Type 2 diabetes: where do i start?


#1

You’ve just been diagnosed with type 2 diabetes and if we’re being honest, you’re probably nervous about the lifestyle changes you will have to make and don’t know where to begin. The good news is getting started on your new life with type 2 diabetes is simple. With just a few steps, you’ll begin to redefine normalcy and live a full life with diabetes.

Set Realistic Goals

You and your doctor are working towards a goal to make sure you’re not dependent on medication for the rest of your life. An essential part of the beginning of type 2 diabetes management is understanding what your numbers mean and setting realistic goals for lowering your daily blood sugar numbers and A1C. Understand type 2 diabetes affects everyone differently, so ask your doctor what numbers are optimal for you.

This includes asking your doctor or another member of your diabetes care team what your ideal blood sugar numbers should be before your first meal of the day, two hours after your first bite of a meal, which ranges are too high or low, and what to do in the event your blood sugar is too high or low.

Build Your Support Team

When it comes to building your diabetes care team, always remember you are the most important person in it. While specialists certainly provide the expertise, only you fully understand how diabetes affects your body. Seek recommendations for endocrinologists, nutritionists, dietitians, diabetes educators, and peer support groups from trusted sources such as your primary care doctor. When choosing members of your care team, ensure they respect your values, including cultural ones, and provide a holistic approach to your treatment plan and address the mental and emotional tolls of diabetes self-management.

Also vital to your support team are the people who care about you the most. Whether this consists of family, friends, colleagues, or neighbors, identify loved ones you can confide in about your struggles, fears, and successes with diabetes management. Those in this circle should be non-judgemental, supportive, and help find solutions to your problems, even if they aren’t living with diabetes themselves. Research also shows people with diabetes who join peer support groups are more likely to manage diabetes well, less likely to experience diabetes complications, and have a higher quality of life. The American Association of Diabetes Educators has a list of peer support resources available for those seeking both online and in-person help.

Find the Right Diet and Exercise Plan For You

The general advice for those living with type 2 diabetes is to eat a healthy diet and exercise regularly. But what does that mean for you? In short, whatever you make of it. Living with diabetes doesn’t mean cutting out cake, burgers, or your favorite guilty pleasures. It means adjusting in what quantities and the frequency in which you eat them. If you’re someone who’s had a negative view of healthy foods, living with diabetes can change that perspective for you. Healthy eating can be as simple as recreating your favorite dishes with healthier ingredients.

For example, if you enjoy creamy dishes typically high in fat and carbs such as chicken alfredo and pasta, make it at home instead of buying the canned sauce or pre-packaged meal. Substitute heavy cream for half-and-half, use fresh parmesan and garlic, cook chicken breast in extra virgin olive oil, and substitute white pasta for whole-wheat or quinoa pasta. You can add flavor boosters using fresh or dried Italian herbs such as basil, parsley, and oregano and control the amount of salt you add. Learning to cook healthy at home carries health benefits by helping you control your sodium, fat, and carbohydrate intake, plus it’s fun!

If you’re not a gym person — don’t sweat it (pun intended). There’s no need to purchase an expensive gym membership you’re not going to use. In fact, exercise can be completely free! Lace up your shoes and go for a run, walk, and jog around the neighborhood. If you don’t exercise already, set a goal for the amount of time you’re willing to dedicate to physical activity per day. If that’s 5 minutes around the block for the first week, awesome! Stick with it and build on your progress. The following week, you may want to bump it up to 10 minutes and so on.

Check out resources such as the Beyond Type 1 Food and Diabetes and Exercise pages to generate ideas on how to construct your diet, determine which foods, and workouts suit you.

Identify the Costs of Diabetes Supplies and Care

Diabetes can be expensive. The American Diabetes Association published a report in April 2018 that stated people with diabetes spend over 2 times more on medical expenses per year than a person without diabetes. People with diabetes spend an average of $16,752 on medical expenses per year, with $9,601 of that directly attributed to diabetes care. These costs come from hospital inpatient care, prescription medicines, diabetes supplies, and visits to the doctor.

