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We encourage you to print or e-mail these topics to your patients. You can also locate patient education articles on a variety of subjects by searching on "patient info" and the keyword s of interest. Weight reduction through diet, exercise, and behavioral modification can all be used to improve glycemic management, although the majority of patients with type 2 diabetes will require medication.
See 'Diabetes education' above. Glycemic targets are generally set somewhat higher for older adults and for those with comorbidities or a limited life expectancy and little likelihood of benefit from intensive therapy.
See 'Glycemic management' above and "Glycemic control and vascular complications in type 2 diabetes mellitus", section on 'Choosing a glycemic target'. In the absence of specific contraindications, we suggest metformin as initial therapy for most patients Grade 2B.
Although some guidelines and experts endorse the initial use of alternative agents as monotherapy or in combination with metformin, we prefer initiating a single agent typically metformin and then sequentially adding additional glucose-lowering agents as needed.
See 'Metformin' above and 'Glycemic efficacy' above. We suggest initiating metformin at the time of diabetes diagnosis Grade 2C , along with consultation for lifestyle intervention.
See 'When to start' above. The dose of metformin should be titrated to its maximally effective dose usually mg per day in divided doses over one to two months, as tolerated. See 'Contraindications to or intolerance of metformin' above. See 'Established cardiovascular or kidney disease' above.
The majority of patients in the cardiovascular and renal outcomes trials had established cardiovascular disease CVD or diabetic kidney disease DKD with severely increased albuminuria, and therefore, these are the primary indications for one of these drugs.
See 'Without established cardiovascular or kidney disease' above. Each one of these choices has individual advantages and risks table 1. Choice of medication is guided by efficacy, patient comorbidities, preferences, and cost.
Sulfonylureas remain a highly effective treatment for hyperglycemia, particularly when cost is a barrier. Side effects of hypoglycemia and weight gain can be mitigated with careful dosing and diabetes self-management education. For patients who are injection averse, initial therapy with high-dose sulfonylurea is an alternative, particularly for patients who have been consuming large amounts of sugar-sweetened beverages, in whom elimination of carbohydrates can be anticipated to cause a reduction in glucose within several days.
See 'Symptomatic catabolic or severe hyperglycemia' above and "Insulin therapy in type 2 diabetes mellitus". Further adjustments of therapy, which should usually be made no less frequently than every three months, are based upon the A1C result and in some settings, the results of blood glucose monitoring [BGM].
See 'Monitoring' above. See "Management of persistent hyperglycemia in type 2 diabetes mellitus" and "Insulin therapy in type 2 diabetes mellitus". Why UpToDate? Product Editorial Subscription Options Subscribe Sign in. Learn how UpToDate can help you.
Select the option that best describes you. View Topic. Font Size Small Normal Large. Initial management of hyperglycemia in adults with type 2 diabetes mellitus. Formulary drug information for this topic.
No drug references linked in this topic. Find in topic Formulary Print Share. View in. Language Chinese English. Author: Deborah J Wexler, MD, MSc Section Editor: David M Nathan, MD Deputy Editor: Katya Rubinow, MD Contributor Disclosures. All topics are updated as new evidence becomes available and our peer review process is complete.
Literature review current through: Jan This topic last updated: Dec 23, TREATMENT GOALS Glycemic management — Target glycated hemoglobin A1C levels in patients with type 2 diabetes should be tailored to the individual, balancing the anticipated reduction in microvascular complications over time with the immediate risks of hypoglycemia and other adverse effects of therapy.
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Wing RR, Blair EH, Bononi P, et al. Caloric restriction per se is a significant factor in improvements in glycemic control and insulin sensitivity during weight loss in obese NIDDM patients. Diabetes Care ; Lean ME, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes DiRECT : an open-label, cluster-randomised trial.
Delahanty LM. The look AHEAD study: implications for clinical practice go beyond the headlines. J Acad Nutr Diet ; Evert AB, Dennison M, Gardner CD, et al. Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Lean MEJ, Leslie WS, Barnes AC, et al.
Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. Lancet Diabetes Endocrinol ; Niskanen LK, Uusitupa MI, Sarlund H, et al.
