Diabetes

• Frequent urination
• Excessive thirst
• Sudden loss of weight
• Increased hunger
• Blurry eyesight
• Bedwetting
• Lack of energy or fatigue
• Delayed healing of cuts and other injuries
• Dry skin
• Fungal infections

Type 1 diabetes

Type 1 diabetes is caused by an autoimmune reaction in which the immune system attacks the insulin-producing beta cells of the pancreas, leading to their destruction. As a result, there is very little or no insulin production, which affects blood glucose control.

Although the exact cause of this process is not fully understood, it is believed that genetic and environmental factors, such as viral infections, toxins, or dietary influences, play a role. This type of diabetes occurs most commonly in children and young adults.

Type 2 diabetes

Type 2 diabetes is caused by the body's inability to respond properly to insulin, resulting in insulin resistance. This makes the hormone insulin ineffective, prompting the body to produce more insulin. Consequently, the pancreas fails to meet the body's increasing demand for insulin, leading to inadequate insulin production and high blood glucose levels.

Most cases of type 2 diabetes progress through a stage known as prediabetes, where the cells do not respond normally to insulin.

Other types of diabetes

Apart from Type 1 and Type 2 diabetes, there are other forms of diabetes to be aware of:

• Prediabetes: As the name suggests, prediabetes is a condition where blood glucose levels are higher than normal but not high enough to be classified as diabetes. If left untreated, it can develop into type 2 diabetes and related complications. This condition is also known as 'non-diabetic hyperglycaemia' or 'intermediate hyperglycaemia.' There are typically no clear symptoms of prediabetes, so individuals may have it without knowing. However, early treatment with lifestyle modifications can help maintain blood glucose levels within the normal range.
• Gestational diabetes: Gestational diabetes mellitus (GDM) is defined as diabetes diagnosed during pregnancy and affects a significant proportion of pregnant women worldwide. Women usually develop gestational diabetes between the second and third trimesters. The risk of developing this condition in future pregnancies may also be higher. GDM increases the risk of brain and spinal cord anomalies, obesity, and glucose intolerance (diabetes) in the child. Due to the significant repercussions for both mother and baby, it is crucial for every pregnant woman to be aware of GDM.
• Monogenic diabetes: Monogenic diabetes results from a single gene rather than the contributions of multiple genes and environmental factors, as seen in type 1 and type 2 diabetes. It is much less common, representing 1.5–2% of all cases, and is often misdiagnosed as either type 1 or type 2 diabetes. Monogenic forms present a broad spectrum, including neonatal diabetes mellitus (or 'monogenic diabetes of infancy'), maturity onset diabetes of the young (MODY), and rare diabetes-associated syndromic diseases.

Note: Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are intermediate conditions in the transition between normality and diabetes. Individuals with IGT or IFG are at high risk of progressing to type 2 diabetes, although this is not inevitable.

Depending upon the type, there are several risk factors for diabetes. These include:

Type 1 diabetes

Although there are not many risk factors for type 1 diabetes, some known factors that increase the risk include:

• Presence of certain types of genes
• Environmental triggers or a virus, which can initiate an autoimmune reaction
• Presence of autoantibodies that mistakenly attack the body’s tissues or organs
• Geographic location, as certain countries, such as Finland and Sweden, have higher rates of type 1 diabetes
• Family history of diabetes

Type 2 diabetes

Type 2 diabetes is common in adults, but it is also increasingly seen in older children due to rising childhood obesity. Factors that increase the risk of type 2 diabetes include:

• Being overweight or obese
• Being a smoker
• Family history of diabetes
• Family history of high cholesterol, hypertension, or cardiovascular disease
• Having a sedentary lifestyle
• Suffering from polycystic ovarian syndrome (PCOS)
• Suffering from prediabetes
• Being pregnant
• Recurrent wounds or ulcers that fail to heal
• Stress
• History of diabetes in pregnancy
• History of impaired glucose tolerance

Gestational diabetes

According to the IDF, women with prior gestational diabetes mellitus (GDM) are at a 7.4-fold risk of developing type 2 diabetes compared to women with normal blood glucose levels during pregnancy. This risk is higher 3 to 6 years post-delivery. Factors that increase the risk of gestational diabetes include:

• BMI (Body Mass Index) exceeding 30
• Excessive weight gain during pregnancy
• Family history of diabetes
• History of giving birth to a baby weighing 4.5 kg or more
• Expecting more than one baby (twins/triplets)
• Family history of hypertension
• History of miscarriages or stillbirth
• History of conditions related to insulin resistance or polycystic ovarian syndrome (PCOS)
• History of habitual smoking
• Giving birth to a child with congenital abnormalities

The common lab tests include blood tests and urine tests. Blood tests are:

1. Random blood sugar test

The random blood glucose test measures the levels of glucose circulating in the blood. This test is done to diagnose diabetes and can be taken at any time of the day without fasting. However, other tests are required to confirm the diagnosis. It is performed as part of a routine preventive health check-up or if you have symptoms of high blood glucose (hyperglycemia).

