diabetes.niddk.nih.gov

Taking Control of Your Diabetes
1110 Camino Del Mar, Suite B
Del Mar, CA 92014
Phone: or 1-800-99-TCOYD
www.tcoyd.org

The Diabetic Gourmet
diabeticgourmet.com

Plan Your Meals for diabetes

There’s no such thing as a “diabetic diet.”

Still, you may be confused about what to eat. Here’s the low-down on some things that might be confusing:

• Carbohydrates. Some meal plans want you to count grams of carbohydrates (sugar and starch). Your dietitian can help you learn to count carbohydrates.
  
• Sugar. Most experts say small amounts of sugar are fine, as long as they are part of your meal plan. Sugar is just one type of carbohydrate.
  
• Alcohol. Discuss the use of alcohol with your doctor. Many people with diabetes can have an alcoholic drink now and then—as long as you account for it in your food plan. Be sure to drink alcohol only with food.
  
• Artificial sweeteners. These can replace sugar, but beware of high-calorie, processed foods made with sugar substitutes. Foods that claim to be “sugar-free” or have “no sugar added” may have a lot of carbohydrates. So, read food labels carefully.
  

Tips for planning healthy meals

• Make sure your dietitian knows which foods you like to eat when making your meal plan. If the plan includes foods that you dislike, or if something you love is left out, you’re less likely to stick with it.
  
• Eat a variety of foods. A plateful of different-colored foods will help you get items from all the food groups. Include high-fiber choices, such as fruits, vegetables, and whole grains.
  
• Limit your salt, which can affect blood pressure. Avoid packaged snack foods. Replace table salt with other spices.
  
• Read food labels, so you know what you’re really eating.
  
• Avoid saturated fats, like butter, fatty meats, and cheese. These boost “bad” (LDL) cholesterol. Instead, look for good fats, like omega-3 fats in fish and oils made from plants.
  
• Eat fiber. Good sources are whole wheat breads, high-fiber cereals, vegetables, and fiber supplements. Foods with fiber may help you manage your blood sugar level.
  
• Watch portions. Eat only the amount of food in your meal plan. Eat about the same amount of food each day.
  
• Eat meals about every four to five hours. Do not skip meals.
  
• Eat meals and snacks at regular times every day. If you take a diabetes medicine, eat your meals and take your medicine about the same time each day.
  

Eating healthy on the run

Your life is probably hectic. That can mean dining out a lot. Here are some tips that can help you eat healthier on the run:

• Avoid items called “jumbo,” “giant,” “deluxe,” or “super-sized.” They tend to have more calories.
  
• Choose grilled or broiled sandwiches with lean meats, like turkey or chicken. Avoid creamy toppings, like mayonnaise. Add flavor with lettuce, tomato, and onion.
  
• A salad can be a good choice. But, watch out for high-fat toppings, like dressings, bacon bits, cheeses, and croutons.
  
• Stick to soft tacos and other non-fried foods when you eat Mexican foods. Choose chicken over beef. Pile on lettuce, tomatoes, and salsa. Go easy on cheese, sour cream, and refried beans.
  
• Choose thin-crust pizza with vegetable toppings. Limit yourself to one or two slices. Leave off the meat and extra cheese, which add calories, fat, and sodium.