To practice giving yourself some grace, you can try a short self-compassion meditation technique or check out these tips about self-love and acceptance. You can also use Dr. SELF does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a substitute for medical advice, and you should not take any action before consulting with a healthcare professional.

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I Was Diagnosed With Colon Cancer at Here Are the First Symptoms I Had. Prioritize sleep, even when it feels hard. Ask for the help you need from the people you love. Find your community. Try to give yourself a break.

Carolyn Todd is a holistic health and life coach for people with diabetes. Topics type 2 diabetes diabetes self-care living with type 2 diabetes.

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Short-acting insulin analogs, preferably delivered by a pen, may be used immediately after consumption of a meal, whenever food becomes available.

Unfortunately, the greater cost of insulin analogs should be weighed against their potential advantages. Those with type 2 diabetes and FI can develop hypoglycemia for similar reasons after taking certain oral hypoglycemic agents.

If using a sulfonylurea, glipizide is the preferred choice due to the shorter half-life. Glipizide can be taken immediately before meal consumption, thus limiting its tendency to produce hypoglycemia as compared with longer-acting sulfonylureas e. Homelessness often accompanies the most severe form of FI.

Therefore, providers who care for those with FI who are uninsured and homeless and individuals with poor literacy and numeracy should be well versed or have access to social workers to facilitate temporary housing for their patients as a means to prevent and control diabetes.

Additionally, homeless patients with diabetes need secure places to keep their diabetes supplies and refrigerator access to properly store their insulin. FI and diabetes are more common among non-English speaking individuals and those with poor literacy and numeracy skills.

Therefore, it is important to consider screening for FI, proper housing, and diabetes in this population. Programs that see such patients should work to develop services in multiple languages with the specific goal of preventing diabetes and building diabetes awareness in people who cannot easily read or write in English.

Intensive glucose control is not advised for the improvement of poor cognitive function in hyperglycemic individuals with type 2 diabetes. In individuals with poor cognitive function or severe hypoglycemia, glycemic therapy should be tailored to avoid significant hypoglycemia.

In individuals with diabetes at high cardiovascular risk, the cardiovascular benefits of statin therapy outweigh the risk of cognitive dysfunction. If a second-generation antipsychotic medication is prescribed, changes in weight, glycemic control, and cholesterol levels should be carefully monitored and the treatment regimen should be reassessed.

The most severe form of cognitive dysfunction is dementia. The reverse is also true: people with Alzheimer dementia are more likely to develop diabetes than people without Alzheimer dementia. In those with type 2 diabetes, the degree and duration of hyperglycemia are related to dementia.

More rapid cognitive decline is associated with both increased A1C and longer duration of diabetes However, the ACCORD study found no difference in cognitive outcomes between intensive and standard glycemic control, supporting the recommendation that intensive glucose control should not be advised for the improvement of cognitive function in individuals with type 2 diabetes In type 2 diabetes, severe hypoglycemia is associated with reduced cognitive function, and those with poor cognitive function have more severe hypoglycemia.

In a long-term study of older patients with type 2 diabetes, individuals with one or more recorded episode of severe hypoglycemia had a stepwise increase in risk of dementia Likewise, the ACCORD trial found that as cognitive function decreased, the risk of severe hypoglycemia increased Tailoring glycemic therapy may help to prevent hypoglycemia in individuals with cognitive dysfunction.

In one study, adherence to the Mediterranean diet correlated with improved cognitive function However, a recent Cochrane review found insufficient evidence to recommend any dietary change for the prevention or treatment of cognitive dysfunction Given the controversy over a potential link between statins and dementia, it is worth noting that a Cochrane systematic review has reported that data do not support an adverse effect of statins on cognition.

The U. Food and Drug Administration FDA postmarketing surveillance databases have also revealed a low reporting rate for cognitive-related adverse events, including cognitive dysfunction or dementia, with statin therapy, similar to rates seen with other commonly prescribed cardiovascular medications Therefore individuals with diabetes and a high risk for cardiovascular disease should be placed on statin therapy regardless of cognitive status.

Severe mental disorder that includes schizophrenia, bipolar disorder, and depression is increased 1. The prevalence of type 2 diabetes is two—three times higher in people with schizophrenia, bipolar disorder, and schizoaffective disorder than in the general population Diabetes medications are effective, regardless of mental health status.

Treatments for depression are effective in patients with diabetes, and treating depression may improve short-term glycemic control If a second-generation antipsychotic medication is prescribed, changes in weight, glycemic control, and cholesterol levels should be carefully monitored and the treatment regimen should be reassessed if significant changes are noted Patients with HIV should be screened for diabetes and prediabetes with a fasting glucose level before starting antiretroviral therapy and 3 months after starting or changing it.

If initial screening results are normal, checking fasting glucose each year is advised. If prediabetes is detected, continue to measure levels every 3—6 months to monitor for progression to diabetes.

