Living with diabetes can be a complex undertaking. It is a condition that challenges the emotional and physical well-being of those afflicted. Although diabetes can be overwhelming, it can be managed. With proper attention to the details that make up diabetes, the health complications associated with the disease can be avoided, and a better quality of life can be achieved (Johansson et al., 2015).
Diabetes is a condition involving the hormone insulin and blood glucose. When food is consumed, it is broken down into various components, including glucose, which is a sugar that provides energy to the cells in the body. The glucose enters the blood, and in response, the pancreas releases insulin. Insulin is a hormone that allows the cells to take up glucose, thereby lowering the blood glucose level. In a person with diabetes, this process does not function properly. There are two main types of diabetes. Type 1 diabetes occurs when the pancreas does not produce any insulin. This is usually diagnosed in childhood or early adulthood. Type 2 diabetes occurs when the pancreas does not produce enough insulin or the body develops insulin resistance.
Understanding Diabetes
Diabetes is a chronic health condition that affects how the body processes food and can lead to serious complications if left unmanaged. With an estimated 537 million adults living with diabetes globally, it is the 8th leading cause of death in Australia. There are three types of diabetes: Type 1, Type 2, and gestational diabetes. Type 1 diabetes occurs when the body’s immune system attacks and destroys the insulin-producing cells in the pancreas, resulting in little or no insulin production. It often develops in childhood or early adulthood, but can occur at any age. People with Type 1 diabetes require lifelong insulin therapy to survive (Anand and Jain, 2024). Type 2 diabetes, the most common form, occurs when the body develops insulin resistance, meaning the insulin produced can’t work effectively, or when the pancreas doesn’t produce enough insulin. Type 2 diabetes is often diagnosed in adulthood, although it is increasingly seen in young people. Gestational diabetes occurs during pregnancy when the body cannot produce enough insulin to meet the extra needs, and usually resolves after childbirth but can lead to the development of Type 2 diabetes later in life (C. Bondy et al., 2020).
Common causes or risk factors of diabetes include being physically inactive, overweight or obese, having a family history of diabetes, having gestational diabetes, or being of certain ethnicities. Common symptoms of diabetes include excessive thirst, needing to urinate often, extreme fatigue, blurred vision, cuts and graze that take longer to heal, and unexplained weight loss. It is important to speak to a healthcare professional if experiencing any of the above symptoms, as this can assist in early recognition of the condition. Understanding diabetes, its types, causes, and symptoms is important for effective management. It also provides the foundational groundwork for the practical strategies that follow later in the document. With this information, readers will be empowered to recognize potential symptoms in themselves and seek appropriate care.
Types of Diabetes
Diabetes mellitus, commonly referred to as diabetes, is a group of metabolic disorders characterized by chronic elevation in blood glucose levels, resulting from inadequate insulin production, impaired cellular response to extracellular insulin, and/or impaired glucose metabolism (Singh et al., 2024). Diabetes can take multiple different forms that can be broadly categorized into three major types: Type 1 diabetes (T1DM), Type 2 diabetes (T2DM), and gestational diabetes. The distinction between different types of diabetes is critical because different types of diabetes require different management strategies. T1DM is an autoimmune disorder whereby the body views its insulin-producing pancreatic beta (b) cells as a foreign threat, leading to insulin insufficiency. T2DM is a metabolic disorder that develops through a combination of lifestyle and genetic factors. Other than the characteristic high blood glucose levels, T2DM is defined by insulin resistance where cells do not respond appropriately to insulin, or relative insulin deficiency where the body does not produce enough insulin. Gestational diabetes mellitus (GDM) refers to diabetes that occurs during pregnancy. Although GDM typically resolves after delivery, it increases the risk of developing T2DM later in life. There are commonly held misconceptions about diabetes. For instance, while diabetes is often associated with increased sugar consumption or high body weight, T1DM is unrelated to such factors.
