Living With Diabetes

If you have diabetes, your pancreas either doesn't produce any insulin or doesn't produce enough insulin. Because insulin is needed to carry glucose from your bloodstream into your cells, a lack of insulin leads to high blood sugar.

Without treatment, high blood sugar can cause nerve damage and other serious complications. Fortunately, it's possible to manage your diabetes with lifestyle changes and medications.

If diabetes interferes with your career, your hobbies or your relationships, a few changes to your routine can greatly improve your quality of life.

Type 1 diabetes and Type 2 diabetes cause the following symptoms:

• Frequent urination
• Increased thirst
• Blurred vision
• Increased hunger
• Unexpected weight loss
• Dry skin
• Slow-healing wounds
• Numbness or tingling in your hands or feet

You may have additional symptoms if you have Type 1 diabetes, which is an autoimmune disorder that usually develops early in life.

In people with Type 1 diabetes, the immune system attacks the pancreas, leaving it unable to produce insulin. Symptoms of Type 1 diabetes include abdominal pain, nausea and vomiting.

Type 2 diabetes occurs when your pancreas doesn't produce as much insulin as you need. It usually develops in adulthood, but some children and teens have the disease.

Diabetic Neuropathy

Too much glucose (blood sugar) can damage the nerves, causing a condition known as diabetic neuropathy. If you develop this complication, you may experience tingling or burning sensations, numbness, reduced ability to feel pain or increased sensitivity to touch.

Diabetic neuropathy also puts you at risk for diabetic foot ulcers, which develop due to poor circulation, reduced sensation in the feet and other factors. Without proper treatment, a diabetic foot ulcer can quickly become infected.

In severe cases, it may be necessary to amputate the foot to prevent the infection from spreading.

Kidney Disease

High blood sugar can damage the blood vessels in your kidneys. When the kidneys don't get an adequate amount of blood flow, they can't work efficiently. As a result, fluid and waste products build up in the bloodstream, which may cause swelling, itching, fatigue and other symptoms.

High Blood Pressure

Diabetics have an increased risk of hypertension, commonly known as high blood pressure, because excess blood sugar damages the blood vessels and leaves them vulnerable to a condition known as atherosclerosis.

When you have atherosclerosis, the walls of your arteries are lined with plaque, a sticky substance that can restrict blood flow. As a result, your heart has to work harder to pump blood to other parts of the body.

Left untreated, high blood pressure can lead to stroke, kidney disease or heart disease.

Cardiovascular Disease

Atherosclerosis also contributes to heart disease and increases your risk of stroke and heart attack.

Your risk of developing cardiovascular disease is even higher if you meet any of the following criteria:

• You're obese.
• You have high blood pressure.
• You have high cholesterol. 
• You smoke cigarettes.
• You have a family history of heart disease.

Eye Problems

Some diabetics develop a condition called diabetic retinopathy, which occurs when the blood vessels that supply the retina are damaged. The retina senses light and sends signals to your brain so that you can see a complete image. Therefore, diabetic retinopathy can lead to vision loss and blindness.

If you have Type 1 diabetes, you'll need to take insulin since your pancreas can't produce any. Some Type 2 diabetics can control their blood glucose levels without taking insulin or other medications, but not everyone can.

If lifestyle adjustments don't work for you, your doctor may recommend one of the following types of medications:

• Alpha-glucosidase inhibitors
• Biguanides
• Bile acid sequestrants
• Dopamine agonists
• DPP-4 inhibitors
• Meglitinides
• SGLT2 inhibitors
• Sulfonylureas
• Thiazolidinediones

Each type of medication works to reduce your blood sugar and prevent diabetes complications. Some drugs achieve this goal by reducing glucose production in the liver while others stimulate the release of insulin to help glucose enter your cells. Still others reduce your blood sugar by increasing the amount of glucose excreted by the kidneys.

Your doctor will prescribe a medication based on several factors, including your weight, how much your glucose level varies each day and whether you have any other medical conditions.

Nausea, vomiting, diarrhea and flatulence are among some of the most common side effects of oral medications used to treat diabetes.

