"The groundwork of all happiness is health." - Leigh Hunt

Time for a diabetes tune-up

About 300 pages, recently released 2023 American Diabetes Association Standards of Clinical Care are quite comprehensive. And given the strong link between obesity and diabetes, a crucial topic is weight reduction. For the estimated 37 million Americans currently living with diabetes, what other changes are value noting?

Support for lifestyle change is essential.

A subtle shift within the association's advice over the past five to 10 years, nonetheless, is a large effort to take care of individuals with diabetes, says Dr. Nathan, director of the Diabetes Center and Clinical Research Center in Massachusetts. General Hospital. “This means working with your physician to figure out a lifestyle and medication plan that works for you,” he says. “Doctors don't stand at your dinner table or bedside telling you what to do. They can help you plan and make informed decisions to better manage your diabetes.” But you've gotten to play an energetic role.”

Five Ways to Treat Diabetes

According to Dr. Nathan, listed below are five key points in the rules that individuals with essentially the most common type of the disease, type 2 diabetes, should know. (Many of the following tips also apply to individuals with type 1 diabetes, but those people should seek the advice of their doctors for targeted advice).

Strive for sound, uninterrupted sleep. Experts have long recognized the link between poor sleep and obesity. Mounting evidence suggests this. Sleep problems are also associated with diabetes risk.. “Altered sleep patterns can affect blood sugar control,” Dr. Nathan says. There's a reason. Because it's more common in individuals with diabetes (especially those that are obese), with any symptoms — loud snoring, snoring and gasping during sleep, and a full night's sleep. However, daytime sleepiness ought to be evaluated. Ask your doctor about an at-home sleep test.

Don't “diet”. Many popular diets — keto, paleo, intermittent fasting, and others — may help people drop pounds. But once they stop following the weight loss program, most individuals regain the burden they lost. Instead, it's more practical to slowly work toward a healthy eating pattern that you may follow over the long haul, says Dr. Nathan. Good selections include the Mediterranean variety of eating and the closely related DASH weight loss program. Avoiding sodas and other sugary drinks is particularly necessary for individuals with diabetes. You must also reduce how often you eat sugary, sweet and fatty foods, and eat more high-fiber carbohydrates, corresponding to whole-wheat bread and brown rice.

Exercise safely. Walking is right exercise for most individuals, provided you begin slowly and step by step increase your distance and speed if you happen to usually are not physically energetic. People with diabetes must pay special attention to selecting well-fitting shoes and check their feet repeatedly for redness, blisters or sores. This is because diabetes could cause neuropathy (numbness as a consequence of nerve damage), which may leave you unable to feel minor shocks and injuries to your fingers and toes. This can lead to more severe foot problems and result in amputation.

Work towards a healthy weight. The three suggestions above may help people drop pounds, but many individuals with obesity need medication to lose significant amounts of weight. Metformin, essentially the most commonly prescribed drug to lower blood sugar, may help people lose a median of 5 kilos. And while modest weight reduction improves diabetes and its complications, large losses are much more helpful.

Two relatively recent diabetes medications, semaglutide (Ozempic) and terzeptide (Monjaro), may help with weight reduction of 15 to twenty kilos, respectively. They also reduce hemoglobin A1c levels by two percentage points. (A1c is a three-month average measurement of blood sugar.)

“These drugs, given by once-weekly injection, are very promising, and should continue as first-choice additions to metformin for people with diabetes and obesity,” says Dr. Nathan. But because they're so expensive (about $1,000 monthly before insurance) and should be taken indefinitely, they're not realistic for everybody, he adds. In contrast, metformin costs only $4 monthly.

Know your treatment goals. As up to now, most individuals with diabetes should Aim for an A1c of 7% or less. Even if you happen to don't drop pounds, reaching this goal can reduce your risk of great diabetes complications, corresponding to vision and kidney problems and neuropathy, says Dr. Nathan.

Diabetes also increases your risk of heart disease. The goal blood pressure is lower than 130/80 mm Hg. The goal is to cut back LDL cholesterol by not less than 50% (or reach 70 mg/dL or less). If you have already got heart disease, the rules recommend an excellent lower LDL goal of 55 mg/dL. “Many of the people I treat take cholesterol-lowering statins, and I often increase their dose to help them reach a lower goal,” says Dr. Nathan. Nathan says. In some cases, a mix of cholesterol-lowering medications may help lower stubbornly high LDL.