Diabetes Type 2

Just Diagnosed? What You Need to Know About Type 2 Diabetes
By Maureen Connolly 
Published 5/3/2012 
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I've got diabetes?
Being diagnosed with type 2 diabetes can be scary, but rather than sit back and do nothing out of fear or because you’re feeling defeated, consider this uplifting news: Cleveland Clinic docs say when it comes to diabetes, you get a “do-over.” “If you’re willing to make some major lifestyle changes, the vast majority of people with type 2 diabetes are able to reverse the complications of the disease,” says Michael Roizen, MD, chief wellness officer of Cleveland Clinic’s Wellness Institute. This means you reduce your dependence on medications (or omit them altogether) and avoid the serious complications that can develop, such as blindness, serious skin infections and amputations. In the short run, you’ll also feel better and have more energy.
Where do I start?
“The first step is to actually realize that you have a life-threatening condition,” says Dr. Roizen. “The next step is to get emotionally involved with your body.”
I didn't even know I was at risk for diabetes.
You’re definitely not alone. The number of folks in the U.S. with diabetes has tripled in the past 20 years. An estimated 24 million Americans, including children and teens, now have this debilitating and potentially life-threatening disease — and a quarter of them don’t even know it, according to the Centers for Disease Control and Prevention.
Why the rise in type 2 diabetes?
“We have the same genes as we had 20 or 30 years ago, but we’re consuming 860 more calories per day on average than we did in 1984. The quantity as well as the quality of the food — more processed and high in sugar, trans fat and white flour — are leading to obesity and a constant state of inflammation throughout our bodies, which are two of the major triggers for diabetes,” says Dr. Roizen. Genetics are a factor, meaning you inherited a predisposition toward developing the disease, despite being active and eating well. But more often than not, lifestyle factors, specifically diet and obesity, appear to play the biggest role.
Will cutting back on calories help?
You bet. One of the easiest ways to cut calories: Reduce portion sizes so you’re eating one-third less at each meal and you can shave off 500 to 1,000 calories per day! Not quite sure what a healthy portion looks like? The Meal Measure can help. This nifty little tool is designed with pre-portioned compartments (protein, starch and vegetable or fruit) and follows the USDA My Pyramid serving sizes. Just place the measure over your plate, fill, remove and enjoy knowing you’re not overeating.
Are there foods I must avoid?
“Keep away from the five food felons, which are major contributors to this disease,” says Dr. Roizen. These include: trans fats, saturated fats, added sugars, syrups and any grain but 100 percent whole grain. “You need to look for these felons in the ingredient labels of your favorite foods — and if they show up in the first five ingredients (excluding parentheticals), don’t eat them,” he says. “Without these felons in your diet, you can begin to reverse the effects of this disease,” he says.
Which foods should I focus on eating?
When it comes to diabetes, slow-burning foods are the way to go: whole grains, fiber-filled fruits and vegetables, and lean protein. Foods like fish, chicken, apples and whole-grain pasta provide a more steady release of glucose as they break down in the body, as opposed to the sugar spikes you get from eating things like white pasta, bagels and juice.
Can I still drink soda?
You’re going to want to rethink your drink choices: The average 12-ounce can of soda contains a whopping 39 grams of sugar. Sweetened teas and sports drinks aren’t much better. And that heaping tablespoon of sugar you add to your venti Starbucks each morning isn’t doing your diabetes any good either. Instead, get in the water habit and your waistline and arteries will thank you. If water is too boring, then liven things up with a little lemon or cucumber slice, or try unsweetened teas. And what about diet sodas? True, they’re sans sugar, but there’s research that shows artificial sweeteners may stimulate appetite, which is not what you want or need.
Is exercise really that important?
Next to a healthy diet, exercise is the diabetic’s best friend. Here’s why: That spare tire around your middle, known as visceral fat, as well as those jiggly arms and thighs, actually make it harder for your cells to absorb glucose, which is your body’s main source of fuel. “When you replace some of this fat with lean muscle mass, your body becomes more efficient in how it processes sugar, which helps guard against insulin resistance,” says Elizabeth Ricanati, M.D. founding director of Cleveland Clinic’s Lifestyle 180 program. Essentially, exercise can actually train your body to become more sensitive to the glucose because when you burn calories you’re primarily burning glucose.
Which exercise is best to control diabetes?