Because of this, it’s extremely important to understand how your health insurance plan can help you cover the costs of diabetes management. Adequate coverage can be the difference in preventing serious complications. Read about health coverage in your state and see if you’re eligible for financial assistance. If brand-name diabetes medications and supplies are too expensive, ask your doctor to prescribe generic versions. Also, you can purchase some diabetes supplies such as glucose meters, lancets, and test trips over-the-counter at your local pharmacy. Finally, research local health clinics that may provide low-

Being diagnosed with Type 2 diabetes can be scary, but it’s not a death sentence and with proper management, you will be able to live your best life with it. This guide is meant to relieve the stress and confusion diagnosis brings. Another important reminder is diabetes does not define you. You are still a whole, entire person who deserves to enjoy everything life has to offer and with a positive outlook on your treatment plan, your support system, and access to adequate resources, you will thrive with type 2 diabetes.

Original post: https://beyondtype2.org/type-2-diabetes-where-do-i-start/


#2

What did you mean under realistic goals. that “you and your doctor are working towards a goal to Make sure you are not dependant on medication for the rest of your life”. That does not seem to me to be a realistic goal.

There are many comments that you have made about type 2 diabetes that I find confusing or I think they are not correct


#3

Mila - I too read the statement “You and your doctor are working towards a goal to make sure you’re not dependent on medication for the rest of your life” and found it interesting.

Take a look at the 2019 Standard of Care, specifically section 9, figure 9.1
http://care.diabetesjournals.org/content/42/Supplement_1

The current standard nearly all doctors are following is a “Treat to Fail” standard. They expect Step 1 to fail and plan for it. This is then followed by Step 2 and 3 failing. This results in more medication. Then you get to Step 4 which is baslin insulin which is still not addressing the first issue all T2s face.

The first thing all T2s face is they lose their robust first phase insulin release. The issue all diabetics have is their body is not producing enough insulin for its needs. Non-diabetic, over weight, inactive, insulin resistant people naturally grow huge beta cell clumps to make more insulin. In T2s that is not the case. As a result they need more externally taken insulin especially when they are eating. Get their body the insulin it needs when it needs it, keep it in a non-diabetic range and amazing things happen.

Its sad to say but most doctors follow the current standard of care and in most cases this will lead to more and more medications. Sadly, not fewer.

The great news is in 2019 we have the tools and we know how to safely stop the progression in most cases and see significant health improvement in many. Maybe sooner than later the standard of care will reflect these tools.


#4

My Provider and I are working to either lower me to 500mg metformin ER once a day or come off completely. Am almost at 20% body wt loss. Taken 7 months to lose 30 lbs but it based on lifestyle changes in eating no a fad quick fix. Starting a1c was 9 now down to 6.1-2 at 27lbs wt loss. For diabetes less than 4 yrs since dx a UK study has shown the weight loss of 20% can achieve normal values. It was a longitudinal study and those who kept weight off watched carb intake and did moderate exercise such as walking Were able to maintain with little to no medication.
Sadly in US we do not focus as much on these ideals.


#5

Mila do you have a response to these discussions?


#6

Congradulations on the great control


#7

This article is part of the Beyond Type 2 content, it was written by the Project Manager as part of the resources for T2. I suggest you that if you have any questions contact her.


#8

Actually maybe she should contact me.
I don’t represent myself as any expert just a well controlled T2 doing LCHF going from and A1c of 12 to now 5.7 no meds.
Now About T’Mara (I apologize is the spelling is off)
There is no such thing as all diabetics need to eat Sugar for the nutritional value.
There is none.


#9

@TaraSBT2 I believe @T2Tom would be a great person to interview.


#10

Mila, It was good of you to make an effort, but you’re not type 2 are you. This was a more for a T1 post with questionable A1c. Eat the pasta but cut the fatty sauce :grinning:


#11

An effort of what? :rofl:


#12

Hi Everyone!

I’m T’ara, the Project Manager of Beyond Type 2 and the author of the article above. It’s very nice to meet all of you! Thanks for the engaged discussion and comments. I agreed that the statement “Working towards a goal to make sure you’re not dependent on medication for the rest of your life” should’ve been worded better, so I’ve restated it to working with your doctor to manage and live well with diabetes. I understand getting off medication isn’t a realistic goal for everyone, some are just fine with managing it with medication.