Five-year follow-up study on plasma insulin levels in newly diagnosed NIDDM patients and nondiabetic subjects. Norris SL, Zhang X, Avenell A, et al.
Long-term effectiveness of lifestyle and behavioral weight loss interventions in adults with type 2 diabetes: a meta-analysis. Am J Med ; United Kingdom Prospective Diabetes Study UKPDS. BMJ ; Umpierre D, Ribeiro PA, Kramer CK, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis.
JAMA ; Jeon CY, Lokken RP, Hu FB, van Dam RM. Physical activity of moderate intensity and risk of type 2 diabetes: a systematic review. Egan AM, Mahmood WA, Fenton R, et al.
Barriers to exercise in obese patients with type 2 diabetes. QJM ; American Diabetes Association Professional Practice Committee. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes Diabetes Care ; S Kobayashi Y, Long J, Dan S, et al.
Strength training is more effective than aerobic exercise for improving glycaemic control and body composition in people with normal-weight type 2 diabetes: a randomised controlled trial. Diabetologia ; Look AHEAD Research Group, Wing RR, Bolin P, et al.
Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. Pillay J, Armstrong MJ, Butalia S, et al. Behavioral Programs for Type 2 Diabetes Mellitus: A Systematic Review and Network Meta-analysis.
Ann Intern Med ; Johansen MY, MacDonald CS, Hansen KB, et al. Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial. Lingvay I, Sumithran P, Cohen RV, le Roux CW.
Obesity management as a primary treatment goal for type 2 diabetes: time to reframe the conversation. Look AHEAD Research Group, Pi-Sunyer X, Blackburn G, et al.
Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Arterburn DE, O'Connor PJ. A look ahead at the future of diabetes prevention and treatment.
Look AHEAD Research Group, Gregg EW, Jakicic JM, et al. Association of the magnitude of weight loss and changes in physical fitness with long-term cardiovascular disease outcomes in overweight or obese people with type 2 diabetes: a post-hoc analysis of the Look AHEAD randomised clinical trial.
Look AHEAD Research Group. Eight-year weight losses with an intensive lifestyle intervention: the look AHEAD study. Obesity Silver Spring ; Look AHEAD Research Group, Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial.
Arch Intern Med ; Gregg EW, Chen H, Wagenknecht LE, et al. Association of an intensive lifestyle intervention with remission of type 2 diabetes. Jakicic JM, Egan CM, Fabricatore AN, et al. Four-year change in cardiorespiratory fitness and influence on glycemic control in adults with type 2 diabetes in a randomized trial: the Look AHEAD Trial.
Kuna ST, Reboussin DM, Borradaile KE, et al. Long-term effect of weight loss on obstructive sleep apnea severity in obese patients with type 2 diabetes.
Sleep ; Wing RR, Bond DS, Gendrano IN 3rd, et al. Effect of intensive lifestyle intervention on sexual dysfunction in women with type 2 diabetes: results from an ancillary Look AHEAD study. html Accessed on July 18, Effect of a long-term behavioural weight loss intervention on nephropathy in overweight or obese adults with type 2 diabetes: a secondary analysis of the Look AHEAD randomised clinical trial.
Surwit RS, van Tilburg MA, Zucker N, et al. Stress management improves long-term glycemic control in type 2 diabetes.
Ismail K, Winkley K, Rabe-Hesketh S. Systematic review and meta-analysis of randomised controlled trials of psychological interventions to improve glycaemic control in patients with type 2 diabetes. Safren SA, Gonzalez JS, Wexler DJ, et al. A randomized controlled trial of cognitive behavioral therapy for adherence and depression CBT-AD in patients with uncontrolled type 2 diabetes.
Williams JW Jr, Katon W, Lin EH, et al. The effectiveness of depression care management on diabetes-related outcomes in older patients. Colagiuri S, Cull CA, Holman RR, UKPDS Group. Are lower fasting plasma glucose levels at diagnosis of type 2 diabetes associated with improved outcomes?
prospective diabetes study Choi JG, Winn AN, Skandari MR, et al. First-Line Therapy for Type 2 Diabetes With Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists : A Cost-Effectiveness Study. Abdul-Ghani MA, Puckett C, Triplitt C, et al.
