Diabetes Management

We can help you manage your diabetes through support, education, and tools for people with Type 1, Type 1.5, and Type 2 diabetes. Our goal is to help you understand your diagnosis, treatment, and care plan so you can take control of your health and successfully manage your diabetes. 

We want you to get well, be well, and stay well. That’s why you’ll have a diabetes management care team to help you every step of the way: 

Nurse Care Coordinator: The RN Care Coordinator is someone you’ll rely on, a bridge between you and the team of healthcare professionals. They will be your main contact person throughout the program. The RN Care Coordinator is in charge of ensuring you make progress in the program, get the help you need, and achieve your goals for managing your diabetes.

Primary Care Providers:  Primary Care Providers offer medical advice and support to help you manage your diabetes effectively. They can give guidance and counseling throughout your journey and adjust medications as needed.

Health Coaches: Health Coaches will be there to help you use what you know about diabetes management and give guidance on healthy eating, exercise, sleep, stress, and smoking. Some Health Coaches at Crossover are also registered dietitians who can give specific advice about eating plans. There’s no one-size-fits-all solution, so you work with your coach to ensure success by making a plan that’s realistic and sustainable for you.

Fitness Coaches*: Wherever you are with your health, our Fitness Coaches can help. During the fitness check, you’ll get personalized advice to help you reach your goals with consideration to your lifestyle, ambitions, and financial situation. Remember, there are many ways to exercise that don’t require a gym. Plus, the first fitness check and all of our online classes are free!

*Fitness Coaching and Physical Medicine is not available to all members. Check with your employer or benefits team to see if you have access to this service. 

Mental Health Therapists:  Did you know that people with diabetes are 2-3 times more likely to suffer from depression? We offer mental health services for managing a wide range of disorders like anxiety and depression. If you’re going through a tough time or just want to talk about how a diabetes diagnosis affects you, you can talk to someone and get the support you need.

Physical Medicine Providers*:  Physical Medicine services are available to help you manage your activity levels and are tailored to your specific needs. They include gradually increasing your exercise levels even if it feels challenging at first. We’ll also help you overcome negative thoughts or beliefs about exercise and find activities that work for you. Our goal is to help you overcome any physical barriers you might have and establish a regular exercise routine. We’ll also teach you the correct way to exercise to prevent any injuries.

*Fitness Coaching and Physical Medicine is not available to all members. Check with your employer or benefits team to see if you have access to this service.

Specialists: You might need help from other experts to manage your diabetes. These specialists include endocrinologists, podiatrists, nephrologists, optometrists, and dentists. The good news is, Crossover’s Care Navigators can help you find specialists when you need them.

• Endocrinology: An endocrinologist is a doctor who specializes in hormone-related diseases including diabetes. If your primary care provider thinks it would be helpful, they may refer you to one to take a closer look at your medications or if you have other health conditions that could benefit from their expertise.
• Podiatry: If you have diabetes, you might need extra care for your feet. That’s where a podiatrist comes in. They specialize in feet and can help you take good care of yours. Wondering what your feet have to do with diabetes? Take a look at our Foot Care Section below!
• Nephrology: If you have diabetes, it’s important to know that it can harm your kidneys. A nephrologist is a doctor who specializes in taking care of kidneys. So if your Primary Care Provider thinks your diabetes has caused problems with your kidneys, they may send you to see one. 
• Optometry: Taking care of your eyes is very important if you have diabetes. That’s why regular visits with an optometrist, a doctor that specializes in eye care, are key. They’ll make sure your diabetes isn’t having a negative effect on your eye health and catch problems before they worsen. Optometrists are available at some Crossover locations. If not, your care team will help you find one. 

Dentist: Visiting a dentist regularly is crucial for maintaining good gum and teeth health, especially if you have diabetes. Taking care of your oral health can actually help you gradually lower blood sugar levels. You’ll want to make it a priority to see a dentist on a regular basis.

