Aging & Health A to Z
Lifestyle & Management
Managing Diabetes with Diet and Exercise
Healthy eating and exercise can improve your overall health, help manage your blood glucose level, and decrease your risk of the complications of diabetes.
Your healthcare providers will help you design a diet and exercise program that is right for you. They’ll help you increase your level of physical activity in safely and gradually, so you can stick with it over time. Your diet and exercise plan will also take into account any other illnesses or physical limitations you may have. Your healthcare professional may also have you work with a dietician to help you develop a healthy food plan that you will enjoy.
Choose Healthy, Low-calorie Foods—and Watch the Calories
To help manage your blood glucose levels, you need to control the number of calories you eat each day. But you don’t have to give up taste and satisfaction! Here’s how to eat well and healthfully when you have diabetes:
- Eat smaller portions at each meal. If you eat out, share what you order with a friend or bring home part of your meal to eat the next day.
- Eat cereals, breads, and pasta made with whole grains instead of white flour. Substitute brown rice for white rice and sweet potatoes for white potatoes.
- Read labels on cereal, bread and pasta boxes and choose those containing at least 3 g or more fiber per serving.
- Eat a variety of brightly-colored, low calorie fruits and vegetables. Aim for 6 to 9 servings a day. Especially good choices include: Leafy greens (spinach, chard, kale, collards, mustard greens, dark green or red lettuces), broccoli, broccoli rabe, red peppers, carrots; berries, cherries, apples, pears, and citrus fruit.
- Drink water or unsweetened tea instead of fruit juices, soft drinks, or other beverages high in sugar.
- Avoid eating processed and prepared foods. These foods are loaded with fat, calories, and sodium, plus they often contain unhealthy ingredients such as trans fats and high fructose corn syrup.
- Choose the salad option (with low-fat dressing) at fast food restaurants. At family style restaurants, choose broiled poultry, fish, or lean meat entrees with steamed veggies, and skip cheesy, buttery or creamy sauces. Opt for oil and vinegar dressings on salads.
- Limit the amount of alcohol you drink.
- Less than 30% of your total daily calories should come from fat. The healthiest fats for you are found in foods such as whole grains, fatty fish (salmon, sardines, mackerel, herring, trout), avocados, walnuts, almonds, sunflower seeds, and peanut butter.
- Choose olive and canola oil for cooking and salads.
- Good protein foods include eggs, low-fat dairy products, lean meats, poultry, fish, beans, and nuts.
- Your diet should also be high in fiber and rich in appropriate vitamins and minerals.
- Avoid sugary desserts and sweets. Choose fruits canned in its own juice instead of sugar syrup.
Exercise is essential for losing weight and controlling your blood glucose. Even small increases in physical activity can help.
People with pre-diabetes or diabetes should try to exercise 20 to 30 minutes at least three times a week. If you are able, exercising 20 to 30 minutes on most days provides even greater benefit.
Activities such as doing yard work or cleaning the house count as exercise, as long as they increase your heart rate and cause you to sweat lightly. Walking, swimming, and water aerobics are also great forms of exercise.
Exercise can be more fun if you do it with a friend or a group. Exercise classes are available at many local hospitals, community and senior centers, and adult education programs. An exercise teacher can help guide you on how to prevent injuries and modify exercises for any physical limitations you may have.
Other Important Steps in Managing Your Diabetes
Taking an Active Role in Your Treatment
Medicare pays for a visit with a diabetes educator once every year. Ask your healthcare professional to give you a referral. The educator will teach you how manage your diabetes and will work with you to develop a self-management program.
Ask the diabetes educator as many questions as you need to, as often as you need to, to be sure you know everything you need to know to manage your diabetes. Make sure you fully understand the answers to all your questions.
If you need assistance, your family or other caregivers should also receive training and become involved in your diabetes self-management. Caregivers may need to take over the self-management program if an older person with diabetes begins to have mental difficulties or becomes significantly disabled.
High and Low Blood Glucose
Despite your best efforts, you could experience problems. Here are some symptoms to watch out for; if you have any of these, call your healthcare provider at the first sign of trouble.