Initial combination therapy with metformin, pioglitazone and exenatide is more effective than sequential add-on therapy in subjects with new-onset diabetes. Results from the Efficacy and Durability of Initial Combination Therapy for Type 2 Diabetes EDICT : a randomized trial.
Diabetes Obes Metab ; Hong J, Zhang Y, Lai S, et al. Effects of metformin versus glipizide on cardiovascular outcomes in patients with type 2 diabetes and coronary artery disease.
Kooy A, de Jager J, Lehert P, et al. Long-term effects of metformin on metabolism and microvascular and macrovascular disease in patients with type 2 diabetes mellitus. Maruthur NM, Tseng E, Hutfless S, et al.
Diabetes Medications as Monotherapy or Metformin-Based Combination Therapy for Type 2 Diabetes: A Systematic Review and Meta-analysis. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes Jia W, Weng J, Zhu D, et al.
Standards of medical care for type 2 diabetes in China Diabetes Metab Res Rev ; e Marso SP, Bain SC, Consoli A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes.
Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. Mann JFE, Ørsted DD, Brown-Frandsen K, et al. Liraglutide and Renal Outcomes in Type 2 Diabetes. Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes REWIND : a double-blind, randomised placebo-controlled trial.
Dulaglutide and renal outcomes in type 2 diabetes: an exploratory analysis of the REWIND randomised, placebo-controlled trial. Kanie T, Mizuno A, Takaoka Y, et al.
Dipeptidyl peptidase-4 inhibitors, glucagon-like peptide 1 receptor agonists and sodium-glucose co-transporter-2 inhibitors for people with cardiovascular disease: a network meta-analysis.
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Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. Neal B, Perkovic V, Mahaffey KW, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes.
Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. de Boer IH, Khunti K, Sadusky T, et al. Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association ADA and Kidney Disease: Improving Global Outcomes KDIGO.
Shyangdan DS, Royle P, Clar C, et al. Glucagon-like peptide analogues for type 2 diabetes mellitus. Singh S, Wright EE Jr, Kwan AY, et al. Glucagon-like peptide-1 receptor agonists compared with basal insulins for the treatment of type 2 diabetes mellitus: a systematic review and meta-analysis.
Davidson MB. Successful treatment of markedly symptomatic patients with type II diabetes mellitus using high doses of sulfonylurea agents.
West J Med ; pdf Accessed on April 21, Palmer SC, Mavridis D, Nicolucci A, et al. Comparison of Clinical Outcomes and Adverse Events Associated With Glucose-Lowering Drugs in Patients With Type 2 Diabetes: A Meta-analysis.
Tsapas A, Avgerinos I, Karagiannis T, et al. Comparative Effectiveness of Glucose-Lowering Drugs for Type 2 Diabetes: A Systematic Review and Network Meta-analysis. Kahn SE, Haffner SM, Heise MA, et al. Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy.
Nathan DM. Thiazolidinediones for initial treatment of type 2 diabetes? Qaseem A, Barry MJ, Humphrey LL, et al. Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus: A Clinical Practice Guideline Update From the American College of Physicians. Davies MJ, Aroda VR, Collins BS, et al.
Management of hyperglycaemia in type 2 diabetes, A consensus report by the American Diabetes Association ADA and the European Association for the Study of Diabetes EASD. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient.
It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances.
Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient.
UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. All rights reserved. Topic Feedback. Initiation and adjustment of insulin regimens in type 2 diabetes mellitus.
Ask your doctor if you should be tested. Regular physical activity means getting at least minutes a week of brisk walking or a similar activity. Imagine: You and the National Diabetes Prevention Program. Watch the video! A lifestyle change program offered through the CDC-led National Diabetes Prevention Program can help you make those changes—and make them stick.
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Type 2 Diabetes Overview Symptoms Diagnosis Causes Treatment Complications Diet. Type 2 Diabetes. By Kristeen Cherney, PhD. Medically Reviewed. Kacy Church, MD.
Diagnosis Symptoms Jump to More Topics. If you have to pee frequently, are constantly fatigued despite getting enough rest, or have suddenly lost weight, you may have hyperglycemia, or high blood sugar. How Is Hyperglycemia Diagnosed, Exactly? A1C is a two- to three-month average of your blood sugar levels, says Dr.