Causes and Symptoms
Diabetes occurs when the body is unable to effectively manage blood glucose (sugar) levels. There are several causes of diabetes, which can be considered in terms of genetic predisposition and lifestyle choices. Certain groups of people are more likely to get diabetes than others because of their ethnic background, family history, and age. However, these predispositions can be offset by the right environmental choices, such as exercise and diet. This means that an individual’s lifestyle plays a significant role in the risk of developing diabetes (Asif, 2014). On the other hand, some people are easily able to manage their blood glucose levels regardless of their genetic predisposition, and this is generally the result of health-promoting life choices (Pinchevsky et al., 2020).
Diabetes symptoms include excessive thirst, excessive hunger, frequent urination, extreme fatigue, blurry vision, cuts/bruises that are slow to heal, and tingling/numbness in the hands or feet. The most common symptoms of diabetes in children include excessive thirst, excessive hunger, frequent urination, weight loss, and fatigue. The symptoms of diabetes may not be obvious initially, and this is especially true for type 2 diabetes. This is one of the many reasons why it is important for people to be attentive and monitor their health. If they notice symptoms of diabetes as previously described, it is recommended they contact a healthcare professional. Recognizing the symptoms of diabetes early on makes it possible to intervene early on, thus preventing further complications. The goal is to educate the reader so they understand what points to monitor for, as well as provide a more thorough understanding of diabetes in general that may promote proactive health behaviors.
Daily Monitoring and Management
The most important part of living with diabetes is daily monitoring. At first, daily checks might seem daunting, but after a while, it becomes routine. The goal of daily health checks is to have blood glucose levels as close to “normal” as possible. This means maintaining a fasting level of 70-130 mg/dL and a post-meal level of less than 180 mg/dL (Bode et al., 2021). Maintaining blood glucose levels in this range can help reduce the risk of diabetes-related complications.
There are many tools for monitoring glucose and other health indicators. Continuous glucose monitors (CGMs) are a good option for people who want to reduce the number of finger pricks. This device, which is worn on a person’s body, measures glucose levels in the skin every few minutes. CGMs can be linked to phones and smartwatches and send alerts when levels are getting too high or low. CGMs work best for people who are getting a lot of highs and lows or those who have hypoglycemia unawareness. Another option is a continuous ketone monitor, which helps track the risk of diabetic ketoacidosis (DKA). These monitors take some time to get approved by insurance, but they can be very helpful for some people.
If a person decides that a CGM isn’t the best option, traditional blood tests can also provide good insight into glucose levels. A finger prick can give a reading in under a minute or a drop of blood sent to a lab can provide a reading of HbA1c, or average glucose levels over the past few months. HbA1c is the most common test for tracking glucose levels over time, and a goal of less than 7% is recommended. This means having an average glucose level of less than 154 mg/dL. Besides glucose, it is also important to regularly check other health indicators such as ketones. A good approach is to check health indicators daily or a few times a week but only do lab tests every few months. All health readings should be recorded in a consistent place to see trends over time and recognize when something is going wrong.
Monitoring might take 30 minutes a day at first, but it can be done in 10 minutes or less when it becomes routine. One easy way to integrate daily monitoring into a routine is to set reminders for the same time each day. It is recommended to do daily health checks in the morning before food or insulin to get a baseline reading. Setting reminders at the same time every day will help keep tracking health indicators a priority. After a time, it will become routine, and these daily checks can also be done at the same time as something else, such as brushing teeth or making coffee. Daily monitoring can be overwhelming at first, but it becomes second nature over time. As important as monitoring is, it is useless without taking the right medications. It is essential to adhere to all prescribed treatments. When a medication is taken can often be just as important as how much is taken; for example, some medications must be taken with food, while others must be taken on an empty stomach. Keeping medications in their original bottles makes it easier to check how they should be taken, and it is a good idea to get in the habit of taking medication at the same time every day.
It is crucial to understand what each medication does and why it is important for good diabetes control. It is a good idea to ask a doctor or pharmacist to explain the different medications a person is taking. Understanding this information makes it easier to stick to treatment and recognize if something is wrong with a medication. When possible, it is better to use one pharmacy for all medications because the same pharmacist will then oversee all prescriptions and be able to spot potential problems. Any time a medication is changed or stopped, it is best to ask a doctor to write this down in case there is confusion later. As a safety measure, all medications should be taken as prescribed, even if there are concerns. Always discuss concerns about medications with a doctor to find a better treatment plan. Living with diabetes can be overwhelming, but the more disciplined a person is with managing their health, the easier it will become over time. Daily monitoring and management are essential for staying healthy, but it will all become routine after a few months. Overall health will improve the more effort is put into management, and it is worth it.