According to the American Diabetes Association guidelines for diabetes testing, the values for random blood glucose test are as follows:

• Normal: Less than 140 mg/dl
• Prediabetes: Between 140 and 200 mg/dl
• Diabetes: Greater than or equal to 200 mg/dl
• Pregnant women: Greater than or equal to 200 mg/dl
2. Fasting plasma glucose test (FPGT)

The fasting blood glucose test is a common test prescribed for diabetes. It measures glucose levels in the blood after fasting (empty stomach). Ideally, you should not eat or drink anything except water for 8-12 hours before the test. It is the simplest and fastest test to diagnose and monitor diabetes.

According to the American Diabetes Association guidelines for diabetes testing, the values for FPGT are as follows:

• Normal: Less than 100 mg/dl
• Prediabetes: Between 100 mg/dl to 125 mg/dl
• Diabetes: Greater than or equal to 126 mg/dl
• Pregnant women: Between 90-140 mg/dl
3. Postprandial blood glucose (PPBG) test

This test measures glucose levels in the blood 2 hours after the last meal. It is usually recommended to screen for prediabetes and diabetes types 1 and 2 and to monitor treatment efficacy. The test is generally recommended when blood glucose levels fall between 140 and 200 mg/dl.

According to the American Diabetes Association guidelines for diabetes testing, the values for PPBG are as follows:

• Normal: Less than 140 mg/dl
• Impaired glucose tolerance (prediabetes): Between 140 and 200 mg/dl
• Diabetes: Greater than or equal to 200 mg/dl
4. Hemoglobin A1c (HbA1c) test

This blood test measures a person’s average blood glucose level over the past 2 to 3 months. It is ideally used to assess how well diabetes is managed with medication. If fasting and postprandial levels are high, HbA1c is advised to confirm the diagnosis.

According to the American Diabetes Association guidelines for diabetes testing, the values for HbA1c are as follows:

• Normal: Less than 5.7%
• Prediabetes: Between 5.7% to 6.4%
• Diabetes: Greater than or equal to 6.5%
• Pregnant women: Between 6% to 6.5%
5. Oral glucose tolerance test (OGTT)

This test checks blood glucose levels before and 2 hours after consuming a sweet drink (usually a glucose solution). It helps determine how well your body processes glucose, aiding in the diagnosis of diabetes.

According to the American Diabetes Association guidelines for diabetes testing, the values for OGTT are as follows:

• Normal: Less than 140 mg/dl
• Prediabetes: Between 140 mg/dl to 199 mg/dl
• Diabetes: Greater than or equal to 200 mg/dl
• Pregnant women: Greater than or equal to 200 mg/dl
6. Other tests

If diagnosed with diabetes, you may need to undergo several health tests periodically. These include:

1. Blood pressure

According to the American Heart Association, your blood pressure should be less than 120/80 mmHg. Keeping blood pressure under control reduces the risk of diabetes-related complications such as heart attacks, blindness, or kidney damage. Get your blood pressure checked at every doctor’s visit or twice a month. Self-monitoring and maintaining a blood pressure diary are recommended if you have high blood pressure coexisting with diabetes.

2. Eye examination

Visit an ophthalmologist once a year for a detailed eye examination. The doctor will check for any damage to the nerve tissues at the back of the eye (retina), as diabetes may lead to diabetic retinopathy and cataracts.

3. Foot examination

It is important to visit your doctor for a foot examination at least once a year to check your pulse and reflexes. You may also be examined for unhealed cuts, infections, sores, or loss of feeling in your feet.

4. Lipid profile test

Cholesterol is present in your blood as HDL (good cholesterol) and LDL (bad cholesterol). In diabetes, LDL levels and triglycerides tend to increase, while HDL levels decrease, raising the risk of heart disease and stroke.