When it comes to diabetes, there’s a lot of information to wrap your head around. Let’s start by explaining the various types of diabetes and how they’re different from one another.

Type 1 Diabetes

Type 1 diabetes is a condition where your body’s immune system mistakenly attacks the cells in your pancreas that produce insulin. Insulin is a hormone that helps your body absorb sugar into your cells. Without enough insulin, sugar builds up in your blood instead of being used by your cells. This is why people with Type 1 diabetes need to take insulin injections or use an insulin pump to regulate their blood sugar levels.

Handouts:

Diabetes Education – Diabetes and Your Health (ENGLISH)

Información sobre diabetes – la diabetes y su salud (ESPANOL)

Diabetes Education – Type 1 Diabetes FAQs. (ENGLISH)

Información sobre diabetes – Preguntas frecuentes sobre la diabetes tipo 1 (ESPANOL)

Type 1.5 Diabetes

Type 1.5 Diabetes, also known as Latent Autoimmune Diabetes in Adults (LADA), is a slow-progressing type of diabetes that’s caused when your immune system mistakenly attacks the cells in your pancreas that produce insulin. Unlike other types of diabetes, you may not need insulin right away after being diagnosed with LADA. It can take several months or even years before you need insulin treatment. LADA is often misdiagnosed as Type 2 diabetes for two main reasons. Firstly, LADA is commonly found in people who are over the age of 30, whereas Type 1 diabetes is usually diagnosed at a younger age. Secondly, people with LADA may still produce some insulin, while those with Type 1 diabetes do not.

If you or someone in your family has a history of autoimmune disease, it increases your risk for type 1.5 diabetes. Additionally, if you are an overweight child or teenager with symptoms of diabetes but the treatments for Type 2 diabetes are not working for you, it’s important to be aware of the possibility of Type 1.5 diabetes.

Handouts:

Diabetes Education – Diabetes and Your Health (ENGLISH)

Información sobre diabetes – la diabetes y su salud (ESPANOL)

Diabetes Education – Type 1.5 Diabetes Overview (ENGLISH)

Descripción general de la diabetes – tipo 1.5 (ESPANOL)

Type 2 Diabetes

Now, let’s talk about Type 2 diabetes. Unlike Type 1 diabetes, where the pancreas doesn’t produce insulin at all, in Type 2 diabetes, the pancreas still produces insulin, but the body doesn’t use it effectively. This means that the sugar can’t enter the cells easily, causing it to accumulate in the blood, making the blood sugar level too high.

Handouts:

Diabetes Education – Diabetes and Your Health (ENGLISH)

Información sobre diabetes – la diabetes y su salud (ESPANOL)

Diabetes Education – Type 2 Diabetes FAQs (ENGLISH)

Información sobre diabetes – preguntas frecuentes sobre la diabetes tipo 2 (ESPANOL)

What Are the Symptoms of Diabetes?

If you have Type 1 or Type 1.5 diabetes, you may experience some symptoms like feeling extremely thirsty all the time, feeling very tired, needing to pee a lot, losing weight without trying, and having blurry vision. In severe cases, you might also feel nauseous or vomit, have pain in your belly, or find it hard to catch your breath.

Type 2 diabetes usually causes no symptoms. When symptoms do occur, they can be similar to Type 1 and 1.5 and include needing to urinate often, intense thirst, and blurry vision.

How Do I Know If I Have Diabetes And What Type I Have?

Your care providers can perform blood tests to check your blood sugar levels and determine if you have diabetes. If you do, your Primary Care Provider or nurse will then establish if it is Type 1, Type 1.5 or Type 2 based on various factors including your test results and age.