Dodell says your doctor may also test your blood sugar levels through a fasting glucose test. What Are Some of the Common Signs and Symptoms of High Blood Sugar?
In addition to frequent urination, fatigue, and sudden weight loss, symptoms of hyperglycemia may include: [ 1 ]. What Are the Health Consequences of High Blood Sugar? During ketoacidosis, your body breaks down large amounts of fat at once, and as a result, ketones are excreted and sent to your urine.
Signs of ketoacidosis from high blood sugar can include dry mouth, fruity-smelling breath, nausea, and shortness of breath. You may even have anxiety and vomiting.
Another possible complication of high blood sugar is called hyperglycemic hyperosmolar syndrome. Hyperglycemic hyperosmolar syndrome is considered an emergency and can lead to potentially life-threatening dehydration or even coma. What Are the Different Causes of High Blood Sugar?
In these cases, episodes of hyperglycemia are usually temporary. Your blood sugar may rise after you eat a large meal or as a result of a high-endurance workout. Emotional stresses and illnesses can also cause these fluctuations.
Are You at Risk for High Blood Sugar? How to Know You may be at risk for high blood sugar if you have diabetes and you: [ 7 ].
Genetics can also play a role, especially if you have a family history of diabetessays Dodell. He explains that certain health conditions can raise your risk of high blood sugar, including damage to the pancreas — such as pancreatic cancer or pancreatitis — infection, pain, and polycystic ovary syndromea hormone disorder that can cause infertility.
That said, you should try to avoid these foods to help prevent blood sugar spikes: [ 11 ]. To help keep your blood sugar levels steady, try eating fish twice a week, as well as concentrating on plant-based fats and fiber-rich foods regularly.
You may also consider talking to your doctor or dietitian about the following diets: [ 12 ]. Cutting down on overall portion sizes can also help keep blood sugar levels steady.
If you do have a larger meal than normal and take insulin, you may need to up your insulin dose to compensate. Consider using the plate method, which can help you control your portions, or working with a dietitian to come up with a custom meal plan.
How Lifestyle Changes Can Also Help You Avoid Hyperglycemia Exercise is one of the best ways to get rid of high blood sugar. Work with your healthcare provider or hire a personal trainer to figure out which exercises are best for you, based on your goals and your overall fitness level.
Some exercises can affect your blood sugar more than others. For instance, high-intensity workouts, such as running or spinning, burn more glucose, while longer bouts of low-intensity exercises, like walking, burn more fat. Either option can help increase insulin sensitivity.
You should also measure your sugar before and after each workout. How Technology Can Help You Keep Your Blood Sugar Levels Balanced If you have diabetes, you should wear a medical ID bracelet in case your blood sugar spikes to a dangerous range.
You can even attach a USB drive to the bracelet with key personal information that a medical professional might need in case of an emergency. Avoiding and treating hyperglycemia is a three-tiered process — this includes taking your treatments as directed, exercising, and eating a healthy diet with smaller portions.
Editorial Sources and Fact-Checking. Sources Diabetes: Symptoms and Causes. Mayo Clinic. Understanding Your Average Blood Sugar. UCSF Diabetes Education Online. The A1C Test and Diabetes. National Institute of Diabetes and Digestive and Kidney Diseases.
Diabetes: Diagnosis and Treatment. Hyperglycemia and Diabetes. Diabetes and DKA Ketoacidosis. American Diabetes Association. Hyperglycemia in Diabetes: Symptoms and Causes. Complications of Diabetes. Diabetes UK. How Gestational Diabetes Can Impact Your Baby.
Polycystic Ovary Syndrome PCOS. UCLA Health. Diabetes Diet: Create Your Healthy-Eating Plan. An Update on the Mediterranean, Vegetarian, and DASH Eating Patterns in People With Type 2 Diabetes.
Diabetes Spectrum. Severe Maternal Hyperglycemia Exacerbates the Development of Insulin Resistance and Fatty Liver in the Offspring on High Fat Diet. Experimental Diabetes Research.