5. Kidney function tests

Annual kidney function tests (blood tests) and urine tests are recommended. In diabetics, blood vessels in the kidneys may be injured, impairing their ability to filter blood properly, which can affect kidney health.

6. Dental checkup

Get examined every 6 months by a dentist for your gums and teeth, as high blood glucose levels can lead to oral problems such as gingivitis, periodontitis, oral thrush, and dry mouth.

7. Liver function tests (LFT)

These should be done annually to determine liver health by measuring proteins, liver enzymes, or bilirubin levels in your blood. Type 2 diabetes is associated with liver function impairment, increasing the risk of fatty liver disease, liver cirrhosis, and liver failure.

8. Vitamin B12 test

If you have been taking metformin for a long time, it is important to check your Vitamin B12 levels, as metformin may cause Vitamin B12 deficiency. Periodic measurement of Vitamin B12 levels is especially recommended if you have anemia or peripheral neuropathy.

Prevention of Diabetes

With simple lifestyle changes such as diet control, staying active, maintaining a healthy weight, and avoiding vices, you can lower your risk of type 2 diabetes. Here are a few tips to get started.

1. Make healthy food choices

• Taking care of your diet is one of the most essential components to manage and prevent diabetes.
• Switch to oils with a high volume of monounsaturated fats and polyunsaturated fats like olive oil, canola oil, soybean oil, or rice bran oil. Limit intake to one tablespoon a day.
• Restrict intake of foods with a high glycemic index like white bread, white rice, fatty foods, and soda.
• Consume foods with a low glycemic index like multigrain flour, whole grains, dals, most fruits, non-starchy vegetables, and carrots.
• Limit consumption of fast food such as chips and processed foods.

2. Watch your weight

• Losing weight can help regulate blood sugar levels. If you have type 2 diabetes, losing just 4-6 kg can lower your glucose levels.
• The distribution of fat in the body can also impact diabetes risk and management. Individuals with abdominal adiposity (fat around the belly) are more prone to type 2 diabetes than those with fat predominantly in the thighs, hips, and buttocks.

3. Exercise regularly

• Regular exercise is an effective way to maintain a healthy body and prevent diabetes. Aim for at least three sessions a week, lasting 30 to 45 minutes each.
• Warm up for 5 minutes before starting to exercise and cool down for 5 minutes afterward.
• Be more active throughout the day by parking your car further from your destination, opting for stairs instead of elevators, or walking while talking on the phone.

4. Manage stress better

• Stress can make blood sugar levels harder to control. Avoid unnecessary stress by engaging in activities that help relieve it, such as reading, traveling, sports, and hobbies.
• Consider relaxation techniques like meditation and yoga to alleviate anxiety and stress. Join a yoga club or dedicate 10-15 minutes each day to practice meditation.

5. Go for regular health check-ups

• As most diabetes symptoms are not detected until late in its course, it is wise to undergo preventive health check-ups to monitor your diabetes risk.
• Schedule a health check every 6 months to a year if you have risk factors for diabetes, such as hypertension, obesity, or heart disease.

6. Quit smoking

• Smoking has been found to directly increase the risk of several diabetes complications, including cardiovascular diseases, stroke, eye diseases, nerve damage, and kidney damage.
• It also reduces blood flow to the feet and other extremities, leading to foot problems and slowing the healing of injuries. Irregular blood flow can result in infections and unwanted mouth ulcers, increasing the risk of oral health issues.
• Quitting smoking is essential to lower your risk of diabetic complications. Consult your doctor for strategies to help you quit smoking. Tobacco is harmful to your health. Say no to tobacco.

Diabetes can be treated with medications and injections along with a few lifestyle modifications. Based on your blood glucose level, your doctor might recommend medicines or injections to control diabetes. Some of the common types of medicines for diabetes include:

