Patient information from BMJ

Diabetes: what can I do to keep healthy?

Last published:Jul 10, 2020

If you have diabetes, making changes to your lifestyle, having regular check-ups, and following your doctor's treatment plan can help you stay healthy.

What health problems might I get?

If you have diabetes you have too much glucose in your blood. Glucose is a kind of sugar that your body uses for energy. But if it builds up in your blood it can cause problems. You might get damage in the blood vessels of your feet, kidneys, and eyes. You also have more of a chance of having a heart attack or stroke.

There are many things you can do to reduce your chance of having these health problems. We've listed them below. Doing these things has many benefits for your health. They help to:

• keep the levels of glucose in your blood as close to normal as possible

• control your blood pressure, and

• keep your cholesterol (a fatty substance in the blood) at a healthy level.

Your doctor or nurse can help you work out the levels of blood glucose, blood pressure, and cholesterol that you should aim for.

Eating a healthy diet

There are healthy eating guidelines for people with type 2 diabetes. But doctors are keen to stress that many people benefit from food plans that are tailored to what's best for them. So your doctor might refer you to a dietitian who will help you find a food plan that suits you.

In general, though, doctors recommend that people with type 2 diabetes eat a balanced, low-fat diet with plenty of fibre. You don't need to buy special diabetic foods.

Things to avoid include:

• too many sugary foods and drinks

• starchy, carbohydrate-rich foods such as white bread and pasta. Avoid these, or choose the wholemeal options instead, and

• saturated fats.

Healthier foods for people with type 2 diabetes include wholegrains, beans and pulses, oily fish, fruit and vegetables, and low-fat dairy products.

The aim is to lose weight, if you are overweight, and to stop your blood pressure from getting too high. A healthy diet can also help keep your blood glucose and cholesterol under control.

Stopping smoking

Smoking increases your chances of having a heart attack or a stroke. It also makes other circulation problems worse.

If you have diabetes your chances of a heart attack, a stroke, or other circulation problems are already higher than for most people. So it makes sense to give up smoking, to reduce your risk as much as possible.

Stopping smoking isn't easy, but help is available. Getting professional help from your doctor, a nurse, or a trained counsellor can help you stop smoking. There are also treatments that can help, including nicotine replacement therapy and medications.

Taking exercise

If you haven't exercised much in the past, making exercise part of your life might seem hard. But exercise has great benefits. It will help keep down the level of glucose in your blood. It will also:

• help keep your weight down

• help keep your blood pressure and cholesterol under control, and

• help reduce your chances of having a heart attack or a stroke.

Talk to your doctor about what sort of exercise is best for you. Most doctors advise people to do some kind of physical activity every day. Broadly speaking there are two kinds of exercise, and doctors recommend doing a mixture of both.

Aerobic exercise, such as brisk walking or cycling, gets you out of breath and makes your heart and lungs work harder.

Resistance strength training, such as lifting weights, makes your muscles work harder.

So, for example, you might want to do some aerobic exercise on some days, and some gentle resistance training on others. Try to find an exercise you enjoy, so it's easier to keep at it.

Ask your doctor if you need to change your medication when you exercise. Exercise uses up glucose, so you might need to take less medicine or take it later. If you are going to exercise for a long time you might need to eat a snack first.

Regular check-ups

When you're first diagnosed with diabetes you'll probably need to see many different health professionals, to check whether you have any health problems. Once your treatment is going well you might only need check-ups twice a year. These check-ups are important to make sure your treatment is working and you're not getting any health problems.

You should have these tests at least once a year:

• a blood or urine test to check if your kidneys are working properly

• a test of your blood sugar control. This is called an HbA1c test. It shows doctors how well your treatment is working. For example, in the UK it is recommended that you have this test at least twice a year. You might need to have this test more often if your diabetes is not well controlled.

• an eye test.

You might also have your cholesterol checked.

During a check-up, your doctor will look at:

• your weight, to see if you need to lose some weight to control your diabetes better

• your legs and feet: Your doctor will examine your skin and check to see if your circulation and nerves are working properly. You may need to see a foot doctor if you have any problems with your feet

• your blood pressure

• your eyes: You might need to see an eye doctor for this check. The doctor will examine the backs of your eyes (your retina). Diabetes can damage your retina and affect your eyesight.

Your doctor may also help you to learn how to check your blood glucose at home, especially if you need to take insulin.

Taking medicines

Some people control their diabetes with just diet and exercise. But most people with diabetes need to take medicines. There are different types.

• Medicines to control your blood glucose. Keeping your blood sugar as close to normal as possible may help you avoid damage to your eyes, kidneys, and feet.

• Medicines to keep your blood pressure and cholesterol levels healthy. These medicines reduce the chance of a heart attack or a stroke. You might also need to take a low dose of aspirin or a similar medicine, to thin your blood.

You'll probably need to take more than one type of medicine. It can be hard to keep track of all the medicines you are taking. Ask your doctor or pharmacist for help. You might want to try a pill organiser.

It's important to take all your medicines as prescribed by your doctor. This gives you the best chance of staying healthy.

Adjusting your medication

It's likely that your doctor will adjust your medications from time to time. This is a good sign. It means that your doctor is paying close attention to your condition, and changing your medication based on what your body needs at a particular time. It doesn't mean that you are doing anything wrong. 

Side effects of medications

Some medicines have side effects. If you are having problems with your medicines, don't just stop taking them. Talk to your doctor first. You don't have to put up with side effects. You may need to switch to a different type of medicine, or to a different dose.

Some people with type 2 diabetes need regular insulin injections to control their blood glucose. But you are unlikely to need insulin straight away, and you might never need it.

If your doctor thinks you would benefit from insulin, you'll usually have plenty of time to discuss it before you start injections, and you'll learn all about insulin and how to use it.