Diabetes risk is increased with certain protease inhibitors PIs and nucleoside reverse transcriptase inhibitors NRTIs. PIs are associated with insulin resistance and may also lead to apoptosis of pancreatic β-cells. NRTIs also affect fat distribution both lipohypertrophy and lipoatrophy , which is associated with insulin resistance.

Individuals with HIV are at higher risk for developing prediabetes and diabetes on antiretroviral ARV therapies, so a proper screening protocol is recommended In those with prediabetes, weight loss through healthy nutrition and physical activity may reduce the progression toward diabetes.

Among HIV patients with diabetes, preventive health care using an approach similar to that used in patients without HIV is critical to reduce the risks of microvascular and macrovascular complications. For patients with HIV and ARV-associated hyperglycemia, it may be appropriate to consider discontinuing the problematic ARV agents if safe and effective alternatives are available Before making ARV substitutions, carefully consider the possible effect on HIV virological control and the potential adverse effects of new ARV agents.

In some cases, antidiabetes agents may still be necessary. Suggested citation: American Diabetes Association. Strategies for improving care. In Standards of Medical Care in Diabetes— Diabetes Care ;39 Suppl. Sign In or Create an Account.

Search Dropdown Menu. header search search input Search input auto suggest. filter your search All Content All Journals Diabetes Care. Advanced Search. User Tools Dropdown. Sign In. Skip Nav Destination Close navigation menu Article navigation.

Previous Article Next Article. Diabetes Care Concepts. Care Delivery Systems. When Treatment Goals are not Met. Tailoring Treatment to Vulnerable Populations. Article Navigation. Position Statement December 16 Strategies for Improving Care American Diabetes Association American Diabetes Association.

This Site. Google Scholar. Get Permissions. toolbar search Search Dropdown Menu. toolbar search search input Search input auto suggest. B Treatment decisions should be timely and based on evidence-based guidelines that are tailored to individual patient preferences, prognoses, and comorbidities.

B Care should be aligned with components of the Chronic Care Model to ensure productive interactions between a prepared proactive practice team and an informed activated patient. A When feasible, care systems should support team-based care, community involvement, patient registries, and decision support tools to meet patient needs.

Delivery system design moving from a reactive to a proactive care delivery system where planned visits are coordinated through a team-based approach Self-management support Decision support basing care on evidence-based, effective care guidelines Clinical information systems using registries that can provide patient-specific and population-based support to the care team Community resources and policies identifying or developing resources to support healthy lifestyles Health systems to create a quality-oriented culture.

Healthy lifestyle choices physical activity, healthy eating, tobacco cessation, weight management, and effective coping Disease self-management taking and managing medications and, when clinically appropriate, self-monitoring of glucose and blood pressure Prevention of diabetes complications self-monitoring of foot health; active participation in screening for eye, foot, and renal complications; and immunizations.

A systematic approach to achieving intermediate outcomes involves three steps:. A Providers should recognize that homelessness, poor literacy, and poor numeracy often occur with food insecurity, and appropriate resources should be made available for patients with diabetes.

B In individuals with poor cognitive function or severe hypoglycemia, glycemic therapy should be tailored to avoid significant hypoglycemia. C In individuals with diabetes at high cardiovascular risk, the cardiovascular benefits of statin therapy outweigh the risk of cognitive dysfunction.

A If a second-generation antipsychotic medication is prescribed, changes in weight, glycemic control, and cholesterol levels should be carefully monitored and the treatment regimen should be reassessed. Search ADS.

Long-term and recent progress in blood pressure levels among U. adults with diagnosed diabetes, Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M. European Association for the Study of diabetes EASD. Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association ADA and the European Association for the Study of diabetes EASD.

Article CAS PubMed PubMed Central Google Scholar. van HL, Rijken M, Heijmans M, Groenewegen P. Self-management support needs of patients with chronic illness: do needs for support differ according to the course of illness? Lorig KR, Holman H. Self-management education: history, definition, outcomes, and mechanisms.

Ann Behav Med. Frei A, Svarin A, Steurer-Stey C, Puhan MA. Self-efficacy instruments for patients with chronic diseases suffer from methodological limitations - a systematic review.

Health Qual Life Outcomes. Nolte E, Knai C, Saltman R. Assessing chronic disease management in European health systems : concepts and approaches. Copenhagen, Denmark: European Observatory on Health Systems and Policies, a partnership hosted by WHO; Powers MA, Bardsley J, Cypress M, Duker P, Funnell MM, Fischl AH, Vivian E.

Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the academy of nutrition and dietetics. J Acad Nutr Diet. Kujala S. User involvement: a review of the benefits and challenges.

Behav Inform Technol. Download references. The authors thank the patients who participated in this study. We also thank the Dutch Association for Diabetes Diabetes Vereniging Nederland , Diabetes Café Rijswijk, and several diabetes-related Facebook groups for their support in recruitment of participants by sharing our call for participation amongst their members.

Faculty of Industrial Design Engineering, Delft University of Technology, Delft, the Netherlands. Astrid N. Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.

Dorijn F. Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. You can also search for this author in PubMed Google Scholar.

