Living Well with Diabetes: 100 Years Later

January of 2022 marks the 100^th anniversary of Leonard Thompson, a 14-year-old, seriously ill patient with diabetes, receiving the first successful insulin injection. Prior to 1922, diabetes treatment was often limited to following very restrictive or near-starvation diets. The miraculous discovery of insulin by Dr. Frederick Banting and Charles Best forever changed the course of diabetes treatment and dramatically increased the lifespan for people living with diabetes.

Seven Tips for Diabetes Management and Self-Care

100 years later, living with diabetes is still a daily challenge. New medications and technology can reduce some of those burdens, but effective diabetes self-care still hinges on a person’s ability to engage in what the Association of Diabetes Care and Education Specialists identified as the following seven essential self-care behaviors:

Tip One: Adopt a Healthy Eating Plan for Diabetes Wellness

Is it possible to enjoy food and manage diabetes well? Absolutely! There is not a one-size-fits-all approach to eating with diabetes, but there are a variety of healthy eating patterns that can fit into a diabetes management plan. A healthy eating plan includes a variety of colorful vegetables, fruits, whole grains, dairy, lean sources of protein and oils. Limiting intake of sugary drinks, salt, saturated fat and alcohol can also lead to better health and wellness. Think of your body like a race car and strive to put high-quality “fuel” into it as much as possible.

Tip Two: Manage Your Blood Sugar with Regular Physical Activity

Get active! Moving more and sitting less is a great way to help decrease blood sugar levels and reduce the risk of future health issues. The CDC recommends getting at least 150 minutes per week (20 to 25 minutes per day) of moderate-intensity physical activity. Some examples include walking briskly, doing housework, mowing the lawn, dancing, swimming, bicycling and playing sports.

Being active and doing things you enjoy can help:

• Improve mood
• Decrease stress and anxiety
• Improve blood pressure and cholesterol
• Increase fitness
• Boost muscle strength and endurance
• Decrease body fat

Tip Three: Routinely Monitor Blood Sugar Levels

How well can a car be driven if the driver is blindfolded? Not very well! The same goes for trying to manage diabetes without any information about what’s happening or how it’s going. Routine blood sugar monitoring is a great way to:

• Learn how different things like food, activity, stress, medications, etc. affect blood sugars
• Get actionable data to make more informed decisions about food, medication and activity
• Better understand blood sugar trends and patterns to learn what works well (and what doesn’t)
• Evaluate if the diabetes care plan is working well
• Spot problems sooner rather than later

Tip Four: Understand Your Medication 

Most people with diabetes need at least some medication to help the body regulate blood sugar levels. This may include different types of insulin, pills or non-insulin injectable medication. How much medication a person needs (and what type) may also change over time, especially when there are changes to a person’s health. What are some good questions to ask when being prescribed a medication for diabetes?

• How does this medication work?
• What are the possible side effects?
• Does this medication have any other potential health benefits?

It’s also good to share with a provider if:

• There are concerns about the medication(s) being taken
• Prescribed medications have been stopped
• Medication plans are too complex and cannot be taken consistently

Tip Five: Problem Solve and Take Action

Living with diabetes can be a daily challenge. Following a treatment plan to the letter doesn’t always provide the expected results, and what the body needs to stay balanced may also change over time. When problems occur, try to approach the problem in three steps:

• Identify the problem:
  • Example: Mid-afternoon physical activity is causing blood sugar levels to go too low
• Find solutions:
  • Increase blood sugar monitoring frequency?
  • Have snacks available?
  • Adjust medication?
• Act:
  • Eat a snack prior to exercising
  • Check blood sugar before, during and after exercise
  • Talk with a health care provider about possibly getting a continuous glucose monitor with low alarms
  • Talk with a health care provider about a possible medication adjustment
  • Have fast-acting sources of carbohydrate available during physical activity

Tip Six: Incorporate Risk Reducing Behaviors Into Your Routine

There are rarely any guarantees in life, but there is plenty of evidence to support making certain behavioral changes to help reduce risk and prevent complications from diabetes. What types of healthy behaviors can reduce risk?

• Participating in recommended health checkups and screenings (both medical and dental)
• Daily foot care
• Daily brushing and flossing
• Getting recommended vaccines
• Not smoking
• Getting enough quality sleep
• Following a healthy eating plan
• Moving more and sitting less
• Taking medications as prescribed
• Talking with the health care team if emotions are negatively impacting self-care behaviors

Tip Seven: Develop Healthy Coping Strategies

Simply knowing how to check blood sugar, take medication, inject insulin, etc. isn’t always enough to be successful with diabetes management. Emotional well-being plays a big role in being able to effectively deal with the constant demands of daily diabetes care. This can be especially challenging when life starts throwing curveballs. It’s important to find healthy ways to cope, and to not engage in habits that can negatively impact health – such as smoking, overeating, avoiding people or using substances.

           What are some healthy ways to cope with stress?

• Ask for help: Diabetes is better as a team support! Managing a chronic condition can often feel very isolating, but people living with diabetes don’t need to feel alone. Having a network of family, friends, peers with diabetes and health care team members can provide crucial support, feedback and encouragement when the journey of diabetes self-management becomes difficult.
• Move your body: Going for a walk or engaging in some form of enjoyable physical activity can help the brain release chemicals that improve mood.
• Think positively: It’s easy to focus on what’s not going well, but don’t forget to celebrate the wins! Making it to an appointment, remembering to take medication, picking up a refill … all those efforts count! Also think about activities and people that make life enjoyable and remember when things don’t go according to plan that tomorrow is a brand-new day and another opportunity to try again.
• Be kind to yourself: It’s normal to have good days and bad days when managing a demanding chronic condition like diabetes. The goal is not perfection (spoiler alert: that’s not possible), but rather to:
• Do the best you can
• Reflect on what’s working, what’s not, and then move on
• Do something you enjoy daily

Lastly, if doing any diabetes research online be sure to check out this list of resources from the Association of Diabetes Care and Education Specialists.

The Association also offers this webpage to help support healthy self-care behaviors.

Lindsay Schlichting, BSN, RN, CDCES is an Inpatient Diabetes Care and Education Specialist at Denver Health.