What You Can Do: Your Role in Your Type 2 Diabetes Treatment Plan

By Caitlin Ultimo Reviewed by Clifton Jackness, My Dear

Be in the driver’s seat when it comes to executing your diabetes treatment plan.

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Videos: Eating Smart With Martha McKittrick, RDWhether you've just been diagnosed with type 2 diabetes or you’ve been living with it for months or years, your involvement in your treatment plan is crucial. Diabetes isn’t something that can be successfully managed simply by showing up to your doctor appointments. The real treatment happens at home, with steps you take yourself — making smart lifestyle changes and committing to medications and blood sugar monitoring.

“People with type 2 diabetes must be the ones who execute the treatment plan,” says Deborah Malkoff-Cohen, MS, RD, a certified dietitian and diabetes educator at the Newman Family Support Center at the Institute of Reconstructive Plastic Surgery at NYU Langone Medical Center, in New York City. “Their doctor or dietitian isn’t with them every day when they’re eating. People with type 2 diabetes should be empowered to address the issues on their own.”

And while tackling your treatment plan isn’t always easy, there are ways to keep your spirits high and your blood sugar levels under control.

Understand Type 2 Diabetes and How to Manage It

Understanding type 2 diabetes and learning the techniques and practices that work best for you is the first step in managing your disease properly. Many tools are available that can help you take action. Podcasts, health news alerts, books, blogs, and online support groups are all great sources for information on type 2 diabetes treatment advances. “It’s true that it’s hard work to manage type 2 diabetes,” says Amber Taylor, MD, the director of diabetes at the Center for Endocrinology at Mercy Medical Center, in Baltimore. “However, I try to motivate people through knowledge. The more they know, the better they can fight the disease process and complications.”

In addition to following an integrative health plan, Denise Baron, who’s been living with type 2 diabetes for the last six months but has had symptoms for close to a year, found an online workshop called the Diabetes World Summit to be extremely helpful. “I listen to different experts while I cook or go for my walk,” says Baron, a resident of Philadelphia. Joining such a workshop, or a type 2 diabetes support group, is a good way to stay informed and to receive positive reinforcement as you carry out healthy lifestyle activities with other participants.

Build a Care Team You Can Lean On

It’s important to have a good relationship with your doctor and to have access to a dietitian or a certified diabetes educator. “People with type 2 diabetes use different advice from all of us,” Dr. Taylor says. “Maybe they’ll pick up something from the nurse that I didn’t mention.”

It’s also helpful to reach out to friends and family and share the challenges you face in living with type 2 diabetes. Their help may come in handy more often than you think. If that tray of too-sweet cupcakes is calling your name at your niece’s birthday party, informed family members may be able to steer you in a better direction.

Be Honest and Open About Having Type 2 Diabetes

Be honest with yourself and your medical team when it comes to your treatment, and always make sure you understand your medications and when and how to take them.

It’s important to book an appointment earlier than scheduled if you’re having problems that may be related to a medication, such as side effects. And, Taylor says, “sometimes we’ll ask people to come back sooner than three months, particularly if they’ve started a new medication. We hate to find out that a person didn’t even start a prescribed medication — for example, maybe insurance authorization was needed, but no one contacted the office to let us know.”

It's also important not to skip doses of your medication.

If your health doesn't seem to be improving, be honest with yourself about what may be the real reasons for that. Are you taking your medicine or insulin as prescribed? Are you eating right and exercising regularly?

Make Your Meals Work With Your Treatment Plan

A diagnosis of type 2 diabetes doesn’t mean your days of enjoying carbs and sweets are over — but your days of overindulging should be. Moderation, portion control, and meal planning are all important for those with type 2 diabetes to keep in mind. “It’s helpful to meet a person with type 2 diabetes halfway — to work with them where they are in their current diet,” Malkoff-Cohen says. “No food is completely off-limits — we can find a place for the foods you love in your new diet.”

Malkoff-Cohen suggests that those with type 2 diabetes never eat a carb-only meal or snack. “At breakfast,” she says, “have an egg or an avocado before cereal.” Including protein and healthy fats in your meal helps slow the body's absorption of carbohydrates and can help stabilize blood sugar levels. “I once had a patient who had a doughnut and coffee every day, so I suggested we tweak that to half a doughnut after two hard-boiled eggs,” says Malkoff-Cohen.