Any activity that gets you moving and breathing a little hard on a regular basis will do. Walking is probably one of the best exercises because it’s free and you can do it just about anywhere and anytime. If you haven’t been exercising, start out with 10-minute walks two or three days per week. Your goal: 30 minutes, five or more days per week, or 10,000 steps per day. Pressed for time? No worries — break up the walk into smaller chunks. Need motivation? Walk with a friend, your dog (or your neighbor’s dog) or your favorite music. When you can, follow your walk with five to 10 minutes of resistance training using weights or bands. You’ll create even more lean muscle mass and further improve insulin sensitivity.
Do I need to take precautions before exercising?
You should check with your doctor before beginning a vigorous exercise program for two reasons: First, you want to make sure that you do not have a significant blockage in a coronary artery that could put you at risk for a heart attack. Your doctor can decide if any diagnostic testing is necessary. Second, if you’re taking medications for diabetes, exercise can cause lower blood sugars, which can put you at risk for hypoglycemia and complications, such as seizures or loss of consciousness. So medications may need to be adjusted by your medical provider.
You should also invest in a quality pair of walking shoes, wear comfortable cotton socks, and check out your feet before you lace up: Over time, high blood sugar can impair circulation and nerve function, making your feet prone to slow-healing sores that become infected.
Will I need special medications to control my diabetes?
Medications for diabetes are important so that the blood sugars can be controlled, says Thomas Morledge, MD, medical director for Cleveland Clinic’s Wellness Enterprises. Testing blood sugars is also essential to taking control of diabetes, instead of being the victim of diabetes. “However, the cornerstones of management and reversal of type 2 diabetes are lifestyle enhancements: good food choices, regular exercise, stress management and weight loss,” says Dr. Morledge. “It’s exciting to see the blood sugars getting lower when some of these simple changes start to take hold. When the lifestyle changes kick in, with the help of your practitioner, medications can often be reduced or at times even stopped.”
Can stress cause type 2 diabetes?
Stress seems to get blamed for just about everything these days. And when it comes to diabetes, stress is definitely a culprit. For one, stress is a major trigger for emotional eating and overeating. A stressed body craves foods high carbs, fat and sugar, all of which raise blood sugar. On top of this, when you’re stressed, your body also releases hormones, such as cortisol, that also raise blood sugar. To top it off, being newly diagnosed with type 2 diabetes will initially add to your stress as you’re faced with learning new ways to eat, monitoring your blood sugar and finding time for exercise, so it’s more important than ever to practice stress-reduction methods that work for you.
How can I learn to handle stress better?
Figuring out ways to handle your stress will enable you to stick with and follow through on all the new lifestyle commitments you’ll need to stick with in order to take control of this disease. When you’re stressed, it’s just too easy to cancel exercise, revert to bad eating habits and forget to take your meds. Tops on our list: exercise, a major de-stressor. Bike, swim, dance, practice yoga — just do whatever makes you move! Meditation, guided imagery and deep breathing also help you feel more balanced and step outside of yourself so that you can break the stress cycle. And remember that every little bit helps. So throughout your day, look for ways to slow down and breathe, even if it’s just for a few seconds while you’re waiting for that red light to turn green.
How can I get my emotional eating under control?
Many of us turn to food when we’re stressed. Sidestep the emotional eating trap by taking charge with a food journal, recommends Peggy Doyle, RD, LD, a certified diabetes educator and outpatient dietitian at Cleveland Clinic’s Fairview Hospital Wellness Center. Any time you eat, be it at a mealtime or “just because,” note the reason, what you ate and how you felt when eating. You’ll learn to identify your emotional triggers and become more aware of what and why you eat.
Why does my doctor keep stressing the importance of a good night's sleep?
Studies have shown that when we get less sleep than we need (either because of poor habits or due to diseases such as sleep apnea), we need to use more insulin (the primary hormone related to diabetes) to utilize the same amount of glucose, explains Dr. Ricanati. This can lead to insulin resistance over time, which is a precursor to diabetes. “Indirectly, a secondary consequence of poor sleep that can contribute to diabetes involves our bodies’ appetite hormones. Sleep can disrupt these hormones too, which can increase our risk of obesity. Obesity is another risk factor for diabetes.”
What will happen if I don't make these lifestyle changes?
Doing nothing means you will suffer the ill effects of this debilitating disease and risk a premature death. In 2007 diabetes was the seventh leading cause of death. Diabetes is also the leading cause of new cases of blindness among adults under age 75, kidney failure, and non-accident/injury leg and foot amputations among adults.

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