: Preventing hyperglycemiaGET INVOLVED | Proper diet and exercise seem to be the prescription for many common health problems: high blood pressure and cholesterol, heart disease, stroke, and obesity. Diet and exercise Weight loss resulting from healthy eating and increased physical activity enables muscle cells to use insulin and glucose more efficiently, thus lowering diabetes risk. Contact a health care provider if you have questions about your health. Interactive Nutrition Facts label: Monounsaturated and polyunsaturated fats. See 'Diabetes education' above. |
Breadcrumb | However, kidney and cardiac benefits have been shown in patients with eGFR below this threshold. Health education via mobile text messaging for glycemic control in adults with type 2 diabetes: a systematic review and meta-analysis. Research Faculty. Have you been less active than usual? A lifestyle change program offered through the CDC-led National Diabetes Prevention Program can help you make those changes—and make them stick. Financial Services. |
Hyperglycemia in diabetes - Diagnosis & treatment - Mayo Clinic | In the event of a severe hypoglycemic episode, a car accident, or other emergency, the medical ID can provide critical information about the person's health status, such as the fact that they have diabetes, whether or not they use insulin, whether they have any allergies, etc. Emergency medical personnel are trained to look for a medical ID when they are caring for someone who can't speak for themselves. Medical IDs are usually worn as a bracelet or a necklace. Traditional IDs are etched with basic, key health information about the person, and some IDs now include compact USB drives that can carry a person's full medical record for use in an emergency. Your best bet is to practice good diabetes management and learn to detect hyperglycemia so you can treat it early—before it gets worse. Breadcrumb Home Life with Diabetes Get the Right Care for You Hyperglycemia High Blood Glucose. What causes hyperglycemia? A number of things can cause hyperglycemia: If you have type 1, you may not have given yourself enough insulin. If you have type 2, your body may have enough insulin, but it is not as effective as it should be. You ate more than planned or exercised less than planned. You have stress from an illness, such as a cold or flu. You have other stress, such as family conflicts or school or dating problems. You may have experienced the dawn phenomenon a surge of hormones that the body produces daily around a. to a. What are the symptoms of hyperglycemia? The signs and symptoms include the following: High blood glucose High levels of glucose in the urine Frequent urination Increased thirst Part of managing your diabetes is checking your blood glucose often. How do I treat hyperglycemia? What if it goes untreated? Ketoacidosis is life-threatening and needs immediate treatment. Symptoms include: Shortness of breath Breath that smells fruity Nausea and vomiting Very dry mouth Talk to your doctor about how to handle this condition. Medical IDs Many people with diabetes, particularly those who use insulin, should have a medical ID with them at all times. How do sugary drinks lead to this increased risk? Weight gain may explain the link. What to drink in place of the sugary stuff? Water is an excellent choice. A long-term analysis on data from 40, men in the Health Professionals Follow-up Study found that drinking one ounce serving of diet soda a day did not appear to increase diabetes risk. The types of fats in your diet can also affect the development of diabetes. Healthful fats, such as the polyunsaturated fats found in liquid vegetable oils, nuts, and seeds can help ward off type 2 diabetes. The evidence is growing stronger that eating red meat beef, pork, lamb and processed red meat bacon, hot dogs, deli meats increases the risk of diabetes, even among people who consume only small amounts. The researchers looked at data from roughly , people, about 28, of whom developed diabetes during the course of the study. Not surprisingly, the greatest risk reductions came from ditching processed red meat. How meat is cooked may matter too. Why do these types of meat appear to boost diabetes risk? The high levels of sodium and nitrites preservatives in processed red meats may also be to blame. Furthermore, a related body of research has suggested that plant-based dietary patterns may help lower type 2 diabetes risk, and more specifically, those who adhere to predominantly healthy plant-based diets may have a lower risk of developing type 2 diabetes than those who follow these diets with lower adherence:. Add type 2 diabetes to the long list of health problems linked with smoking. Evidence has consistently linked moderate alcohol consumption with reduced risk of heart disease. The same may be true for type 2 diabetes. Moderate amounts of alcohol—up to a drink a day for women, up to two drinks a day for men—increases the efficiency of insulin at