Let your doctor know if you have a new medical diagnosis, including kidney disease, liver disease or coronary artery disease, as some of these medications are contraindicated in people with certain health conditions.

Even if you have diabetes, you can still live a full life filled with loving relationships, a rewarding career and enjoyable hobbies, but you may have to make some adjustments to make sure you maintain a healthy weight, keep your blood glucose levels in an acceptable range and receive regular medical care.

Therefore, diabetes can affect your life in the following ways.

Financial Considerations

Having diabetes can change your financial situation, especially if you don't have health insurance. Some oral medications are inexpensive, but others come with high out-of-pocket costs. Additionally, shortages can drive up the price of insulin and other diabetes drugs, making it even more expensive to manage the condition.

If you have a low-cost, high-deductible health insurance plan, you may need to switch to a more expensive plan to ensure more of your costs are covered. You may also have to pay copays and deductibles, increasing your monthly costs.

Heightened Levels of Anxiety

Some people with diabetes feel anxious about their health, making it difficult to concentrate on other activities. This is especially common in people who just received a diagnosis and feel overwhelmed with everything they need to learn to manage the disease.

If your diabetes gets worse, you may also worry that you will develop kidney disease, diabetic retinopathy or another serious complication.

Physical Symptoms

Diabetes causes a wide range of symptoms, some of which cause more discomfort than others. If your glucose levels aren't under control, you may have blurry vision, numbness in your limbs, extreme hunger or thirst, frequent urination or dizziness.

Abnormal glucose levels may even cause fainting, which can be distressing if it happens at work or school. All of these symptoms can make you feel uncomfortable and make it difficult to carry out your regular activities.

Social Interactions

When you have diabetes, you need to be adept at having social interactions without deviating from your care plan. If your employer has a catered lunch, for example, you may need to bring your own food to ensure that you can participate without eating foods that might cause your blood sugar to spike.

When you're first diagnosed, you'll need to educate your loved ones about diabetes and how it affects your life. You may also need to explain to friends that you need to take a break from social activities to take your medication or check your blood sugar.

Sexual Health

Poorly controlled diabetes can cause complications that affect your sexual health.

For example, high blood sugar can cause genital yeast infections, vaginal dryness or irregular menstrual periods in women.

Men with diabetes may experience erectile dysfunction due to reduced blood flow to the penis, which can occur when high blood sugar damages the blood vessels. Nerve damage can also affect the frequency and quality of a man's erections.

Timing of Insulin Injections

If you take insulin, you need to time your injections appropriately. Some forms of insulin must be taken approximately 15 minutes before a meal, so you'll need to plan accordingly when cooking or dining out.

At work, you may need to step out of a meeting or block off time in your calendar to ensure you can take your insulin on time.

Travel Considerations

When you travel, you'll need to make sure you pack your medications, injection supplies or whatever else you need to manage your diabetes while you're away. You should also keep glucose tablets or hard candies in a purse, fanny pack, bookbag or carry-on bag to ensure you can access them immediately if your blood sugar gets too low.

Diet Adjustments

The foods you eat have a major impact on your blood sugar level, so it's important to follow a healthy eating plan when you have diabetes.

There's no single plan that works for every diabetic, so work with your doctor or a registered dietitian to determine how many calories you should consume each day and how many grams of carbohydrate, protein and fat you should include in each meal.

Unless your doctor recommends otherwise, you should focus on eating plant-based foods and limited amounts of fish, poultry and low-fat dairy products. 

To manage your diabetes without sacrificing your favorite foods, try some of the following tips:

• Instead of having a high-calorie appetizer, eat a salad or order a soup made from broth instead of a cream base.
  
  
• When you go out to eat, order smaller portions or split a regular portion with your companion. If you're dining alone, take some of your food home with you and eat it the next day.
  
  
• Ask for salad dressing on the side.
  
  
• Use olive oil or balsamic vinegar instead of dressings made with a lot of sugar.
  
  
• Instead of ordering a slice of cake or bowl of ice cream for dessert, have a bowl of fresh berries.
  
  
• Choose non-starchy vegetables when possible.