A. Oral Antidiabetics

1. Biguanides
   This class of drugs helps to improve glucose control by suppressing glucose production by the liver, decreasing the absorption of glucose by the intestine, and increasing insulin sensitivity. Metformin is generally the first medication prescribed for type 2 diabetes.
2. Sulphonylureas
   These drugs are known to increase the secretion of insulin by the pancreas to manage diabetes. Some common examples include:
   • Glimepiride
   • Glipizide
3. Thiazolidinediones
   This class of drugs helps control diabetes by increasing insulin sensitivity in the muscles and fat tissues. An example of this class is:
   • Pioglitazone
4. Meglitinides
   This class of drugs increases the secretion of insulin by the pancreas to treat diabetes. Common examples include:
   • Repaglinide
   • Nateglinide
5. Alpha-glucosidase Inhibitors
   These drugs inhibit the enzyme alpha-glucosidase, thereby decreasing the absorption of glucose by the intestine. Commonly available drugs in this class include:
   • Acarbose
   • Miglitol
6. DPP-4 Inhibitors
   This class of drugs works by improving the secretion of insulin by the pancreas, thereby helping in the treatment of diabetes. Examples include:
   • Sitagliptin
   • Saxagliptin
7. Incretin Mimetics
   These oral antidiabetics increase the secretion of the hormone insulin and help in controlling diabetes. Known as glucagon-like peptide 1 (GLP-1) receptor agonists or GLP-1 analogues, this class includes:
   • Exenatide
   • Liraglutide
   • Dulaglutide

B. Insulin Injections

This includes insulin (mainly human insulin), which increases the uptake of glucose by the cells and helps to control diabetes. There are five different types of insulin available currently, recommended based on the severity of the condition:

• Rapid Acting Insulin (Examples: lispro, glulisine)
• Short Acting Insulin (Examples: insulin regular, semilente)
• Intermediate Acting Insulin (Examples: lente, insulin Isophane)
• Long Acting Insulin (Examples: ultralente, protamine zinc)
• Ultra-Long Acting Insulin (Examples: glargine, detemir, degludec)

Here’s more on how to use insulin injection for diabetes.

C. Insulin Pumps

Insulin pumps are small-sized computer devices that deliver small doses of short-acting insulin continuously, mimicking how the pancreas works. It provides a steady flow throughout the day and night, known as basal insulin, and an extra dose during meals, called bolus, based on the body’s insulin requirements. You simply attach it to your body using an infusion set. Talk to your doctor if you want to know more about insulin pumps to manage your diabetes.

D. Transplants

For some people with type 1 diabetes, a pancreas transplant may be an option. Islet transplants are also being studied. With a successful pancreas transplant, you would no longer need insulin therapy. However, transplants aren't always successful and may pose serious health risks in some cases.

E. Bariatric Surgery

Also known as weight loss surgery, bariatric surgery helps to reduce fat through surgical means. Although it is not specifically considered a treatment for type 2 diabetes, individuals with type 2 diabetes who are obese and have a body mass index higher than 35 may benefit from this surgery.

Whether you’re trying to prevent or control diabetes, your nutritional needs are virtually the same as everyone else, so no special foods are necessary. However, certain modifications in terms of quantity and type of food might be required.

1. Eat More

• Healthy fats from nuts, olive oil, fish oils, flax seeds, or avocados
• Fruits and vegetables—ideally fresh, the more colorful the better; whole fruit rather than juices
• High-fiber cereals and breads made from whole grains
• Fish and shellfish, organic chicken or turkey
• High-quality protein such as eggs, beans, low-fat dairy, and unsweetened yogurt

2. Eat Less

• Trans fats from partially hydrogenated or deep-fried foods
• Packaged and fast foods, especially those high in sugar, baked goods, sweets, chips, desserts
• White bread, sugary cereals, refined pastas or rice
• Processed meat and red meat
• Low-fat products that have replaced fat with added sugar, such as fat-free yogurt

3. Choose High-Fiber, Slow-Release Carbs

Carbohydrates have a significant impact on your blood sugar levels—more so than fats and proteins—so you need to be smart about the types of carbs you consume. Limit refined carbohydrates like white bread, pasta, and rice, as well as soda, candy, packaged meals, and snack foods. Focus on high-fiber complex carbohydrates—also known as slow-release carbs. They are digested more slowly, thus preventing your body from producing too much insulin.

Fruits in Diabetes

There is mixed perception about the intake of fruits for diabetes. Some people believe that diabetics should completely cut down on fruits from their diet while others think that one can include as many fruits as they want as they don’t impact blood glucose levels. However, neither is true. It is best to include fruits as an integral part of your daily meal plan while monitoring the carbohydrate content. Here is a quick guide to help you with your daily fruit needs:

Whole Fruits

• 1 small apple
• 1 small chickoo
• 1 small orange
• 1 small guava
• 1 small pear

Cut Fruits

• Half banana
• 1 slice mango
• 1 cup papaya
• 3/4 cup muskmelon
• 1 ¼ cup watermelon