Blood Glucose Testing
Blood glucose testing can be done in several different ways. The most common way is to use a small meter to test a drop of blood taken from your finger. Many people with diabetes have a meter at home. This is sometimes called self-monitoring of blood glucose (SMBG) or capillary blood glucose testing. Your health care provider may also test your blood with a lab-based analyzer. This is sometimes called central laboratory blood glucose testing. Results from these tests may be used to assess your diabetes management at A1C intervals. Another option for blood glucose testing involves wearing a small sensor that continuously measures blood glucose levels. This is sometimes called continuous glucose monitoring (CGM) and can be used for “real-time” blood glucose monitoring (Sly and Taylor, 2023). A CGM system may be used alone or with an insulin pump to automatically deliver insulin based on your blood glucose levels.
People with diabetes should regularly test blood glucose. Regular testing will help you learn how food, activities, and medicines affect your blood sugar levels (Adams, 2015). In general, blood glucose should be tested before meals and at bedtime. When first learning how to control blood glucose, it may be necessary to check levels more often such as two hours after meals or whenever symptoms of high or low blood glucose occur. Work with a doctor or diabetes educator to create a testing schedule. Record all test results in a logbook. This will help to see patterns in blood glucose levels. This data can help to make better decisions about what to eat, how much to exercise, and whether diabetes medicines need to be increased or decreased.
Testing regularly can be tough at times. Here are some tips for how to test blood glucose during certain situations: 1. Make a travel kit to keep testing supplies organized when travelling. Be sure to bring an extra test meter just in case the primary one is lost or broken. 2. Try to test before exercise, especially if insulin has been taken or food is not eaten. Testing before exercise can prevent blood glucose levels from going too low. 3. Be sure to test blood glucose before driving. Low blood glucose levels can affect concentration and reaction time, making driving dangerous.
Medication Management
Medication management is a critical aspect of living with diabetes. There are various medications available to treat diabetes, including insulin and oral hypoglycemics. Each medication has a different impact on blood sugar levels and understanding when and how to take these medications is crucial to their effectiveness. It is important to follow the healthcare provider’s guidance on how much medication to take and when, and to ask about any concerns (Anne Hanson, 2010). Dosage may need to be adjusted for certain events, such as illness or missed meals. Medication can assist in managing diabetes, but it is not a cure and healthy lifestyle choices should still be maintained.
All medications have the potential for side effects, and it is important to be aware of these. Side effects should be discussed with a healthcare provider; it may be possible to try a different medication with fewer side effects (García-Pérez et al., 2013). It is also important to know what to monitor when taking medications, such as blood sugar levels. If experiencing problems with medications, it is essential to discuss these concerns with a healthcare professional. They may be able to make adjustments to therapy or offer alternatives to help avoid complications and side effects. Always read the information that comes with prescribed medications; it contains very important information about the medication.
Understanding drug interactions is a vital component of medication management. This includes being aware of and avoiding potential interactions with over-the-counter drugs, herbal medicines, or supplements. Extra care should also be taken to limit the potential for drug interactions while hospitalized. This section aims to equip readers with the tools to handle their medications responsibly and avoid common pitfalls. On the next page is a list of important questions to consider when taking any medication.
