11 Things You Can Do Today for a Healthier Future With Type 2 Diabetes

Walking after meals can lower postprandial blood sugar (your blood sugar after eating) and help with weight management. It doesn’t have to be a long walk. “Just 10 to 20 minutes of moderate movement can help bring blood sugars down when you do the activity after a meal,” Segura says. In fact, taking a 10-minute walk right after meals may even be more effective at keeping blood sugar levels balanced than taking a single 30-minute walk at another point in the day, according to a study published in the December 2016 issue of Diabetologia. To increase your motivation to get moving, set post-meal alarms on your smartphone, use a wearable fitness-tracking device to track your steps, or enlist a walking buddy, Powell suggests.

Strength-training is a type of exercise that can make your body more sensitive to insulin and help lower blood sugar, and it should be part of everyone’s fitness regimen.

But you don’t need to use dumbbells or fancy weight machines — or even set foot in a gym — to reap the benefits. You can lift canned goods or bottles of water right at home. Segura suggests putting two or three books into two different bags and doing arm raises with them. She also recommends doing body-weight exercises like push-ups, sit-ups, squats, wall-sits, and lunges. If you haven’t exercised in a while (or if you’re elderly), Segura suggests starting lower with sets of five reps, rather than 10 or 15, and then adding more as you feel up to it. And remember to always talk to your doctor before starting a new exercise routine.

Blood sugar meters measure and show you how much sugar is in your blood. “A piece of advice I find myself giving to every newly diagnosed patient is not to be afraid of a meter,” Segura says. “Sometimes patients just don't want to touch one. They feel like it’s a punishment if they have to use it, like their blood sugar must be bad if they have to check.” But Segura explains that the blood sugar meter is a tool to be used so that you can be better informed. “It gives you more control over your blood sugar,” she says, “and more power over your health.”

And today, there are more types of blood glucose meters than ever, such as continuous glucose monitors (CGM) that work through a sensor placed under your skin. These devices, which allow easy, convenient, real-time readings of glucose levels, have revolutionized glucose monitoring, says Sandra Arévalo, MPH, RDN, CDE, director of community and patient education at Montefiore Nyack Hospital in New York and a spokesperson for the Association of Diabetes Care and Education Specialists (ADCES). “Not everybody needs to check [their levels] seven times a day but if you do, you can have a discussion with your doctor about whether a CGM might be easier for you,” says Arévalo. This may “help lead to the treatment you need and eventually decrease the risk of negative consequences of diabetes.”

People with diabetes are at an elevated risk of eye problems, such as diabetic retinopathy and macular edema, so it’s important to get examined by an eye doctor at least once a year. “Many times, when people are newly diagnosed with diabetes they haven’t seen an eye doctor for a while,” Powell says. A common reason people don’t go to the eye doctor is because they think their eyes are fine: “Many of the early signs of diabetic retinopathy don’t cause any noticeable visual symptoms or changes in vision,” he says. “Only the eye doctor can detect early diabetic changes in the eye before they cause visual problems.” If you haven’t already scheduled your annual eye exam, see to it!

Nutrition labels contain a lot of useful information for people with type 2 diabetes — but only if you learn how to interpret the label. “It’s not just sugar that affects blood sugar,” Segura says. “We also have to pay close attention to carbohydrates.” When you eat carbs, your body breaks them down into sugar, which can raise your blood sugar level.

The front of a food package may indicate that a food is sugar-free, but when you check the “total carbohydrate” amount on the back of the package, it might be a different story. “We’ve got to look at all of the pieces: the sugar, the carbohydrate, the fiber,” Segura says. She adds that learning to analyze how these pieces work together takes time. The bottom line: Just because a package says that a food is sugar-free doesn’t mean you can eat as much of it as you want.

