What to know about living with and managing diabetes

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All forms of diabetes affect the body’s ability to convert glucose to energy using insulin. The three main types of diabetes include:

• Type 1 diabetes: Sometimes called juvenile diabetes because it usually begins in childhood, type 1 diabetes is an autoimmune disease. The body destroys insulin-producing cells, reducing the body’s ability to metabolize glucose. People with type 1 diabetes need insulin treatment.
• Type 2 diabetes: The most common type of diabetes is most prevalent among adults, with rates beginning to rise in middle age. It causes insulin resistance, which means that the body produces insulin, but cannot use it effectively. Lifestyle changes may improve a person’s symptoms, but some need medications, such as insulin.
• Gestational diabetes: This form of diabetes develops during pregnancy and is usually temporary, though it increases a person’s risk of later developing diabetes. Gestational diabetes reduces the body’s ability to use insulin to metabolize glucose, causing high blood sugar. A person may be able to manage symptoms with lifestyle changes, but if these do not work, they may need insulin.

Because diabetes affects the body’s ability to metabolize glucose, high glycemic index foods are more likely to increase a person’s blood glucose and cause diabetes complications. This means they should reduce sweetened, processed foods and simple carbohydrates, such as white bread and white pasta, from their diet.

Instead, a person should focus on eating nutrient-dense foods. Some other strategies for a healthier diet include:

• reducing foods high in saturated fat, such as fried foods
• eating more fiber and protein, which are more nutritionally dense, filling, and do not cause blood sugar spikes, helping a person maintain healthy levels
• reducing intake of high fructose corn syrup
• eliminating empty calories in the form of sweetened drinks
• replacing white breads and pastas with whole grain options
• eating fruit when a person craves something sweet

People with type 2 diabetes often carry excess weight or have obesity. This can increase their risk of diabetes complications, such as heart disease. Exercise may help a person achieve or maintain moderate body weight.

Exercise can also increase the body’s sensitivity to insulin, which can improve a person’s diabetes symptoms and support healthy blood glucose levels. Unless a doctor has specifically told a person not to exercise, almost everyone can benefit from exercise. More exercise generally offers more benefits.

The Centers for Disease Control and Prevention (CDC) recommends a minimum of 150 minutes of moderate-intensity physical activity per week. Some strategies for increasing a person’s activity levels include:

• trying a new hobby that encourages physical activity, such as gardening or hiking
• making exercise social by joining a sports team or a walking club
• finding organic ways to incorporate exercise into the day, such as frequently walking around the office or doing yoga
• incorporating exercise into a daily schedule, perhaps by exercising before breakfast each morning

Because people with type 1 diabetes do not produce enough insulin, they need insulin treatment. A person may need to give themselves insulin injections or use an insulin pump.

People with type 2 diabetes and gestational diabetes may need insulin if they cannot control their blood glucose with lifestyle changes alone.

Several other medications may also help a person’s diabetes symptoms when insulin alone does not work. Some drug classes a doctor may recommend include:

• GLP-I receptor agonists
• SGL-2 inhibitors
• DPP-4 inhibitors

A person might also need medication for diabetes-related complications. Some common drugs include:

• medications for high cholesterol
• high blood pressure medications, such as beta-blockers
• blood thinners to reduce the risk of blood clots

It can take time to make the healthy changes that diabetes requires. A person should focus on making incremental changes that steadily improve their health. A routine may make these changes easier. Some strategies for building a healthy routine include:

• incorporating exercise into a person’s daily schedule
• planning meals in advance to make it easier to make healthy food choices and monitor what a person eats
• quitting smoking and reducing or eliminating alcohol by avoiding others when they are smoking or drinking
• identifying a person’s triggers for unhealthy choices — some people smoke when they feel stressed or eat more at family gatherings
• helping a person succeed by ensuring healthy snacks are available and providing a variety of enjoyable physical activities, such as an exercise bike in their home office

Major life changes can affect a person’s routine, making it more difficult to maintain a healthy lifestyle. For example, when a person is sick, they may be less able to exercise or make healthy meals.

When life changes disrupt a person’s routine, consider slowly reincorporating healthy habits one by one. Small changes matter and add up. Also, finding alternative ways to maintain a healthy lifestyle can be helpful.

For example, a person working long hours, who cannot exercise, can still eat healthy meals. They might also take frequent breaks to walk or stretch during audio calls.

Various physiological changes throughout of a person’s life may also affect their diabetes symptoms and management.

For instance, stress can influence a person’s blood glucose levels. Menopause may affect the body’s insulin secretion ability and sensitivity, too. However, hormone replacement therapy has positive effects on a person’s blood sugar levels. It is important to talk with a doctor about how major life changes may affect a person’s diabetes and ways to best reduce any negative effects.

A person with diabetes will need support to make necessary lifestyle changes. Moreover, insulin injections and regular medical appointments may feel stressful or overwhelming. Some strategies for finding the right support include:

• joining an online or in-person diabetes support group
• learning as much as possible about diabetes — the American Diabetes Association (ADA) offers a wide range of educational materials for people living with diabetes
• finding a doctor who specializes in diabetes, usually an endocrinologist
• regularly monitoring a person’s symptoms, and telling a doctor if their symptoms change or get worse
• telling loved ones about a person’s goals for diabetes treatment can help them understand a person’s specific needs, and they may be more supportive, such as not pressuring a person to eat another piece of cake

Diabetes is a chronic illness that often gets worse with time, especially without effective treatment or healthy lifestyle changes.

Both genetic and environmental factors play a role in the development and progression of diabetes. Therefore, even with a healthy lifestyle, a person may require medication and ongoing medical support.

People with diabetes should find a doctor they like and trust to help them develop a comprehensive plan for living with diabetes.