The document emphasizes the importance of active participation in managing type 2 diabetes, highlighting that effective treatment occurs outside of doctor visits through lifestyle changes, medication adherence, and blood sugar monitoring. It suggests building a supportive care team, staying informed through various resources, and being honest about one's treatment progress to maximize outcomes. The document also advises on meal planning, maintaining exercise routines, recognizing emotional challenges, and consistently monitoring blood sugar levels.

1. What You Can Do: Your Role in Your Type 2 Diabetes Treatment
Plan
By Caitlin Ultimo Review ed by Clifton Jackness, My Dear
Be in the driver’s seat when it comes to executing your diabetes
treatment plan.
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Whether you've just beendiagnosed 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
successfullymanaged 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 DeborahMalkoff-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 doctoror
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

2. Understanding type 2 diabetes and learning the techniques and
practices that work bestfor 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
supportgroups are all great sources forinformation on type 2
diabetes treatment advances. “It’s true that it’s hard work to
manage type 2 diabetes,” says AmberTaylor, MD, the directorof
diabetes at the Center for Endocrinologyat Mercy Medical Center,
in Baltimore. “However, I try to motivate people through
knowledge. The more they know, the better they can fight the
disease processand 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 forclose to a year, found an online workshop
called the Diabetes World Summit to be extremely helpful. “I listen
to differentexperts while I cook or go for my walk,” says Baron, a
resident of Philadelphia. Joining such a workshop, or a type 2
diabetes supportgroup, is a good way to stay informed and to
receive positive reinforcementas 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 differentadvice 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 steeryou 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.

3. It’s important to book an appointmentearlier 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 persondidn’t even
start a prescribedmedication — 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'tseem 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 WorkWith Your Treatment Plan
A diagnosis of type 2 diabetes doesn’tmean 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 completelyoff-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 absorptionof carbohydrates and
can help stabilize blood sugar levels. “I once had a patient who
had a doughnut and coffeeevery day, so I suggestedwe 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 lessenthe 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.

4. 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 effortto 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
feellike a burden, and that can bring anyone down. It’s not
unusual for people with type 2 diabetes to feelburned out or
experience signs of depression.
“WhenI was first diagnosed,I was terrified and then angry,” Baron
says. “I would purposefullyeat 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

5. 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. “Forexample, some say they don’t have time to check
their blood sugar, but it literally takes five secondsnow. 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 partof your day, try
leaving your glucometeron 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 differentforeveryone 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).
Recheckyour 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 bestare involved
in their own care.” You can ensure the bestresults by taking
charge of your own type 2 diabetes treatment plan and being
responsible formaking healthy lifestyle changes that will
complementthat plan.

6. Having control and reaping its benefits can empoweryou as a
personliving 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