Being diagnosed with type 2 diabetes can feel like a whirlwind, and a terrifying one at that. There is tons to digest after a diabetes diagnosis, and while this simple guide won’t answer every question you might have, it will help to outline the most important things you need to know.
The first, and perhaps most important thing to say is that although a diabetes diagnosis can be scary, there is now research to say that type 2 diabetes can be put into remission. And that same research shows that the sooner you act, the better your chances of reaching remission. But before getting into that, let’s start with the basics!
Type 2 diabetes is the most common form of diabetes. It is an endocrine disorder (i.e. one caused by dysregulation of hormones) that disrupts the processes by which our bodies use sugars taken in through food.
When we eat food, and particularly food rich in sugar (or glucose), the levels of glucose in our bloodstreams rise. The tissues of our body require sugars to function properly, so they then take these sugars from the bloodstream thanks to the action of a hormone secreted by the pancreas called insulin. When insulin isn’t made in high enough levels or when it’s not able to work as it should—as is the case in pre-diabetes and type 2 diabetes—this sugar, or glucose, is left in the bloodstream longer than it should be, which can lead to a whole host of complications. This state of elevated blood sugar is called hyperglycaemia.
In the UK, diabetes diagnosis is typically made by measuring a blood sample for something called HbA1c, which measures your average blood glucose over about the last three months. But what should you do after receiving the diagnosis?
While hyperglycaemia is the marker we use to identify type 2 diabetes, it’s an outcome of the disease rather than a cause. So it’s important to know the underlying cause of why hyperglycaemia occurs in the first place.
There are two things that can in tandem lead to elevated blood sugar. The first is a reduced ability of the pancreas to create and release insulin into the bloodstream in response to elevated sugar levels. Research has shown that, in type 2 diabetes, it is fat cells inside of the pancreas that prevent it from doing this job appropriately.
The second is the decreased efficiency of insulin on our tissues, a condition called "insulin resistance," which indicates that our cells are resistant to the action of insulin and, as a result, sugars have a much more difficulty entering the tissues to be used.
Both of these things—and therefore type 2 diabetes as a disease—are directly impacted by body weight and eating and exercise habits.
Following the diagnosis of type 2 diabetes, the most important thing is to adopt a whole series of behaviors and measures aimed at controlling your blood sugar, which can help to reduce the risk of complications of diabetes as well as even potentially help you reach remission of the disease.
To begin with, it’s important to say that a diabetes diagnosis doesn’t mean giving up the foods you love entirely, but rather that it’s important to think about improving your diet overall and being aware of how the foods you eat can impact your body. Because weight is so associated with type 2 diabetes, a diet (combined with an exercise plan) that leads to weight loss and long term maintenance of healthy weight is truly the best treatment for the disease.
We don’t have space here to talk about all of the intricacies of eating in a balanced and sustainable way, but here are a few of the most important points:
Some people like to use a food diary, writing down the foods consumed and their quantities, sometimes alongside blood sugar readings. At the end of the day, there is no perfect diet for managing type 2 diabetes, as each of us reacts differently to different foods, so really it’s about finding what works for you—for your food preferences, your budget, and your lifestyle.
Physical activity, together with diet, can also help to keep your weight under control and lower insulin resistance—which, when taken together, improves blood glucose levels both after meals and in the interval between meals.
It’s important to know that exercise doesn’t have to be lifting huge weights or running marathons. Physical activity in adequate amounts—so just 150 minutes of exercise per week (that’s just 20 minutes per day!)—has been shown to have huge health benefits. Do keep in mind that blood glucose levels decrease during physical activity, so if you’re implementing a new exercise it’s important to look out for symptoms of hypoglycaemia.
Exercise also improves the cardiovascular system, helps control hypertension, and improves the utilisation and supply of oxygen in our tissues. Some people find a fitness tracker useful for getting into a routine, while others use mobile apps for inspiration and tracking. Another great motivator can be to exercise with a group or with a “gym buddy”, or getting a personal trainer if your budget allows for it.
The diagnosis of diabetes can have a negative psychological impact as well, leading to feelings of fear, anxiety, a sense of insecurity, and/or mood and sleep disorders.
First and foremost, it’s important to know that diabetes should never be considered a personal failure. Because type 2 diabetes has such close associations with weight and eating habits, many people blame themselves for the disease—but that only makes things worse.
At Habitual, we spend an entire three months focusing on mental habits and our relationship with food, how we speak to ourselves, and other factors that influence our health. Making a lasting change isn’t just about knowing the facts—it’s about believing in yourself and having the confidence that you can change your life.
Some people may prefer a more hands-on approach, and choose to see a psychologist or a psychotherapist who can help to achieve this mental fortitude and resilience necessary to diabetes management and remission.
Another key element to consider is the importance of social support, whether that comes in the form of friends, family, or even disease support groups. Surrounding yourself with people who support your health goals can completely change your ability to tackle the challenge of managing or reversing type 2 diabetes.