Health Care

It's important to see a doctor regularly to ensure that your diabetes is well-managed. In addition to your primary care doctor, you may need to see an endocrinologist, a medical specialist who diagnoses and treats problems related to hormones.

Insulin is a hormone, which is why endocrinologists work with people who have diabetes. If you develop diabetes complications, you may need to see a cardiologist (heart specialist) or nephrologist (kidney specialist). It's also important to have regular eye exams to make sure that you don't have any signs of diabetic retinopathy.

Diabetic neuropathy puts you at an increased risk of foot ulcers, so you may also need to see a podiatrist to keep your feet healthy and prevent serious infections. Podiatrists specialize in diagnosing and treating problems with the feet and ankles.

Physical Fitness

Getting plenty of exercise can help you manage your diabetes and improve your quality of life. Physical activity has two main benefits for people with diabetes:

• Muscle contractions cause the cells to take up glucose even if you don't have any insulin available.
  
  
• Exercise increases your insulin sensitivity, which means your body uses insulin more efficiently.

In addition to lowering your blood sugar, exercise also improves your blood pressure and cholesterol levels, lowers your A1C, reduces your risk of heart attack and stroke, increases your energy and helps you maintain a healthy weight. 

Forms of Exercise

The American Diabetes Association recommends that you get at least 30 minutes of aerobic exercise per day, five days per week. Aerobic activity improves your cardiovascular health, increases your endurance and helps relieve stress.

Walking, playing tennis, swimming, dancing and golfing are all aerobic exercises that are also fun to do, which means you're more likely to keep doing them.

You should also engage in strength training to build muscle and preserve your muscle mass. Lifting weights, doing calisthenics and using resistance bands are all forms of strength training.

If you don't have the money to join a gym or purchase home gym equipment, try walking up and down the stairs, riding your bicycle or jogging in a public park.

Check with your doctor before starting any exercise program to make sure it's safe.

Exercise and Hypoglycemia

Because exercise increases your insulin sensitivity and causes your cells to take up glucose, you can develop hypoglycemia — low blood sugar — during or shortly after your workout. To prevent hypoglycemia, check your blood sugar before and after exercise.

If your blood sugar level falls below 100 milligrams per deciliter, you may need to take glucose tablets or use gel glucose. Keep these items with you when you exercise so that you can use them if you need them.

If you don't have glucose tablets or gel glucose, eating a tablespoon of sugar or honey can help increase your blood sugar level.

Travel Tips for Diabetes

If you take insulin, it can be helpful to ask your doctor for a letter explaining your condition and your need to have insulin, syringes and other supplies with you when you travel. Such a letter can help you avoid hassles when going through airport security.

You should also ask for an insulin prescription to keep with you. If you lose your insulin while traveling, you'll be able to get the prescription filled at a local pharmacy, ensuring that you can continue controlling your blood sugar even when you're far from home.

Pack Extra Supplies

Don't assume that your trip will work out exactly the way you planned. Due to flight delays, natural disasters or other circumstances, you may have to extend your trip. That's why you should pack more supplies than you need.

If you miss a flight or get stuck hundreds of miles from home, you'll still be able to manage your diabetes.

Learn to Speak the Language

If you plan on traveling internationally, learn how to say "I have diabetes" in the language of your destination country. It can also be helpful to learn phrases related to foods, beverages, physical activities and medications.

For example, you may want to learn how to say "I need sugar, please" in case you develop hypoglycemia during your trip.

Stay on Track

Finally, try not to stray too far from your routine when you travel. It can be fun to sleep late or try new things, but you should follow your eating plan as closely as possible, continue exercising and take your medications as scheduled.

Sticking to your routine can help you avoid diabetic emergencies when you're far from home and aren't familiar with the local health care system.

• American Council on Exercise
  
  
• American Diabetes Association
  
  
• Americans with Disabilities Act
  
  
• Association of Diabetes Care & Education Specialists
  
  
• CDC Manage Diabetes
  
  
• InsulinHelp.org
  
  
• Joslin Diabetes Center
  
  
• MyPlate
  
  
• National Institute of Diabetes and Digestive and Kidney Diseases
  
  
• USDA FoodData Central
  
  
• World Diabetes Foundation