People diagnosed with type 2 diabetes must confront the troubling reality that they face a greater likelihood of heart disease, stroke, kidney failure, and other serious ills down the road. Why? Since their bodies can't properly use insulin—a hormone that controls blood glucose levels—glucose (sugar) that should be ushered into cells for energy instead builds up in the blood, wreaking havoc if left unchecked. A diagnosis, however, is the first step toward getting blood sugar levels back under control. With other steps including exercise and regular checkups, diabetes complications can be avoided. U.S. News asked the experts what they advise all type 2 diabetics do.
Confirm the diagnosis. Even if a first test says you're diabetic, a second is advised before deeming the diagnosis official. The initial results may be unreliable if, say, the lab made a mistake or if you accidentally ate or drank before being tested, says endocrinologist John Buse, past president of medicine and science at the American Diabetes Association. Patients aren't supposed to eat or drink before undergoing the fasting plasma glucose and oral glucose tolerance tests. The hemoglobin A1c test, however, which measures average blood glucose levels over three months, can provide an accurate diagnosis even if given soon after a meal or if you have a cold or other infection, which can throw off the results of those other tests. (Despite its strengths, the A1c should still be done twice.) People whose A1c is at least 6.5 are considered diabetic and are often put on medications to lower blood sugar.
Assemble your team. Regular visits with your primary-care physician are key. He or she will focus on helping you reach your target blood pressure, cholesterol, and blood sugar levels, and can refer you to other helpful healthcare providers such as a diabetes educator or dietitian. Dietitians can help you devise a diabetes-friendly meal plan that will still suit your taste buds; diabetes educators make certain you know the ins and outs of your disease, including how to check your blood sugar at home, for example. Gretchen Youssef, an educator and dietitian at Washington Hospital Center in D.C., says that personalized diabetes education soon after diagnosis can dramatically improve blood sugar levels.
Start on medication. Metformin, a generic drug, is generally recommended as a first-line treatment for type 2 diabetes. The reason, says Buse, is that people who try to manage the disease with lifestyle changes alone are not always successful, while metformin, which has little risk of side effects, can help get blood glucose down to healthy levels. If your blood sugar still doesn't budge, however, your doctor may prescribe a different diabetes drug. In addition, says Buse, diabetics over age 40 should talk to their doctor about taking a cholesterol-lowering statin to protect against heart disease, the No. 1 killer of people with diabetes. The ADA also advises that most men older than 50 and women over age 60 take 75 to 162 milligrams of aspirin every day to prevent heart attacks.
Get on a meal plan. Diabetics are often encouraged to tweak their diet to consume fewer carbohydrates and fats, since carbs can cause blood sugar spikes, while fatty foods can raise cholesterol. That doesn't mean you have to give up all your favorites, however. Trimming portion sizes, cutting out saturated and trans fats, and substituting soda or sweet tea for unsweetened, lower-calorie beverages may do the trick. A food diary may also help by revealing which foods have the biggest effect on blood sugar.
Exercise. Regular physical activity not only helps to shed pounds but can also improve blood sugar levels. Diabetics should spend at least 30 minutes, five days a week doing moderate exercise such as walking or swimming. But if you're the type who'd rather watch football on TV than toss one in the backyard, realize that exercise doesn't have to be a production. It can be incorporated into your daily routine, says Buse. Hang laundry instead of using the dryer; take the stairs instead of the elevator; park farther away from the supermarket entrance.
Updated on 11/22/10: This article is based on a story originally written by Michelle Andrews in 2008.