- Very High Blood Glucose. This is an uncommon but serious complication of diabetes that occurs most often in older adults. A sudden illness, particularly an infection, or certain medications can trigger a glucose spike. Watch out for symptoms like these:
- Physical weakness
- Lack of energy
- Low Blood Glucose. Low blood glucose usually occurs when you take too much diabetes medication or you skip a meal. Illness and infections can also cause low blood glucose. Watch for these symptoms:
Since it can be easy to confuse symptoms of low and high blood sugar, at the first sign of any unusual symptoms, measure your glucose level, then call your healthcare professional right away to alert him or her to your condition. And call promptly if you’re unable to measure your glucose.
If your blood sugar tests low, you should be able to raise it quickly by eating a piece of candy, having a spoonful of honey, or drinking a glass of fruit juice. That’s why it’s a good idea to keep hard candies handy, just in case. Since this sugar boost only lasts a little while, though, it’s important to eat a meal as soon as possible.
If low blood glucose is frequent or severe, your healthcare provider will need to check your diabetes treatment plan and change it, if necessary. You might just need a better plan for controlling your blood glucose levels. You might need to visit your healthcare provider more frequently for check-ups, or see a diabetes care specialist.
Understanding Your Medications
You need know about all the medications you are taking, not just your diabetes medication. Ask your healthcare provider(s) to tell you about each medication he or she prescribes for you, including:
Why you are taking the medication
How and when to take the medication
Common side effects of the medication
Extreme or chronic stress can raise blood sugar levels. Though you can’t avoid stress, you can learn to manage your reaction to it.
These tips can help:
- Don’t put unnecessary demands on yourself – try to avoid being a perfectionist or workaholic.
- Schedule time for things you enjoy, such as socializing with friends or family, gardening, singing or playing an instrument, or doing crafts or other creative activities.
- Keep a positive attitude and focus on the things in your life that are going well.
- Talk to a close friend, family member, your spouse or partner, or a counselor or clergy member about the things you find stressful.
- Exercise is an excellent way to relieve stress.
- Learn and use simple relaxation techniques, such as listening to calming music or sounds, deep breathing, muscle relaxation, or meditation.
Complications of Diabetes
Over time, high levels of sugar in your bloodstream can damage your nerves and the small blood vessels in your heart, kidneys and eyes. This puts you at higher risk for visual impairment and blindness, and for developing heart and kidney problems.
Symptoms or signs of serious health conditions that are often caused by diabetes include:
- Heart disease
- Blood vessel problems, such as narrowing of the arteries
- Nerve problems (usually burning, tingling, or numbness of the feet or hands)
- Foot problems (sores or nerve problems)
- Eye problems (including impaired vision or blindness)
- Kidney problems
- Erectile dysfunction
Because heart problems are so common with diabetes, your healthcare provider will check for other conditions that can also cause heart trouble, such as smoking, high blood pressure, being overweight, high cholesterol, and family history.
Preventing and managing risk factors for heart disease in older adults with diabetes is especially important. These steps include:
- Losing weight if necessary
- Increasing physical activity
- Quitting smoking
Since diabetes can cause blood vessel and circulation problems, you’re at very high risk for serious foot problems that, unfortunately, can sometimes lead to amputation. Taking excellent care of your feet is a vital part of diabetes management.
Your healthcare provider should examine your feet at least once a year, and you should examine your feet every day. Tell your healthcare provider right away about any changes to your feet or any signs of damage, including sores or discolored toes.
You must also take good care of your toenails to prevent foot infections. Ask your healthcare provider to refer you to a foot doctor (podiatrist), especially if it’s hard for you to care for your toenails yourself.
The blood vessel and circulation problems associated with diabetes can also affect your eyes. Have a thorough eye examination by an eye doctor (ophthalmologist), every year or as often as recommended.
Other Steps to Prevent Diabetes Complications
To help monitor whether you may be developing diabetes complications, work with your healthcare provider to:
- Review all the medications you are taking that might be increasing your blood glucose, such as certain water pills (diuretics) or certain steroid medications for asthma or arthritis.
- Have a urine test every year. Having a protein called albumin in your urine can be a sign of kidney damage.
- See your dentist twice a year and work closely with him or her to keep your teeth and gums healthy.
- Get a flu shot every year and a pneumonia vaccine once at age 65, and every five to six years after age 65.
- Protect your skin from the sun with hats and clothing, and keep your skin clean and moisturized. Take care of cuts and bruises to prevent infections.
Updated: March 2012
Posted: March 2012