Tips to Get Your Diabetes Under Control

Make these expert suggestions for managing your diabetes top on your list.

Living well with type 2 diabetes means making certain precautions part of your routine, says Amy Campbell, MS, RD, CDE, manager of clinical education programs at Joslin Diabetes Center in Boston. She offers this advice.

Make a date with a dietitian. "It's a myth that there's a one-size-fits-alldiabetes diet," Campbell says. A dietitian can help you develop an eating plan that's right for your age, weight, activity level, andmedications, and can also set daily calorie and carbohydrate targets. You'll probably meet several times at first; after that, once a year.

Check your feet daily. High blood sugar levels can damage nerves in your feet, leaving you unable to feel cuts, blisters, and other injuries. High blood sugar also increases your risk of infection, allowing a simple blister to develop into a grave problem in a matter of days. Amputationis a real danger, Campbell says. Can't reach your feet? Ask a family member or friend to give them a daily once-over, or use a mirror. Call your doctor immediately if you spot redness, cuts, blisters, or swelling.

Keep moving. People with type 2 diabetes are often insulin resistant, meaning their bodies don't use insulin properly and they need extra insulin to allow their cells to take in sugar from their blood. Exercise appears to increase insulin sensitivity, improving glucose uptake to your body's cells.

Aim to be active 30 minutes a day, at least five days a week. Any activity that raises your heart rate enough to make it slightly difficult to talk (brisk walking, taking the stairs, vacuuming vigorously) counts toward your daily total. The benefits are real: Shed just 5% to 10% of your body weight to dramatically improve glucose control.

See clearly. Make an annual appointment for a dilated-eye exam with an ophthalmologist or an optometrist experienced in treating people with diabetes. Dilation allows the doctor to look for diseases such as retinopathy, one of the most common complications of diabetes. "'It used to spell blindness for people, but we now have laser surgery and other ways to prevent it,"

Take your best shot. Get a flu shot every fall. People with diabetes are prone to complications if they get the flu. "They're more likely to be hospitalized for the flu than people who aren't diabetic," Campbell says. The flu can also cause blood sugar levels to skyrocket, which may trigger severe complications and slow healing. For added protection, Campbell recommends a pneumonia vaccine. Ask your doctor if you should get one.

Quit smoking . Smoking is especially harmful for people with type 2 diabetes. Smoking appears to increase insulin resistance and also causes blood vessels to narrow, limiting circulation to your legs and feet. Your doctor can help you make a plan to quit.

Know Your Type 2 Numbers

In addition to recording daily blood sugar levels, be sure to track other numbers, which tell you how well your treatment plan is working.

A1C This number measures your average blood glucose level over the previous two to three months. Aim for a number under 7%, and have your A1C tested at least twice a year.

Lipid levels Your cholesterol and triglyceride numbers offer valuable insights into heart health, which is critical because type 2 diabetes increases heart disease risk. Your target numbers and how often you should have these tests vary depending on your individual risk, so ask your doctor.

Blood pressure High blood pressure (a reading of 140/90 or higher) often goes hand-in-hand with diabetes and increases your risk of heart disease and diabetes complications. Have your blood pressure checked each time you visit the doctor.

Microalbumin This test checks for small amounts of protein in the urine, which is important for gauging kidney health. If caught early, kidney disease can be controlled by keeping A1C, blood sugar, and blood pressure in their target ranges.

Expert Tip

"Sugar-free foods aren't necessarily better. They're often made with sugar alcohols, such as sorbitol and mannitol, which have a laxative effect in some people."

Amy Campbell, MS, RD, CDE