Healthy Lifestyle Choices
Healthy lifestyle choices can be powerful allies in managing diabetes. While daily diabetes management is vital, focusing on healthier living habits can also bring remarkable enhancements. Small adjustments can accumulate into life-altering transformations, so take things one step at a time. Healthy choices encompass nutrition, exercise, weight control, and other factors that nurture the body and spirit. Nutrition is at the core of a healthy lifestyle. Customized meal planning helps maintain proper blood sugar levels, making great strides toward better overall health and diabetes management. Nutritious food choices do not have to be tasteless or boring, but every effort counts. When embarking on this path, consider the following tips (C Weller and N Vickers, 2021):
• **Portion control**: Sometimes, the greatest challenge is not what to eat but rather how much. The importance of portion size cannot be stressed enough. Food can be categorized as “good” or “bad,” but overindulging is never wise, even with the healthiest foods. Eating three balanced meals daily prevents excessive hunger and provides the proper energy boost throughout the day. During the first few weeks of adjusting to healthier portions, it may be beneficial to measure food with measuring cups or a scale. Preparing single-serving meals can also control portion sizes. Dividing up food in advance prevents mindless munching straight from large packages. Generally, keep in mind that when adding or taking away portions, being mindful of the size of bowls, plates, and serving utensils can help too. Large dishes can make reasonable portions appear minuscule, while smaller dishes can give the illusion of an overflowing plate with just a little extra. In contrast, good choices may be dressed as excess and can introduce unhealthy habits.
Exercise is the second strongest recommendation for controlling diabetes. Regular physical activity improves overall health while actively improving diabetes. While it may not always be easy to fit exercise into a busy schedule, it is worth it for numerous reasons. Exercise enhances mood and energy levels, helps maintain a healthy weight, improves circulation and insulin sensitivity, lowers cholesterol and blood pressure, helps the body deal with stress, and encourages better sleep. The following strategies may be useful for incorporating regular exercise into the daily routine:
• Start small: Start with just 10–15 minutes of any aerobic activity. Walk, jog, swim, jump rope, dance, or use an exercise bike. Gradually increase the time, aiming for 30–60 minutes most days of the week.
• Schedule exercise: Treat exercise as a necessary appointment. Account for it in each week’s schedule and try to stick to it by finding a reliable time for exercise, whether it’s early mornings or evenings.
• Work out with a buddy: Find someone with similar goals. Partnering up can bring accountability and encouragement as motivation may ebb and flow for both people alike.
• Track progress: Documenting progress can be incredibly motivating. Keeping a daily log of what has been accomplished can bring satisfaction and excitement about the future. Consider trying new activities or adding variety to the workout to maintain enthusiasm, such as hiking, kickboxing, or a fun group class.
In short, while diabetes may seem overwhelming at first, lifestyle modifications can lead to significant improvements. An approach is to reassess or simply monitor daily habits. Consider the following questions: What does a normal day look like? How much sleep do you get? What do you eat for breakfast, lunch, dinner, and snacks? What is the daily exercise routine? As subtle adjustments are made in daily routines, the benefits, both physically and mentally, will help propel the effort forward. Simple strategies can prove beneficial for jumpstarting the daily routine. For instance, set daily or weekly goals, such as putting vegetables in every meal, drinking a glass of water before each snack, or preparing for at least 15 minutes three days a week.
Nutrition and Meal Planning
Good nutrition is essential for good health, but it has added importance when living with diabetes. A balanced diet can help regulate blood sugar levels and support overall health. Meal planning ahead of time can make healthy choices easier. Plan to have meals and snacks at similar times each day. This can help keep glucose levels more stable. It is important to consider what is eaten at these meals and snacks, as well as how much. When possible, select foods that are nutrient dense and not overly processed. Foods with fiber, healthy fats, and a good source of protein are good choices. These foods can help keep someone feeling full longer, reducing the chances of overeating (Dyson et al., 2018).
Fruits, vegetables, whole grains, nuts, seeds, healthy oils, eggs, fish, poultry, and lean meats are good sources of nutrients. Whenever possible, cook meals from whole food ingredients rather than opting for pre-packaged or fast-food options. In general, it is best to limit processed foods. If they are consumed, look for options with fewer ingredients and avoid added sugars, high sodium levels, and unhealthy fats. Pay attention to meal portions and try to eat similar portion sizes from day to day (Opoku-Addai et al., 2022). Planning meals in advance is a great way to support healthy eating. Plan to try something new each week, such as: Exploring different dietary plans; Planning meals for each day of the week; Preparing a grocery list based on planned meals; and Cooking multiple portions of meals ahead of time to freeze and eat later. In addition to food choices, it is also important to consider when food is eaten. Try to avoid skipping meals, as this can make it more difficult to keep blood sugar levels stable. Also, be mindful when consuming carbohydrates, as they have a direct impact on glucose levels. Be aware that some foods can have hidden carbohydrates and consider trying lower carbohydrate versions of recipes. Staying hydrated is also essential, so drink plenty of water each day.