getting glucose inside cells. And some studies indicate that moderate alcohol consumption decreases the risk of type 2 diabetes. If you already drink alcohol, the key is to keep your consumption in the moderate range, as higher amounts of alcohol could increase diabetes risk. Type 2 diabetes is largely preventable by taking several simple steps: keeping weight under control, exercising more, eating a healthy diet, and not smoking. Yet it is clear that the burden of behavior change cannot fall entirely on individuals. Families, schools, worksites, healthcare providers, communities, media, the food industry, and government must work together to make healthy choices easy choices. For links to evidence-based guidelines, research reports, and other resources for action, visit our diabetes prevention toolkit. The contents of this website are for educational purposes and are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The Nutrition Source does not recommend or endorse any products. Skip to content The Nutrition Source. The Nutrition Source Menu. Search for:. Home Nutrition News What Should I Eat? What if I already have diabetes? Guidelines for preventing or lowering your risk of developing type 2 diabetes are also appropriate if you currently have a diabetes diagnosis. Achieving a healthy weight, eating a balanced carbohydrate-controlled diet, and getting regular exercise all help to improve blood glucose control. If you are taking insulin medication, you may need more or less carbohydrate at a meal or snack to ensure a healthy blood glucose range. There may also be special dietary needs for exercise, such as bringing a snack so that your blood glucose does not drop too low. For specific guidance on scenarios such as these, refer to your diabetes care team who are the best resources for managing your type of diabetes. Choose whole grains and whole grain products over refined grains and other highly processed carbohydrates. Skip the sugary drinks, and choose water, coffee, or tea instead. Choose healthy fats. Limit red meat and avoid processed meat; choose nuts, beans, whole grains, poultry, or fish instead. The researchers also found that the association was strengthened for those who ate healthful plant-based diets [41]. References Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, Solomon CG, Willett WC. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. New England journal of medicine. Rana JS, Li TY, Manson JE, Hu FB. Adiposity compared with physical inactivity and risk of type 2 diabetes in women. Diabetes care. Tanasescu M, Leitzmann MF, Rimm EB, Hu FB. Physical activity in relation to cardiovascular disease and total mortality among men with type 2 diabetes. Hu FB, Sigal RJ, Rich-Edwards JW, Colditz GA, Solomon CG, Willett WC, Speizer FE, Manson JE. Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. Krishnan S, Rosenberg L, Palmer JR. American journal of epidemiology. Grøntved A, Hu FB. Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a meta-analysis. AlEssa H, Bupathiraju S, Malik V, Wedick N, Campos H, Rosner B, Willett W, Hu FB. Carbohydrate quality measured using multiple quality metrics is negatively associated with type 2 diabetes. de Munter JS, Hu FB, Spiegelman D, Franz M, van Dam RM. Whole grain, bran, and germ intake and risk of type 2 diabetes: a prospective cohort study and systematic review. PLoS medicine. Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. Villegas R, Liu S, Gao YT, Yang G, Li H, Zheng W, Shu XO. Prospective study of dietary carbohydrates, glycemic index, glycemic load, and incidence of type 2 diabetes mellitus in middle-aged Chinese women. Archives of internal medicine. Krishnan S, Rosenberg L, Singer M, Hu FB, Djoussé L, Cupples LA, Palmer JR. Glycemic index, glycemic load, and cereal fiber intake and risk of type 2 diabetes in US black women. Archives of Internal Medicine. Sun Q, Spiegelman D, van Dam RM, Holmes MD, Malik VS, Willett WC, Hu FB. White rice, brown rice, and risk of type 2 diabetes in US men and women. Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC, Hu FB. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. Malik VS, Popkin BM, Bray GA, Després JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Palmer JR, Boggs DA, Krishnan S, Hu FB, Singer M, Rosenberg L. Sugar-sweetened beverages and incidence of type 2 diabetes mellitus in African American women. Ludwig DS, Peterson KE, Gortmaker SL. |
Take Action | Am J Med ; Sulfonylureas remain a highly effective treatment for hyperglycemia, particularly when cost is a barrier. Although historically insulin has been used for type 2 diabetes only when inadequate glycemic management persists despite oral agents and lifestyle intervention, there are increasing data to support using insulin earlier and more aggressively in type 2 diabetes. If you have problems with blood sugar management, consider routinely checking your levels before and after exercising. html Accessed on July 18, Limited data suggest that dipeptidyl peptidase 4 DPP-4 inhibitors are effective and relatively safe in patients with chronic kidney disease. |
