Medically Reviewed On: July 11, 2008

ANNOUNCER: Leading a high-quality, healthy life is very possible for people with diabetes. It often depends on successful, self-management of the disease. Professional diabetes educators can help. Toward that end, a professional organization has put together a list of seven important self-care behaviors.

MARY M. AUSTIN:
1. Healthy Eating
For people with diabetes, mealtime seems to be the most difficult for them to manage with their disease. They're concerned about if they're eating the right food: Is this a good food for people with diabetes or a bad food for people with diabetes?

And basically all foods, but primarily carbohydrates, are the foods that become glucose.
So when we're planning healthy meals, we look for a balance of carbohydrates within each meal, but overall balance of all nutrients within the diet. And it's also important people with diabetes try to space their meals fairly evenly so that they're not consuming too much food at one time and then going for long periods of time without food.

2. Being Active
For a person with diabetes, especially a person who has type 2 diabetes who may have developed diabetes later in life and has a fairly inactive or sedentary lifestyle, part of the problem is that the inactivity has caused them to be insulin resistant. They're unable to use all the food that they're eating, because of this insulin resistance problem. Physical activity actually helps reverse some of this insulin resistance and people who have diabetes who are physically active utilize the food that they eat much better.

Aerobic exercise helps in actually burning calories, and anaerobic exercise helps in building muscle. For people with diabetes, and as you get older, you lose muscle mass, but muscle mass is the physically, metabolically, active portion of your body composition and it's what requires calories. So if you can maintain good muscle mass and have a combination of aerobic exercise to burn calories and maintain weight and anaerobic exercise to build muscle, you have a better chance of, number one, skeletal strength; you have more flexibility and it helps use up some calories. So a combination of both anaerobic and aerobic would be ideal for people with diabetes.

3. Monitoring
Diabetes is a 24-7 disease and patients need to make adjustments in what they do during the day, depending on what their blood glucoses are. If they're not monitoring their blood glucose, they have no idea what the effect of the meal they just ate may have on their blood glucose or how the medication they're taking is working to control their blood glucose. And some people will also find that, under times of stress, by monitoring their blood glucose, they can better manage and make corrections in their regimen.

4. Taking Medication
Diabetes is managed by a number of different options. One is physical activity and a proper diet, but medication is part of the therapy for a large portion of people with diabetes. If the patient does not take the medication, then their blood glucose will rise. And if they don't take the medications properly, and by "properly," I mean on time and consistently, that also can cause blood glucose to rise and the therapy is basically useless. So medication is a very, very integral part of making sure that the patient stays on their self-management regimen.

5. Problem Solving
The most critical problem-solving for most people with diabetes is how to deal with hypoglycemia. And, if they have a low blood sugar, what do you do about it and what's the most appropriate action to take? So, learning to problem-solve is important, and one aspect of problem-solving is the ability to recognize: What are the signs and symptoms of low blood sugar? Once you have that, because some people say they don't really feel when their blood sugars are getting low until it's too late, but once they have the ability to problem-solve and identify a low blood sugar, then how do you properly treat it? And we tell patients to properly treat it by taking 15 grams of a carbohydrate source and checking their blood sugar before and after that.

6. Reducing Risks
The greatest risk is if a person who has diabetes also smokes, because smoking is another risk factor for cardiovascular disease. It's particularly significant for people with diabetes. So the very first risk reduction, if a person smokes, a goal for that patient is to try to either stop their smoking or reduce it as much as possible.

Risk reduction involves not only the one obvious behavior of stopping smoking, but also having constant and scheduled contact with your healthcare provider is very important. Diabetes does not sit still; it's a progressive disease. And changes occur as you age and also affect the diabetes. Therefore, it's important to make sure that you have vision checked, dental checks, your feet checked every single time you see a physician, getting the appropriate labs that you need. Following the guidelines for appropriate care for people with diabetes is a shared responsibility between the patient and the healthcare provider.

7. Healthy Coping
People with diabetes, they have a greater incidence of depression. And it's unclear if the depression precedes the diabetes diagnosis or occurs afterward, but it is a safe bet that many people will face a bout of depression during their course of a lifetime with diabetes.

And it's important to recognize that this is normal, that this does occur. It's often because of the daily regimen that people have to do and it can wear on them.

So healthy coping is the ability to make sure that you feel comfortable enough to discuss it with your healthcare provider, that it isn't a stigma, it's part of life with the disease. There's help for depression. And healthy coping is a team approach. We all need to be able to recognize it and bring it to a patient's attention and help them go through these rough times.

ANNOUNCER: Successful self-care behaviors can help people with diabetes lead healthy, active lives. But professional diabetes educators caution: Just because they've listed seven steps, people with diabetes shouldn't feel they need to do them all right away, or do them all perfectly. Instead, take those steps you know you can be successful at, and build from there.