Segura recommends eating at least three food groups at every meal. “It helps keep blood sugar more controlled throughout the day,” she says. Instead of just a bowl of oatmeal, have a cup of oatmeal with a handful of nuts and a piece of fruit. Instead of eating two pieces of toast, have a piece of toast, a boiled egg, and a banana. “That’s three food groups instead of just oatmeal or just two pieces of toast,” she says, explaining that it pushes people to think beyond just starch or starch-and-protein combinations.

If you want to have a cookie or some other sweet for dessert, Segura recommends keeping your dinner starch-free and having just lean protein and vegetables, such as chicken breast and sautéed spinach or salmon and asparagus. It’s important to remember that a cookie or a piece of cake is a starch, she says.

When many Americans think of protein, they probably picture beef, pork, or poultry. But there are lots of other proteins that make delicious options for a diabetes diet. “We don’t always need to have a protein from an animal,” says Segura, who often encourages her patients to try plant-based proteins such as beans, legumes, and soy. Other good lean protein options include fish, which are also loaded with heart-healthy omega 3 fatty acids. Dairy and eggs are also proteins, though you may want to consider reduced fat-milk and cheeses and opt for egg whites, depending on your dietary needs.

People who have diabetes have an increased risk of periodontal disease (likely because people with diabetes are more susceptible to infections, according to the American Academy of Periodontology), and the risk is greater if diabetes is not well-controlled. “There are also studies that correlate periodontal disease and cardiovascular disease,” Powell says. While researchers haven’t yet proven a cause and effect, studies have shown that periodontal disease may increase the risk of heart disease.

Since people with diabetes already have an increased risk of periodontal disease and cardiovascular disease, it's particularly important to practice good oral hygiene. Brush at least twice a day for a minimum of three minutes with fluoride toothpaste and floss at least once a day.

When it comes to diabetes management, people can be really hard on themselves. “Patients always want to tell me what they did ‘wrong,’” Segura says. “But I’m a lot more interested in what they were able to do well.”

To this end, she encourages people to “keep their words to themselves nice,” to replace negative thoughts with positive ones, and to move away from thinking in terms of “right and wrong” or “good and bad.” Instead, she says, think of what’s helpful or not helpful and what blood sugar management strategies have or haven’t worked for them.

Choice is also important. For example, if a person with type 2 diabetes chooses to eat pancakes for breakfast, he should not think of this as doing anything “wrong,” Segura says. He’s just choosing to eat a food that may be harder on his blood sugar. “This mindset helps people [avoid] feeling like they’re doing everything wrong,” she adds, which reduces the likelihood that they’ll want to give up altogether.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, up to one-half of people with diabetes have peripheral neuropathy, a type of nerve damage that can impact the feet and legs, and in some cases, the hands and arms.

The good news is that with proper care, most people can prevent serious problems in their feet. “I tell patients to take a few seconds before they go to bed each night to look at their feet and toes, to check for any cracks in the skin, and to keep their feet well moisturized,” Powell says. “And don’t go barefoot.” If you do get a cut, breaks in the skin, or an ingrown toenail, talk to your doctor. Experts at the Centers for Disease Control and Prevention also recommend notifying your doctor if your foot changes shape or color, or if it hurts or suddenly becomes less sensitive.

“More and more studies are coming out showing the detrimental effects of inadequate sleep — including not enough sleep or poor-quality sleep — on people with diabetes,” Powell says. A review of 97 studies published in March 2019 in the journal Healthcare concluded that people who have type 2 diabetes are at increased risk of having a sleep disorder such as sleep apnea, and that people who have sleep disorders have a higher risk of developing diabetes. In other words, the link between sleep and diabetes is a two-way street, with chronic sleep problems seemingly increasing the risk of developing diabetes and diabetes making sleep quality worse.

On the other hand, if you sleep longer and get high-quality sleep, you’ll be more likely to lower your blood sugar levels, say experts at the National Sleep Foundation. Solid slumber may also help with weight management, as poor sleep quality increases your risk of weight gain.

Additional reporting by Katherine Lee