High blood sugar - self-care: MedlinePlus Medical Encyclopedia | In fact, poor sleeping habits and a lack of rest can affect blood sugar levels and insulin sensitivity, increasing the risk of developing type 2 diabetes. They can also increase appetite and promote weight gain 36 , 37 , Additionally, sleep deprivation raises levels of the hormone cortisol, which, as explained, plays an essential role in blood sugar management 29 , Adequate sleep is about both quantity and quality. The National Sleep Foundation recommends that adults get at least 7—8 hours of high quality sleep per night To improve the quality of your sleep , try to:. Good sleep helps maintain your blood sugar levels and promotes a healthy weight. On the other hand, poor sleep can disrupt critical metabolic hormones. High blood sugar levels and diabetes have been linked to micronutrient deficiencies. Some examples include deficiencies in the minerals chromium and magnesium Chromium is involved in carb and fat metabolism. It may potentiate the action of insulin, thus aiding blood sugar regulation 41 , 42 , 43 , Chromium-rich foods include:. However, the mechanisms behind this proposed connection are not entirely known, and studies report mixed findings. As such, more research is needed 41 , 45 , Magnesium has also been shown to benefit blood sugar levels. In fact, diets rich in magnesium are associated with a significantly reduced risk of diabetes In contrast, low magnesium levels may lead to insulin resistance and decreased glucose tolerance in people with diabetes 47 , 48 , Eating foods rich in chromium and magnesium can help prevent deficiencies and reduce the risk of blood sugar problems. However, the overall quality of evidence on these ingredients is low due to insufficient human studies or small sample sizes. Therefore, no conclusive recommendations can be made regarding their use Some of the foods touted to have anti-diabetes effects include 51 , 52 :. Finally, the Food and Drug Administration FDA does not regulate supplements in the same way that it regulates prescription medications. Some foods are believed to have blood-sugar-lowering effects. However, research is still inconclusive, and they may negatively interact with your diabetes medication. If you need help finding a primary care doctor, then check out our FindCare tool here. Maintaining a moderate weight promotes healthy blood sugar levels and reduces your risk of developing diabetes 2 , 26 , 27 , For example, if a person weighs pounds 91 kg and loses just 10—14 pounds 4. These are used as indicators of your blood sugar levels over the past 3 months 60 , Maintaining a moderate weight will support blood sugar management and decrease your risk of developing diabetes. Spreading your meals and snacks throughout the day may help you avoid both high and low blood sugar levels Snacking between meals may also reduce your risk of type 2 diabetes In fact, several studies suggest that having smaller, more frequent meals throughout the day could improve insulin sensitivity and lower blood sugar levels 62 , In addition, eating smaller meals and healthy snacks throughout the day may lower glycated hemoglobin HbA1c readings, indicating improvements in blood sugar levels over the previous 3 months Snacking between meals could keep your blood sugar levels from spiking or plummeting throughout the day. Probiotics are friendly bacteria that offer numerous health benefits, including improved blood sugar regulation 65 , 66 , 67 , Research shows that probiotic intake may lower fasting blood sugar, glycated hemoglobin HbA1c , and insulin resistance in people with type 2 diabetes 65 , 66 , 67 , Interestingly, studies have found that improvements in blood sugar levels are more significant in people who consume multiple species of probiotics and for at least 8 weeks 69 , Probiotic-rich foods include fermented foods, such as:. Insulin is a hormone that balances blood sugar in the body. These are defined as excessive thirst, urination, and appetite, respectively. Many of them include making lifestyle changes, like managing your weight, stress levels, and sleep quality, exercising, and staying hydrated. That said, some of the biggest improvements have to do with your dietary choices. Be sure to talk with your healthcare professional before making lifestyle changes or trying new supplements— especially if you have problems with blood sugar management or are taking medications. Read this article in Spanish. