While there is no cure for diabetes, with treatment and self-management strategies, a person can live a long and healthy life.

Diabetes is a chronic disease that affects millions of people around the world. In the United States, 1.5 million people receive a diabetes diagnosis every year. Diabetes also affects children and adolescents. Approximately 193,000 people younger than 20 in the country have diagnosed diabetes.

The American Diabetes Association (ADA) notes in 2017 guidelines that self-management and education are crucial aspects of diabetes care. Diabetes self-management can reduce blood sugar levels, mortality risk, and health-care costs, as well as weight in people with excess weight. In this article, we discuss strategies that people with diabetes can use every day to improve their health.

Self-monitoring

Two important indicators of diabetes control are levels of glycated hemoglobin and blood glucose. Measuring glycated hemoglobin requires a blood test in a doctor's office, but a person can measure their blood glucose at home.

Doctors recommend that people using insulin check their glucose levels. The right frequency of these checks varies from person to person, but doctors usually recommend monitoring levels before and after meals, at bedtime, and before exercising.

People with diabetes who are not taking insulin should also check their blood sugar levels. Self-monitoring can provide information about the effects of dietary changes, physical activity, and medication on blood sugar levels. With a blood glucose meter, a person can measure their blood sugar level at any time. There are also continuous glucose monitors, which provide real-time information about blood sugar levels. These automatically measure levels every 5 minutes through a small sensor inserted under the skin. When a person uses it appropriately, this type of technology can improve health outcomes. A health-care team can use at-home blood sugar readings to modify medication, nutrition, and self-management plans.

Maintain a healthy weight

It is important for people with diabetes or prediabetes to achieve and maintain a healthy weight. When doctors closely monitor weight loss progress, a person more likely to achieve their goals.

Research suggests that, among people with excess weight, modest, consistent weight loss can help manage type 2 diabetes and slow the rate at which prediabetes becomes diabetes. They also noted that making dietary adjustments can lower glycated hemoglobin levels by 0.3% to 2% in adults with type 2 diabetes. Nutrition therapy can also lead to improvements in the quality of life. To facilitate these lifestyle adjustments, the ADA recommends consulting a registered dietitian with expertise in diabetes and weight management.

Get good nutrition

Following a meal plan can be among the most challenging aspects of diabetes self-management. Developing a plan with a registered dietitian who is knowledgeable about diabetes-specific nutrition can help.

For some people, dietary changes alone are not enough to control blood sugar levels. Diabetes is a progressive disease, which means that it can worsen over time. The ADA recommends using a combination of medication and nutrition therapy to reach blood sugar targets.

The basis of meal planning involves portion control and favoring healthful foods. The diabetes plate method is one tool designed to help people control their calorie and carbohydrate intakes. It involves mentally dividing the plate into three sections. Half of the plate should contain nonstarchy vegetables, a quarter can contain grain-based and starchy foods, and the remaining quarter should contain protein.

Exercise regularly

Research has shown that exercise can help control blood sugar levels, reduce cardiovascular risk factors, promote weight loss, and improve well-being.

Researchers behind one study found that engaging in a structured exercise program for at least 8 weeks lowered glycated hemoglobin levels by an average of 0.66% in participants with type 2 diabetes. The ADA recommends exercising for at least 10 minutes per session and getting a total of at least 30 minutes of exercise on most days of the week. If a person exercises every day—or lets no more than 2 days pass between workouts—this may help reduce insulin resistance.

Members of a diabetes healthcare team can help develop and tailor an exercise plan that is safe and effective. In addition to exercising regularly, it is important to avoid spending long periods in a seated position. Breaking up sedentary periods every 30 minutes can help with controlling blood sugar.

Stop smoking

The ADA advises all people with prediabetes or diabetes to avoid tobacco products, including e-cigarettes. People with diabetes who smoke have higher risks of cardiovascular disease, premature death, and diabetes complications, as well as less blood sugar control compared with people who do not smoke.

Take medication regularly

Nonadherence is a medical term for not taking medication as prescribed. If a person with diabetes does not take their medication as recommended by a doctor, it can lead to:

• Lower success rates in achieving clinical targets
• Increased complications
• Increased likelihood of early mortality
• Increased overall health-care costs

A diverse range of issues can contribute to medication nonadherence. Some may relate to psychological, demographic, and social factors. Key elements can include the cost of treatment and difficulties with health-care providers and the health-care system.

People who have a good support network are more likely to take their medication as prescribed. Doubts about the seriousness of diabetes and the effectiveness of a treatment plan can keep a person from taking their medication, and this can lead to complications. Nonadherence seems to be more common among people who have chronic diseases with symptoms that are not obvious. Also, complex treatment plans can be challenging to follow.

The quality of the patient-doctor relationship is often a key factor in nonadherence. It is important for doctors to address a person's reasons for not following the treatment plan. Likewise, it is important to raise concerns about diabetes treatment with the doctor, who can adjust the plan to help ensure that targets are being met and no complications develop.

Researchers have estimated that the collective cost of medication nonadherence for diabetes, high blood pressure, and high cholesterol in the United States was $105.8 billion in 2010.

Takeaway

Diabetes is not curable, but a person can help manage it at home. This often involves following nutrition and medication plans. For a better outcome, it is important to stop smoking, and many programs are available to help.

A person with diabetes or prediabetes should also be physically active and maintain a healthy weight. A diabetes care team can help develop and tailor an exercise plan. Blood glucose meters and continuous glucose monitors can help a person track their progress and see the effects of self-management techniques.