AS, DH, TD, AE and MM designed the study. AS recruited participants and collected the data. AS conducted the analyses, which were reviewed by DH, TD, AE and MM. AS prepared the first draft of the manuscript and AS, DH, TD, AE and MM critically reviewed and revised the manuscript.

All authors read, contributed to, and approved the final version. Correspondence to Marijke Melles. All authors, A. van Smoorenburg, D. Hertroijs, T. Dekkers, A. Elissen and M. Melles, declare that they have no conflict of interest. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Open Access This article is distributed under the terms of the Creative Commons Attribution 4. Reprints and permissions. van Smoorenburg, A. et al. BMC Health Serv Res 19 , Download citation.

Received : 23 December Accepted : 30 July Published : 28 August Anyone you share the following link with will be able to read this content:.

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Skip to main content. Search all BMC articles Search. Download PDF. van Smoorenburg 1 , Dorijn F. Hertroijs ORCID: orcid. Elissen ORCID: orcid. Abstract Background The number of type 2 diabetes mellitus T2DM patients and related treatment costs are rapidly increasing. Methods Semi-structured interviews, preceded by preparatory assignments, were conducted with ten patients with T2DM treated in Dutch primary care.

Conclusions With this knowledge, support solutions can be designed and implemented that better fit the needs, preferences and abilities of patients with T2DM. Background Diabetes mellitus is a growing healthcare challenge. Study design Patients were invited to prepare themselves for the interviews by filling out so-called sensitising booklets [ 23 ].

Full size image. Results Participant characteristics Sixteen people applied for participation in the study. Table 1 Overview of background characteristics of participants Full size table. Table 2 Aspects named by the participants having most impact 4 or 5 out of 5 on daily life of T2DM patients Full size table.

Discussion The daily care for type 2 diabetes mellitus T2DM mostly comes down to the person suffering from it.

Conclusions This research focused on the needs of a specific patient group; T2DM with stable, adequate glycaemic control. Availability of data and materials The interview records and sensitising booklets generated and analysed during the current study are not publicly available to protect participant confidentiality, but are available from the corresponding author on reasonable request.

Abbreviations GP: General practitioner HbA1c: Glycated haemoglobin T2DM: Type 2 diabetes mellitus. References International Diabetes Federation. Google Scholar InEen. Google Scholar Wermeling PR, Gorter KJ, Stellato RK, de Wit GA, Beulens JW, Rutten GE.

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Acknowledgements The authors thank the patients who participated in this study. Funding The authors received no specific funding for this work. Author information Authors and Affiliations Faculty of Industrial Design Engineering, Delft University of Technology, Delft, the Netherlands Astrid N.

Elissen Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands Marijke Melles Authors Astrid N.

van Smoorenburg View author publications. View author publications. Ethics declarations Ethics approval and consent to participate No ethical approval was needed for the study; as the participants were not physically involved in the research and the questionnaires were not mentally exhausting, the study was not subject to the Dutch Medical Research Human Subject Act.

Consent for publication Not applicable. Competing interests All authors, A.

You are here Home » A to Z » Diabetes: Ten Tips for Self-Management. Diabetes: Ten Tips for Self-Management. English Español. Make healthy food choices. You can choose what, when, and how much to eat. Healthy meal planning is an important part of your diabetes treatment plan.

Decide to be physically active. This helps you keep your cholesterol, blood pressure, and blood sugar under control. Take your medications. You can all take your medications as instructed by your healthcare team, and keep track of your blood sugar levels on your own.

Keep a log book. You can learn which numbers are important for telling you how well you are doing and then watch them improve over time by keeping a log book of your A1C, blood pressure, cholesterol, and so on.

Take the book along to your appointments so you can discuss changes or new instructions with your healthcare team. Watch for symptoms or changes in your health. You can learn which symptoms or changes are important for you to watch out for and tell your doctor about.

Talk with your healthcare team if you feel overwhelmed or unable to manage one or more aspects of your diabetes management. Ask questions when you are not sure about something. Talk with others who are living well with diabetes and kidney disease. They can understand your situation in a special way and give you support.

Get tested for kidney disease. Having diabetes puts you at risk for developing kidney disease. Ask your healthcare team to be tested for kidney disease.

You should be tested for kidney disease at least once a year. Learn more. However, having diabetes does't exclude you from eating your favourite foods or going to your favourite restaurants.

But you need to know that different foods affect your blood sugar differently. Activity has many health benefits in addition to losing weight. Physical activity lowers cholesterol, improves blood pressure, lowers stress and anxiety, and improves your mood.

Being active can also keep your blood glucose levels in check and your diabetes under control. Regular monitoring of your blood sugar levels gives you the information you need to make decisions.

Testing your blood sugar lets you know when your levels are on target and it informs your decisions on activity and food so that you can live life to the fullest. Taking the right medications will help you have greater control over your diabetes and help you feel better.

Insulin, pills that lower your blood sugar, aspirin, blood pressure medication, cholesterol-lowering medication are a few of the medicines used to reduce your risk of complications.