Healthcare providers  may use several tests to confirm and diagnose diabetes. These include:

1. Hemoglobin A1c (HbA1c): It looks at the average level of sugar in the blood over about three months. It gives a steady picture of how blood sugar is doing overall, not just at one moment. If the HbA1c is 6.5% or more, it usually means a person has diabetes.
2. Fasting Blood Sugar Test: This one checks your blood sugar after fasting. If it’s 126 or more on two different days, you might have diabetes.
3. Oral Glucose Tolerance Test (OGTT): It’s a sugary drink test. If your blood sugar is 200 or more two hours after drinking it, that could mean you have diabetes.
4. Random Blood Sugar Test: This is a quick check, no matter when you last ate. If it’s 200 or more and you have symptoms like thirst, peeing a lot, losing weight, or blurry vision, it could be diabetes.
5. Glycated Albumin (GA) Test: This one looks at blood sugar in a different way.
6. Continuous Glucose Monitoring (CGM): This is a wearable blood sugar checker.

The tests your Primary Care Provider recommends  depend on your situation, so talk to your provider about which tests might be right for you.

Managing diabetes starts with understanding blood sugar, which is energy for your body’s cells. When you have diabetes, you need to watch your blood sugar closely because diabetes makes it harder to keep your blood sugar at the right level. It can sometimes get too high or too low. 

Blood Sugar Targets

So what’s the right level for your blood sugar? 

The American Diabetes Association suggests the following targets for most nonpregnant adults with diabetes. Keep in mind, these targets may be different for different people, depending on age and other health conditions. 

• Before a meal: 80–130 mg/dL 
• 2 hours after the start of the meal: Less than 180 mg/dL

Handouts:

Blood Glucose 101 – The Basics (ENGLISH)

Principios sobre la glucosa en sangre – datos básicos (ESPANOL)

In the section above, we mentioned the HbA1c as a way to measure average blood sugar over 3 months. This test can also be used to see how your blood sugar is trending and see how well your treatment plan is working. Although your Primary Care Provider will help determine what blood sugar targets are right for you, generally, an A1c < 7.0% is considered good control. Check out our video to learn even more about the HbA1c and how it translates into an estimated average blood sugar (eAG):

Blood Sugar Monitoring

For an overview of both blood sugar monitoring and management, start with this video:

For someone with diabetes, understanding blood sugar monitoring is essential. Here’s what you should know:

Why Monitor: Checking your blood sugar regularly tells you if your blood sugar is too high (hyperglycemia) or too low (hypoglycemia) and helps you make necessary adjustments or take the right treatment steps.

Frequency: Your healthcare team will advise how often to check. It varies based on your type of diabetes, treatment plan, and unique needs.

Tools: You’ll use a blood glucose meter, a user-friendly device that provides quick results. Your provider might even suggest a Continuous Glucose Monitor (CGM). A CGM is a device that checks your blood sugar levels all the time and gives you real-time information to help manage diabetes.

Target Range: Your healthcare provider will help you set a target range for blood sugar levels. Staying within this range is key to good health and avoiding complications of uncontrolled blood sugar.

Before and After Meals: Testing before and after meals shows how different foods affect your blood sugar and will help guide your dietary choices.

Pattern Recognition: Consistent monitoring helps you spot trends. You’ll understand how your body reacts to food, exercise, stress, and medications.

Record Keeping: Keeping a log of blood sugar readings, including diet and exercise details, helps you and your healthcare team adjust your treatment plan.

Medication Adjustments: If you’re on diabetes medication, monitoring helps you determine if you and your provider need to change your dosage.

Communication: It’s important to share your data with your healthcare team to get their insights and adapt your treatment.

Lifestyle Factors: Understand that stress, illness, and changes in activity can influence your blood sugar. Monitoring during these times helps you understand the effect of these factors and how to adjust for blood sugar control.

Self-Care: Blood sugar monitoring is a fundamental part of diabetes management. Taking an active role in this process can greatly improve your health and quality of life.

Monitoring is a learning process. It may take time to find what works best for you, but your healthcare team is there to provide guidance and support. Don’t hesitate to seek their advice and ask questions along the way.

