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How to live your healthiest life with type 2

By Dale Cooke

Diabetes Queensland Dietitian

 

Type 2 diabetes is a progressive condition which usually starts with insulin resistance (think rusty locks on all your cell doors so glucose can't get in), moves on to pancreatic exhaustion (the pancreas gets worn out trying to produce more and more insulin for those rusty cell door locks), and can include high fasting levels of glucose (the liver gets a bit leaky and leaks its glucose stores overnight) in the morning in some people.

 

And while these all involve higher blood glucose levels (BGLs) in the body, the longer term complications occur from high glucose levels in the large and small blood vessels and around the nerves. 

 

Day to day management involves managing BGLs as close to your target levels as possible. If you don't have target BGLs, talk to your GP, diabetes educator or endocrinologist to work out what is best for you. They vary based on your age and circumstances. 

 

Management of other risk factors may prevent or provide early diagnosis of long-term complications and is vitally important.

 

The evidence-based guidelines your health professionals follow to guide you in your management of type 2 diabetes encourages them to refer you to both group based and individual education opportunities, as both have been shown to be effective. 

 

It's good to join group-based programs, such as Diabetes Queensland's DESMOND program, to learn the basics (or if you've had diabetes for a while it may be a refresher) about managing your diabetes and hearing the health journeys of others. 

 

DESMOND group education has been shown to help people feel less alone with their health issues when they hear how others are managing theirs.

 

The other evidence-based guideline your health professional follows is the Annual Cycle of Care.

 

This set of checks/pathology/investigations was developed from international studies and national strategies and frameworks for diabetes management.

 

A checklist was developed for GPs to use to ensure the health of the person living with diabetes and to reduce the risk of diabetes-related complications.

 

The Annual Cycle of Care, which your GP will prompt you about, covers issues around managing your BGLs. Your GP may recommend you see a diabetes educator for day to day practicalities, for example.

 

Following the cycle of care components may help you to slow down the progression of the condition.

 

There is a check on achieving a healthy weight, eating nutritious foods and increasing fitness.

 

A dietitian and exercise physiologist visit may help you with strategies. 

 

The Annual Cycle of Care also focusses on slowing the longer term complications to blood vessels and nerves by checking on management of cholesterol and blood pressure to keep your heart, brain, kidneys, eyes and extremities healthier. 

 

You are recommended to have regular monitoring of your eyes (optometrist), your feet (podiatrist) and your body's functions (with regular blood pathology recommended by the GP) in the Annual Cycle of Care.

 

A psychologist might also be helpful if you are having difficulties with depression, distress and anxiety. They may help you be motivated to make changes to your lifestyle. How you are coping and your emotional status is part of the Annual Cycle of Care checks.

 

We strongly recommend that you have a health team who you feel you can honestly talk with, who make you feel confident in their advice, who advocates for your health and gives you the tools you need to understand your diabetes. This is your right, so please do not be afraid about being proactive. This is your diabetes.

 

Remember, you may need to prompt your GP or healthcare practitioner about when some of the components of your Annual Cycle of Care need to be checked to make sure you are receiving the best practice management for type 2 diabetes.

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