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. VIEW ALL HISTORY. Blood sugar spikes are when your blood sugar rises and then crashes after eating. This article explains 12 simple ways to avoid blood sugar spikes. Sugary sodas can cause cravings. Here's a guide on how to stop drinking soda. Managing diabetes isn't as simple as just eating right and exercising. Many factors impact our blood sugars, and we might not even know it. What foods help you decrease both your blood sugar and cholesterol? Our nutrition expert answers your question. Several methods can reduce high blood sugar levels at home. Here's how to lower blood glucose, when to go to the emergency room, and when to see a…. Diabetes is a chronic long-term condition. What is type 2 diabetes? What other types of diabetes are there? Type 1 diabetes seems to be caused by a problem with the immune system the system in your body that fights infection. Gestational diabetes is a type of diabetes that some people develop during pregnancy. Gestational diabetes increases the risk of health problems for you and your baby. For example, gestational diabetes can make it more likely that you or your baby will develop type 2 diabetes later in life. Learn more about gestational diabetes. Am I at Risk? Am I at risk for type 2 diabetes? Many things can put you at risk for type 2 diabetes. For example, you may be at risk if you: Have prediabetes Are older than 45 years Are overweight or have obesity Have a parent or sibling with type 2 diabetes Are African American, Alaska Native, Native American, Asian American, Hispanic or Latino, Native Hawaiian, or Pacific Islander Have high blood pressure or high LDL "bad" cholesterol Are physically active less than 3 times a week You're also at higher risk for type 2 diabetes if you: Have had gestational diabetes diabetes during pregnancy Have given birth to a baby who weighed more than 9 pounds Have polycystic ovary syndrome a health condition where the ovaries make more male hormones than normal Learn more about the risk factors for type 2 diabetes. What is prediabetes? Symptoms What are the symptoms of type 2 diabetes? Take Action. Take Action Talk to Your Doctor Talk to your doctor about your risk for type 2 diabetes. Ask your doctor or nurse how to prevent type 2 diabetes. Ask about diabetes prevention programs near you or online. If you're pregnant or planning to get pregnant, talk to your doctor or midwife about gestational diabetes. Find out if you need to get tested for diabetes. Cost and Insurance What about cost? Under the Affordable Care Act, insurance plans must cover: Diabetes screening for adults ages 35 to 70 years who are overweight or have obesity Diet counseling for adults at higher risk for chronic disease Depending on your insurance plan, you may be able to get these services at no cost to you. To learn more, check out these resources: Free preventive care covered by the Affordable Care Act How the Affordable Care Act protects you Understanding your health insurance and how to use it [PDF - KB]. Food and Physical Activity Eat healthy. Get active. Learn more about how to get active. Build a weekly physical activity plan. Try this simple walking program. Healthy Weight Aim for a healthy weight. Try following these tips: Set small, realistic goals — like walking for 10 minutes each day Keep a food and activity diary — write down what and how much you eat each day, as well as how many minutes of physical activity you get Eat smaller portions — and choose water instead of sugar-sweetened drinks Learn more about reaching a healthy weight. Know Your Numbers Get your blood pressure and cholesterol checked. Starting at age 18 years, get your blood pressure checked every 3 to 5 years. If you're older than 40 years or if you're at increased risk for high blood pressure, get your blood pressure checked once a year. You can also buy a blood pressure monitor to check your blood pressure at home. Learn more about getting your blood pressure checked. Quit Smoking If you smoke, take steps to quit. Take these steps to help you quit: Make a list of the reasons you want to quit Set a quit date and make a plan to deal with cravings urges to smoke Talk to your doctor about counseling and medicines that can help you quit Call QUIT-NOW or visit Smokefree. Share sensitive information only on official, secure websites. If you have diabetes, your blood sugar levels are too high. With type 2 diabetes , this happens because your body does not make enough insulin, or it does not use insulin well this is called insulin resistance. If you are at risk for type 2 diabetes, you might be able to prevent or delay developing it. Many Americans are at risk for type 2 diabetes. Your chances of getting it depend on a combination of risk factors such as your genes and lifestyle. The risk factors include:. If you are at risk for diabetes, you may be able to prevent or delay getting it. Most of the things that you need to do involve having a healthier lifestyle. So if you make these changes, you will get other health benefits as well. You may lower your risk of other diseases, and you will probably feel better and have more energy. The changes are:. The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health. How to Prevent Diabetes. What is type 2 diabetes? |
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