Handouts:

Blood Glucose 101 – 5 Steps To Test Your Blood Glucose (ENGLISH)

Principios sobre la glucosa en sangre – 5 pasos para medir su nivel de glucosa en sangre (ESPANOL)

Blood Glucose 101 – Tips to Get a Successful Reading (ENGLISH)

Principios sobre la glucosa en sangre – consejos para obtener una lectura exitosa (ESPANOL)

Managing Your Blood Sugar – The Highs and the Lows

You and your doctor want to keep your blood sugar in the right range most of the time. But it’s important to know what to do if your blood sugar is too high or too low. This will help you feel more confident managing your diabetes and get your blood sugar back to normal quickly. 

When your blood sugar is too high (hyperglycemia): 

High blood sugar can feel like:

• Increased thirst and/or hunger 
• Fatigue (feeling weak or tired)
• Blurred vision 
• Weight loss
• Frequent urination (peeing) 
• Vaginal and skin infections
• Headache 
• Slow-healing cuts and sores
  

Make sure to follow the plan your Primary Care Provider or nurse gave you for your treatment. Remember, everyone’s plan is different. If your blood sugar is higher than 300 on two readings in a row even if you’ve been following your plan, contact your Primary Care Provider or nurse. They’ll tell you what to do next. If your blood sugar goes above 500, even just once, ask someone to take you to the emergency room or call 911. 

Blood sugar that’s been high for too long can result in diabetic ketoacidosis (DKA). DKA is a severe issue often seen in people with Type 1, but it can sometimes affect those with Type 2 in specific situations. DKA occurs when your body doesn’t have enough insulin to use sugar for energy, so it turns to fat instead. This fat breakdown creates something called ketones, which are acidic and can be harmful. It’s a big problem and needs quick attention.

Symptoms of DKA can look like: 

• Fast, deep breathing 
• Headache
• Dry skin and mouth 
• Muscle stiffness or aches
• Flushed face 
• Nausea and vomiting
• Frequent urination or thirst that lasts for a day or more 
• Stomach pain
• Fruity-smelling breath 
• Confusion/disorientation
  

When your blood sugar is too low (hypoglycemia): 

Low blood sugar (<70mg/dl) can feel like: 

• Shaking 
• Feeling sleepy, weak, or having no energy
• Sweating, chills, clammy skin 
• Blurred/impaired vision
• Color draining from the skin 
• Nausea
• Nervousness or anxiety 
• Headaches
• Irritability, impatience, or confusion 
• Coordination problems or clumsiness
• Dizziness, lightheadedness, fast heartbeat 
• Nightmares or crying out during sleep
• Hunger 
• Seizures
• Tingling or numbness in the lips, tongue, or cheeks
  

If your blood sugar is too low, you might feel like eating a lot to make yourself feel better. But this can make your blood sugar levels go too high. Instead, you can follow the “15-15 Rule” to avoid this and keep your blood sugar levels in a healthy range. Here’s how it works: eat 15 grams of a carbohydrate (like the examples below) to raise your blood sugar, and then check it again after 15 minutes. If it’s still below 70 mg/dL, eat another serving of carbohydrates. Keep doing this until your blood sugar is at least 70 mg/dL. Once your blood sugar is back to normal, make sure to eat a meal or snack to keep it from dropping below 70 again.

Examples of 15 grams of carbohydrates:

• 4 ounces (half a cup) of fruit juice
• 1 tablespoon of sugar or honey
• 4 glucose tablets
• 6 Life Savers candies  

Both blood sugar highs and lows can happen, especially when you’re sick. Contact your healthcare provider if you have any of the following:

