How Diabetes is Managed
Managing your diabetes

Once your diabetes has been diagnosed you will work as a team with your health care provider and nurses and, if one is available, a dietitian.

The goal of managing your diabetes is to keep your blood sugars close to the blood sugar levels of people who do not have diabetes. The more normal your blood sugar, the less likely you will be to develop the complications of diabetes.

Management is a balance. The key factors are diet, physical activity and, if necessary, medication.

Ways to manage your diabetes

The goal of diabetes management is to keep your blood sugar and hemoglobin A1c in the recommended ranges.

You do this through:

  • Diet
  • Physical activity
  • Medications, if necessary

Managing your diabetes

  • Most diabetes can be managed if you can to keep your daily blood sugar levels within the following ranges:
    • Fasting blood sugar at 80-110 mg/dl
    • After meals at 180 mg/dl or less
    • Bedtime at 100-140 mg/dl

  • Different factors will affect your blood sugar:
    • Diet (and weight)
    • Physical activity
    • Stress
    • Illness

Click to read a Storyteller talk about - WEIGHT LOSS AND LOW SUGAR

DIET

Why is diet important?

  • Our diets must give us the needed nutrition to keep all of our tissues strong and healthy.
  • We must maintain a balance of food groups to have:
    • healthy weight.
    • normal blood sugar.
    • normal cholesterol.

What is a healthy diet?

Eating well requires:

  • Choosing healthy foods-
    • lean meats.
    • lots of fruits and vegetables - raw and cooked.
    • boiled beans are healthy!
    • whole grains and nuts.
    • whole wheat breads and noodles.
    • unsalted nuts.
    • low fat dairy products - milk, cottage cheese, yogurt, low-fat sour cream.
    • (if you are lactose-intolerant - can't use milk products - you can use lactose-free foods and drinks, use soy milk, use tablets like Lact-aid to remove the milk sugar)

    To get a good idea of what foods you should be eating go to www.mypyramid.gov and click on the 'my pyramid' on the right side. Fill in your age, sex, height, weight and activity level to see how many of each food group you should be eating every day.

  • Using healthy cooking methods
    • boil - beans.
    • steam- other vegetables.
    • bake - vegetables and meats.
    • broil - meats when possible.

    These cooking methods keep most of the natural nutrition in the food without adding fats.

  • Choosing healthy portion sizes
    • about 4 ounces (roughly the size of a deck of cards)
      This is a normal portion of meat, vegetables or grains. If you can eat 1-2 portions of different fruits and vegetables and at least one grain each meal, that's good nutrition.

    Eliminating unhealthy foods, for example:

    • potato chips
    • sugared drinks (soda pop)

    Two cans of soda pop per day (300 calories, nearly 3 ounces of sugar) can cause one pound of weight gain every two weeks with NO nutritional benefit from the pop.

Healthy Diets: Traditional Native American Foods
  • The traditional diets used by our tribal ancestors have been found to be healthy and do not contribute to high blood sugar.
  • Returning to a Native American diet would be ideal, but many of the foods or food sources are not available and/or are too expensive.
  • "(insert a slide showing examples of some traditional food)"

Why is the traditional diet healthy?
  • Wild game meat eaten by the ancestors was low in fat.
  • Food preparation did not include frying or adding sugar.
  • Foods gathered like roots or berries were high in fiber and low in sugar.
  • There was no refined sugar or white flour.
  • Even cooking or gathering berries and nuts required physical exercise.
The food exchange
  • Because persons with diabetes often are taught how to exchange certain foods for another, this has become known as a special diabetes diet or exchange diet.
    • But there is no special diabetes diet. The diet recommended is one that is healthy.
  • Food exchanges can help you balance healthy combinations of carbohydrates (simple and complex), protein, and fats.
  • If you are interested in using food exchanges to help balance your diet, go to this website: www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/fd_exch.htm
Diabetes and alcohol
  • If your blood sugar is well-controlled and if you take proper precaution, it is possible to have alcohol once in a while.
  • No more than one drink per day for women.
  • No more than two drinks per day for men.
    • One drink is:
      • 12 ounces of regular beer (150 calories)
      • 5 ounces of wine (100 calories)
      • 1.5 ounces of 80-proof distilled spirits (100 calories)
Precautions when drinking alcohol
  • Always eat something when you drink.
  • Check the alcohol level of your drink.
    • Account for any extra sugars added to the drink like fruit juices, soda pop or mixes.
Watch out for
  • signs of hypoglycemia (low blood sugar).
  • confusion, rapid heart beat, cold sweats.
Check your blood sugar if you are having these symptoms. If your sugar is low (below 100), treat it by taking glucose tablets or a snack high in sugar.

Another alcohol precaution

  • Before you go to bed after having a drink, eat a snack.
  • Your blood sugar level can drop in the middle of the night.
    • To prevent this, you may want to set your alarm clock to wake you up so you can test your blood glucose and eat a snack if necessary
Why does this happen?
  • When you drink alcohol, your liver stops making glucose while it removes the alcohol from your blood.
  • And it takes the body about 2 hours to remove one ounce of alcohol from your body.
  • This is enough time for your sugar to drop to low levels.

BEING ACTIVE

Exercise is important because it:

  • Helps lower blood sugar (glucose).
  • Reduces blood pressure.
  • Lowers blood fats (lipids) - cholesterol and triglycerides.
  • Assists in weight loss.
  • Reduces stress.
  • Strengthens bones
  • Helps body use insulin more efficiently (your natural insulin and injected insulin).
  • Helps prevent or delay diabetes complications.
Manage your diabetes well!
  • Choose nutritious foods.
  • Maintain a healthy weight.
  • Be physically active
  • Keep your sugars under control



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