Exercise in Diabetes

Exercises are designed to help people with diabetes avoid problems that can result from unwise exercise choices. Aerobic activity is one of the effective exercise options to control diabetes. When done at moderate intensity, it raises your heart rate and makes you sweat, thereby helping you maintain an optimal blood glucose level. Some common forms of aerobic exercises include:

• Brisk (fast-paced) walking
• Light jogging
• Bike riding
• Playing tennis or badminton
• Swimming/water aerobics
• Gymming

Insulin deficit, if left unchecked over the long term, can cause damage to many of the body’s organs, leading to disabling and life-threatening health complications such as:

• Diabetes retinopathy (Eyes): High blood glucose levels increase the risk of eye problems such as blurred vision. It can affect the shape of your lens and damage the blood vessels in your eyes. Diabetic retinopathy can also increase the risk of cataract and glaucoma.
• Diabetic foot (Feet): Diabetes (both type 1 and 2) causes damage to blood vessels and peripheral nerves, resulting in problems in the legs and feet. Two main conditions associated with diabetes are peripheral artery disease (PAD) and peripheral neuropathy, leading to an increased risk of foot problems. PAD refers to the narrowing and hardening of blood vessels, while peripheral neuropathy refers to damage to the small nerves in the feet due to diabetes. In addition, diabetic patients may experience various foot problems such as corns, calluses, ulcers, painful bunions, and fungal infections.
• Diabetic nephropathy (Kidneys): Diabetic kidney disease, also known as diabetic nephropathy, is one of the most common complications of diabetes. Excess glucose can cause thickening of blood vessels in the kidneys and the filtration units (glomerulus), affecting normal kidney function. Healthy kidneys do not allow excess proteins to pass through the filters. When the filtration process is impacted, microalbumin, a type of protein, is excreted in the urine. This gradually increases the pressure on the kidneys, leading to chronic kidney disease and kidney failure in the long run.
• Diabetic neuropathy (Nerves): High blood glucose levels can impair blood flow to the nerves by damaging small blood vessels. This can result in symptoms such as numbness, decreased sensation, and pain in the extremities. Early diagnosis and treatment can help prevent or delay these complications.
• Atherosclerosis (Blood vessels): High blood glucose levels can damage larger blood vessels of the heart, impairing blood flow and increasing the risk of atherosclerosis, which leads to narrowing of arterial walls throughout the body. This narrowing can decrease blood flow to the heart muscle (causing a heart attack), to the brain (leading to stroke), or to extremities (leading to pain and decreased healing of infections).
• Diabetic ketoacidosis: This is a life-threatening condition in which a person’s cells do not receive enough sugar for energy. As a result, the body begins to break down fats for energy, producing a compound called ketones that are released into the blood. It occurs when there isn’t enough insulin in the body to utilize glucose, indicating that diabetes is becoming uncontrolled. Although it can occur in anyone with diabetes, it is more common in people with type 1 diabetes.
• Erectile dysfunction (ED): Individuals with diabetes have a higher likelihood of experiencing ED approximately 10-15 years earlier than non-diabetics. Contributing factors include longer duration of diabetes, older age, poor glycemic control, and neuropathy. ED results from hormonal, neurological, vascular, and psychological effects of high blood glucose levels, leading to increased mental stress, disordered interpersonal relationships, and interference with sexual life, ultimately affecting overall quality of life in diabetics.

Gestational Diabetes Mellitus (GDM)

GDM imposes immediate risks for both mother and fetus and can also affect future health throughout their lives. The immediate complications for the mother include:

• Preeclampsia (characterized by high blood pressure)
• Need for cesarean sections
• Polyhydramnios (excessive amniotic fluid)
• Oligohydramnios (deficiency of amniotic fluid)

The health complications in the baby include:

• Hyperinsulinemia (high insulin level)
• Macrosomia (the baby is significantly larger than normal)
• Shoulder dystocia (infant’s shoulder gets lodged in the mother’s pelvis during delivery)
• Neonatal hypoglycemia (low blood glucose level)
• Respiratory distress syndrome (immature lungs)
• Stillbirth

The science of Ayurveda manages diabetes through a combination of activities that include exercise (Vyayam), dietary regulation (Pathya), panchakarma (bio-purification), and medicines. It is best to consult an Ayurveda consultant before taking any Ayurvedic medicine for diabetes. Some household herbs and spices that you can include in your diet are:

• Powdered Jamun seeds can be taken with water or buttermilk (chaach).
• Methi (Fenugreek) seeds are taken with water 15-20 minutes before each meal. Methi has soluble fibers that slow down the digestion and absorption of glucose.
• Bael leaves are squeezed to prepare fresh juice that can be taken along with a pinch of black pepper.
• Dalchini (Cinnamon) in powdered form can be taken with water as it helps in improving sugar and cholesterol levels.
• Concentrated amla juice taken along with bitter gourd juice helps in releasing more insulin.
• Karela (Bitter gourd) juice is recommended to be taken every morning.