I hope you’re able to find information on Beyond Type 2 that’s relatable to your experience with Type 2 diabetes. As we grow the website, my vision for the program is to provide a community where everyone with Type 2 can have a voice and feel heard. I also hope the program provides an opportunity for people with Type 2 to read other perspectives on how T2D is managed. As we all know, there is no one-size fits all approach to T2D management, and we’re all passionate about our ways of living with it.

I know this because I have Type 2 diabetes too. I’ve read numerous stories and approaches to diet, exercise, medication, doctor’s visits, etc. I’ve tried approaches that some have recommended, including popular diets, that simply don’t work for me. However, I have my way of keeping my blood sugar in check and I respect the way others do, too.

I use my professional background, read, and use up-to-date research on diabetes both the mental and physical aspects, glucose function in the body, the role of nutrients, both micro and macro, to influence the content produced on the website. I understand not everyone will agree with some studies, that’s fine, you are free to tell me why and we can discuss. I encourage open dialogue, especially among Type 2s because we’re a diverse group of people who have a disease that has a lot of variables in its causes and management strategies.

More importantly, since there are so many voices in our community, submit YOUR story to the website. I have Type 2, but my experience doesn’t speak for others, just myself. Your story could inspire someone to try something new.

Finally, because we all have our individual ways of living with Type 2, I ask that no one use their experiences with certain diets, exercises, or any way they’ve managed T2D to invalidate the experiences of others. I hope we can all agree on that.

Anyway, it’s nice to meet all of you! I’ll be poking around in the Forums and jump into discussions! If you want to connect with me directly, email me at hello@beyondtype2.org. :smile:


#13

Hey, Tom!

Let’s connect on how you’ve been able to control diabetes on a LCHF diet.

My email is hello@beyondtype2.org.

  • T’ara

#14

Thx. Control comes with education and life style changes. I may never not be have some needs for meds but set the bar high and do the best u can to reach it is my motto. The more in control the less likely complications.


#15

Tara, when most T2 finish up on insulin, Promoting a drug free future is a bit unrealistic. At diagnosis about 40% of the pancreas cell are finished. Using the minimum amount and delaying changes on the drug ladder is more accurate.


#16

Tara - the best LCHF dietary program is run by Virtahealth.com BUT its not the “cure” they claim it to be.

I would not consider an A1c of 6.5% who are taking no glycemic control medications OR only metformin a great T2 success with the tools we now have.

We know 2+ hours of 140+ BGs cause vascular disease. 12+ hours of 140 BG seems like a mess to me. In 2019 we can do a lot better than 6.5 a lot easier and cheaper than the Virta monthly fee.


#17

Jack - that figure you just posted outlining the current step program is at the root cause of not getting T2s under control and giving them a fighting chance.

As you say by the time of diagnosis 40% beta cell function is lost. In other words the body is getting 40% less insulin than it needs. How would it be if you had a sprained ankle and only had 60% function but everyday you needed to run a marathon and my solution for you was not rest but letting you run the marathon with an ace bandage on the ankle?

Thats pretty much what we do today with the step program planning you will fail at each step. Make the pancreas continue to work all day and never let it rest is never going to make things better. This is the “Treat to Fail” approach currently endorsed by the ADA. Its a mess.


#18

I’m not endorsing it, it’s just the way most T2 are treated by their HCP. Don’t eat fat, it clogs your arteries. Eat lots of carbs, your brain need 120g a day and so it goes.

I haven’t found anything better than keto or LCHF for T2 and add meds as needed.

Older Position Statement, I’m sure the dietitians have got in and cleaned it up now, So that fats are bad and eat lots those healthy carbs. If you cut fats, you have to eat high carb to get the calories.

Fats

Evidence is inconclusive for an ideal amount of total fat intake for people with diabetes;
therefore, goals should be individualized; fat quality appears to be far more important than quantity.

In people with type 2 diabetes, a Mediterranean-style, MUFA-rich [mono fat-rich] eating pattern may benefit glycemic control and CVD risk factors and can therefore be recommended as an effective alternative to a lower-fat, higher-carbohydrate eating pattern.

Carbohydrates

The amount of carbohydrates and available insulin (insulin resistance?) may be the most important factor influencing glycemic response after eating and should be considered when developing the eating plan.

Monitoring carbohydrate intake, whether by carbohydrate counting or experience-based. Estimation remains a key strategy in achieving glycemic control.