Physical Activity
Regular physical activity is one of the most effective ways to enhance insulin sensitivity and blood sugar control. Exercise is a key factor in effective diabetes management. It can help with blood sugar regulation, weight control, and heart health, while also reducing diabetes complications and enhancing mood and mental well-being (R. Colberg, 2017). People with diabetes can derive benefits from all forms of exercise, including aerobic activities such as walking or dancing, sports such as tennis or swimming, and strength training with weights or resistance bands. The goal is to find physical activities that are enjoyable, making it easier to incorporate exercise into a daily routine (Adams, 2015).
Exercise should ultimately be an ongoing part of everyday life. For most people, a good target is at least 150 minutes a week of moderate-intensity aerobic activity, spread over three days per week or more. Three sessions per week of strength training targeting all major muscle groups are also recommended unless health problems prevent it. Before starting a new exercise program, especially if there are complications or other health problems, it is necessary to consult with healthcare providers about assessing fitness level and setting appropriate exercise goals. But being active can usually be added to even the busiest schedule. Take the stairs instead of the elevator; go for a walk during lunch; get off the bus early and walk the rest of the way; park farther away from the destination; and find ways to incorporate more movement into the day.
Emotional Well-being and Support
The physical element of diabetes takes center stage, as living with diabetes necessitates daily management of blood glucose levels, food choices, exercise, and medication. However, one of the most overlooked yet vital elements, particularly in the initial years after diagnosis, is emotional well-being. It is crucial to recognize that living with a chronic condition can be stressful in itself. Alongside the physical regime, there is immense pressure to be “perfect,” leading to anxiety and guilt if something goes wrong. Exploring and acknowledging the emotional impact of chronic conditions such as diabetes can help understand oneself better, in turn assisting in daily management (R. Sridhar, 2020).
The most significant piece of advice is to seek support. Family and friends often want to help but may not know how, especially if they have no experience with diabetes. Communicating needs to loved ones can help address fears, questions, and individual approaches to living with diabetes, fostering mutual understanding. Support from healthcare professionals can also provide guidance on what to ask or discuss with family and friends. Building a strong support network and fostering supportive relationships ultimately helps feel less alone while navigating the ups and downs of diabetes (Hadjiconstantinou et al., 2020).
Living with diabetes can be challenging, but it is certainly manageable. After sharing personal experiences with diabetes, it’s crucial to share strategies that have helped cope with the disease. Consider implementing some of these strategies, which may provide comfort and support. It’s not easy living with diabetes, but developing effective coping skills can help feel in control and confident in managing the disease.
There are many resources available for further education and support in diabetes management. The book “Think Like a Pancreas” is highly recommended for those using insulin, as it covers the basics and delves into more advanced topics. Joining a local support group or an online community can provide comfort in knowing that others share similar struggles and triumphs.
It’s essential to understand that diabetes is not a single diagnosis but a spectrum of conditions, and self-management is not a one-time fix but an ongoing journey. New challenges will arise as life circumstances change, and it may take some time to adjust to changes in routine. However, self-management can become second nature with time, planning, and education. Embrace the journey and take proactive steps towards better health. Living with diabetes may entail extra worries, calculations, and planning, but it should not inhibit living life fully. It’s important to remember that there is hope and empowerment in living with diabetes, and it is possible to embrace health journeys confidently.
Diabetes self-management is complex and may be described by four constituents: adjusting treatment to lifestyle, lifestyle changes, illness comprehension, and the disease’s emotional impact. Diabetes self-management education can take many different forms and be formal or informal, but often entails teaching people how to live with their diabetes (Gale Jones, 2014). Understanding diabetes, its treatment, and how to interact with healthcare providers and the healthcare system is important to avoid complications and hospitalizations. Nonetheless, living with diabetes entails more than professional health education; it also involves family, friends, and other informal educators who contribute to shaping life with diabetes.