Changing a diet that you're used to is difficult, but if you’re used to having rice, pasta, or bread with every meal, you should recognize that such a diet is not helping you and lessen the amount of carbs. “On days when I want a bagel,” says Baron, “I ask, why do I want it, and is it going to hurt or help my diabetes?” Taking the time to think before you eat a particular food is a good way to put the breaks on bad habits.

Don’t Ditch Your Diet When You’re Away From Home

When you're traveling or eating out, it can be difficult to stick to the meal plan you've worked out for your type 2 diabetes, and to resist tempting dishes that you'd avoid at home. But if you're smart about it, you can still enjoy your favorite road and restaurant foods.

If that plate of pasta is too good to pass up, Malkoff-Cohen suggests ordering it for the table to share and choosing a protein dish as your main course. Skipping bread, ordering a healthy soup to help fill you up, and having dishes served with sauce on the side are other easy ways to enjoy a variety of foods without overindulging.

Start Moving and Keep Moving

Whether you go for walks, take a dance class, or start your mornings with yoga poses, it’s important to incorporate exercise into your everyday routine. Malkoff-Cohen suggests that you ask yourself, “Did I sweat today?”

Are you new to exercise? Baron can relate: “I was the one who would sit and read a book while everyone else went for a jog. But now I make a conscious effort to fit in exercise.” A good beginning is to try a walking program, increasing your distance and intensity, or speed, as your physical ability improves.

Know That Having Type 2 Diabetes Can Be Emotionally Challenging

At times, avoiding certain foods or sticking to an exercise plan can feel like a burden, and that can bring anyone down. It’s not unusual for people with type 2 diabetes to feel burned out or experience signs of depression.

“When I was first diagnosed, I was terrified and then angry,” Baron says. “I would purposefully eat things I knew I shouldn’t. It felt as if sugar and bread were my addiction. I had to learn that wanting certain foods is all about emotions and how we feel, but that those moments of craving will pass.”

Blood Sugar Testing: Monitor, Record, and Repeat

Testing your blood sugar is crucial. “If you have type 2 diabetes and you don’t know your blood sugar numbers,” Malkoff-Cohen says, “your head is buried in the sand.”

“Sometimes people with type 2 diabetes need a reality check,” Taylor says. “For example, some say they don’t have time to check their blood sugar, but it literally takes five seconds now. What they’re really saying is that they haven’t made it a priority — they haven't made a habit of it.”

To make blood sugar checks a seamless part of your day, try leaving your glucometer on your bedside table so it’s the last thing you see before bed and the first thing you see in the morning.

Recognize Signs of Low Blood Sugar

Symptoms of low blood sugar (hypoglycemia), and low blood sugar readings themselves, can be different for everyone with type 2 diabetes. A typical low reading, however, is less than 70. And according to the American Diabetes Association, signs of low blood sugar that you should watch for include feeling shaky or nervous, sweating and chills, confusion, rapid heartbeat, blurred vision, weakness, and hunger with nausea. More serious symptoms include seizures and losing consciousness.

If you experience symptoms of low blood sugar, the National Institutes of Health recommends that you follow the “15/15 rule”:

Eat 15 grams of carbohydrates (glucose tablets or gel, 4 ounces of juice, or 2 tablespoons of raisins).Recheck your blood sugar in 15 minutes.If it’s still less than 70, repeat the process.Remember: Your Best Type 2 Diabetes Advocate Is You

“Type 2 diabetes is one of the only diseases that is almost entirely self-managed,” Taylor says. “People that do the best are involved in their own care.” You can ensure the best results by taking charge of your own type 2 diabetes treatment plan and being responsible for making healthy lifestyle changes that will complement that plan.

Having control and reaping its benefits can empower you as a person living with type 2 diabetes. And if you falter or get discouraged from time to time, know that it’s okay — tomorrow affords a new opportunity to make the right choices.

Last Updated: 9/1/2015