Help Make Meds Work Better

Brenda called me the day after this appeared and asked if I had read it. I said that I had not and she asked that I read it and call her back. After I had, I asked her what was so important about it. She said that it reinforced her feelings about controlling her diabetes, which many diabetes articles did not. Then she asked me to use it for a blog. I said I would consider it.

Richard Siegel, MD, co-director of the Diabetes Center at Tufts Medical Center in Boston says to obtain extra help from your medications, you need to make healthy changes in your life. This should help you do a better job of bringing your type 2 diabetes under control. By doing this, you might be able to cut back on the amount of medicine you take, or stop taking medicine.

Some things you should include:

• Get regular exercise.
• Eat a healthy diet.
• Get enough sleep.
• Lower your stress as much as you can.
• Don't smoke or drink too much alcohol.
• Track your blood sugar levels.

Diabetes drugs help your body balance insulin and your blood sugar levels. But you have to eat right and exercise to make them work properly, says Scott Isaacs, MD, an endocrinologist in Atlanta. Medications "are not a substitute" for those good habits, he says.

It's never too late to work with your doctor to create a treatment and lifestyle plan to help you manage your blood sugar and your weight. If you lose extra weight, your doctor may let you cut back on medicine, Isaacs says.

"Just to be able to limit the amount of diabetes medications you take is a good thing," he says. "Losing only 5% of your body weight is enough to make a difference." Set up a meal plan that's got plenty of low-fat foods that are high in fiber. Others may need more fat and less carbohydrates.

"A healthy diet is well-balanced and includes lean proteins from both animal and vegetarian sources, fruits, vegetables, and nuts," Siegel says.

Carbohydrates have the biggest effect on your blood sugar. So, limit or avoid added sugars and refined flours. That can help keep your glucose controlled, and you can still have healthier carbs like beans and whole grains. If you test and find that whole grains cause a significant increase in blood glucose, then you may need to limit these or avoid these in total.

Eat about 25 to 35 grams of fiber each day to help keep your blood sugar levels steady, Isaacs says. It can help you feel full longer, so you might not get hungry soon after eating. Eat fiber from natural foods like beans or whole grains rather than supplements, he says.

Examples include:

• Avocados (a medium one has 8.5 grams)
• Raspberries (a cup has 8.4 grams)
• Blackberries (a cup has 8.7 grams)
• Lentils (a half cup has 8 grams)
• Black beans (a half-cup has 7 grams)
• Broccoli (6 grams per cup)
• Apples (a medium one has 4 grams)

Exercise is just as important as drugs to help manage your diabetes, Siegel says. When you move and rev up your heart rate, it’ll help you burn extra fat and lose weight.

Your routine should include:

• Activity each day that gets your heart pumping, such as brisk walking or swimming
• Two to three sessions a week of strength training, with stretch bands, free weights, or workout machines (on non-consecutive days)
• Stretching or an activity like yoga every day to stay flexible

Regular exercise will build muscles, burn extra fat, and help your diabetes drugs work better, Isaacs says. "Muscle is important. Having more lean muscle mass will improve how well your body processes blood sugar," he says. He recommends weight training for a total of 1 hour (or more) every week to help you build more muscle.

Get more shut-eye, since it might help you keep your blood sugar levels in check. Poor sleep can also make you want to eat more during the day to boost your energy.

"Seven to 8 hours of good-quality sleep may also help to reduce your blood sugars and cardiovascular [heart] risk by lowering some of the body's hormones," Siegel says.

Stress can make it hard to rest at night. That might affect your diabetes, too. If you're anxious from family problems or work, for example, your body might make too many stress hormones, like cortisol. That tells your body to store more blood sugar and fat. When you feel less tense, the drop in cortisol might help your glucose levels, Siegel says. Stress can also cause your body to slow production of insulin. That’ll make it harder for your medicine to work well.

Find ways to relax. Exercise is one way to ease tension and sleep better. You can also try relaxation techniques like meditation.

To get your medications to work better:

• Follow your treatment plan.
• Take your diabetes drugs the way your doctor tells you.
• Manage your diet and weight
• Exercise regularly.
• Get your stress under control.

Your doctor might add drugs to your treatment plan when lifestyle changes alone don’t keep your blood sugar levels where you need them, Siegel says. Even when that happens, keep up your healthy habits, because that can help limit the medication you need.