Homeopathy

Defined as a complementary medicine, homeopathy primarily focuses on improving the functioning of the pancreas to produce insulin. Homeopathy experts rely on the patient’s history and temperament to devise a constitutional medication. However, it is recommended to use homeopathic medicines only if prescribed by the homeopath and alongside the usual course of medications suggested.

Yoga

Yoga asanas help ease stressful thoughts and improve mental health in diabetics. Restorative yoga involves yoga poses and healing through relaxation techniques with conscious breathing, while power yoga has been found beneficial for weight loss, a risk factor for diabetics. It has been studied for controlling both the symptoms and complications associated with type 2 diabetes mellitus.

Acupuncture

This technique uses needles to treat chronic pain. Acupuncture may be effective in treating diabetes and preventing and managing complications of the disease.

Massage Therapy

Massage therapy can be incorporated into relaxation therapy and serves another purpose that can be particularly useful for diabetics. The stress-reducing benefits of massage can help control counter-regulatory stress hormones and assist the body in using insulin more effectively.

As diabetes is a chronic health problem, it is imperative to make small changes in your lifestyle to manage the condition effectively. Here are a few measures to include in your care plan.

1. Learn about the condition

It is essential for a person with diabetes to accept the condition and be well-informed. Learn about the symptoms, potential complications, practical management strategies, and the importance of treatment. This includes:

• Reaching out to your doctor for more information.
• Working with a nutritionist for a customized meal plan.
• Joining support groups to share experiences and enhance diabetes management.

2. Take care of your mental health

Stress, anxiety, and depression are common among individuals with diabetes. According to the CDC, diabetics are 2 to 3 times more likely to suffer from depression than those without diabetes. Many individuals with these mental health issues remain undiagnosed or untreated, which can impair diabetes control and increase the risk of complications.

It is important to monitor your mental health and be aware of warning signs of depression, which include:

• Feeling sad.
• Loss of interest.
• Extreme fatigue.
• Difficulty concentrating.
• Irritability and anxiety.

If you experience any of these symptoms, consult your doctor for appropriate diagnosis and treatment.

Additionally, manage stress and anxiety with simple strategies such as:

• Practicing relaxation techniques like meditation or yoga.
• Talking to friends or family about your stress.
• Trying new hobbies like gardening, dancing, or playing a musical instrument.
• Spending “ME” time doing activities you enjoy, such as reading or taking a stroll in a park.

3. Be ready to tackle emergencies

Getting sick is a part of life; however, individuals with diabetes need to be extra cautious as they are more prone to infections. It is wise to plan for sick days by:

• Stocking up on medicines (including OTC medications) and healthy foods and drinks.
• Recording your blood glucose levels daily, as managing these levels can be challenging when ill.
• Taking your medications consistently.

Diabetics on medication or insulin can experience low blood glucose levels, especially if they skip meals, eat less, or exercise more than usual. In cases of diabetic emergencies, consult your doctor immediately.

4. Diabetes care plan

A diabetes care plan can be divided into four key measures:

• Lifestyle tips: Eat a healthy diet and exercise regularly. A diet rich in proteins, complex carbohydrates, healthy fats, and fiber is crucial for controlling blood glucose levels. Aim for a minimum of 150 minutes of moderate-intensity exercise, such as brisk walking, each week.
• Recording blood glucose levels: Maintain daily charts to track how well your treatment is working. Do not skip or stop taking your medications, even if your diabetes is under control.
• Self-monitoring of blood glucose (SMBG): This is important for knowing your blood glucose level at any time and preventing the consequences of very high or low blood sugar. It facilitates tighter blood sugar control, reducing the long-term risks of complications.
• Regular checkups: These are essential for understanding whether you are meeting your treatment or blood glucose targets. Get your HbA1c level checked every three months, and have a doctor visit every six months. An annual complete checkup should include eye health, lipid profile, and kidney health assessments.

Regular health check-ups are a good strategy to prevent complications related to diabetes.