• Sick for 1 to 2 days without improvement
• Vomiting or diarrhea for more than 6 hours
• Moderate to large amounts of ketones in urine, or blood ketones 0.6-1.5 mmol/l or higher (ketones are chemicals made by the body when it doesn’t have enough insulin in the blood; ketones should not appear in large amounts in the urine.)
• Taking insulin, but blood glucose levels continue to be over 240 mg/dL
• Taking oral meds and pre-meal blood glucose levels are 250 mg/dL or higher for more than 24 hours
• Signs of extreme hyperglycemia (blood glucose is too high, such as over 500 mg/dL)
• Sleepier than usual, stomach pain, chest pain, or difficulty breathing

Handouts:

Blood Glucose 101 – Managing Your Blood Glucose Level (ENGLISH)

Principios sobre la glucosa en sangre – pautas para el control de su nivel de glucosa en sangre  (ESPANOL)

Blood Glucose 101 – Blood Glucose and Illness (ENGLISH)

Principios sobre la glucosa en sangre – glucosa en sangre y enfermedades (ESPANOL)

Blood Glucose 101 – Glucose Warning Signs (ENGLISH)

Principios sobre la glucosa en sangre – señales de advertencia de glucosa (ESPANOL)

In the next several sections, we’re going to start talking about tools that you can use to manage your diabetes and stay healthy. They include:

• Medications
• Physical activity
• Nutrition
• Sleep and Stress
• Vaccines
• Eye Health
• Foot Health

There are various medicines for diabetes, and the type you need depends on the kind of diabetes you have and your specific situation. Let’s go over the most common types:

Insulin: Insulin is a hormone that helps control your blood sugar levels. People with Type 1 always need it. Some folks with Type 2 might need it too. There are different types of insulin, and you can take them by injection or through a pump.

Non-insulin medications (Type 2 diabetes): If you have type 2 diabetes, you might take pills or injections to manage your blood sugar. These medications work differently:

• Metformin: Makes your body use insulin better and reduces sugar made by your liver.
• Sulfonylureas: Makes your pancreas release more insulin. Common brand names in this class include Glucotrol (generic name: glipizide), Diabeta and Micronase (generic name: glyburide), and Amaryl (generic name: glimepiride).
• Meglitinides: Works like sulfonylureas but for a shorter time. Common brand names are Prandin (generic name: repaglinide) and Starlix (generic name: nateglinide).
• DPP-4 Inhibitors: Increases insulin after meals and lowers sugar made by your liver. Frequently prescribed brand names include Januvia (generic name: sitagliptin), Onglyza (generic name: saxagliptin), Tradjenta (generic name: linagliptin), and Nesina (generic name: alogliptin).
• SGLT2 Inhibitors: Helps your kidneys get rid of extra sugar through urine. Widely used brand names are Invokana (generic name: canagliflozin), Farxiga (generic name: dapagliflozin), and Jardiance (generic name: empagliflozin).
• Thiazolidinediones: Improves how your cells use insulin and lowers sugar made by your liver. Well-known brand names are Actos (generic name: pioglitazone) and Avandia (generic name: rosiglitazone).
• GLP-1 Receptor Agonists: These meds are often used for Type 2. They make your pancreas release insulin when your blood sugar is high and also reduce your appetite, which can help you lose weight. They are given by injection. Well-known brand names for GLP-1 Receptor Agonists are Bydureon (generic name: exenatide), Trulicity (generic name: dulaglutide), and Victoza (generic name: liraglutide).
• Amylin Analogs: Used with insulin, they slow down how fast your stomach empties and help manage your blood sugar after meals. Well-known brand names for Amylin Analogs are Symlin (generic name: pramlintide).
• Alpha-Glucosidase Inhibitors: These pills slow down how your body processes carbohydrates, which helps prevent blood sugar spikes after meals. Well-known brand names for Alpha-Glucosidase Inhibitors are Precose (generic name: acarbose) and Glyset (generic name: miglitol).
• Bile Acid Sequestrants: These are usually for high cholesterol, but they can also lower blood sugar. Well-known brand names for Bile Acid Sequestrants are Welchol (generic name: colesevelam).
• Combination Medications: Sometimes, doctors prescribe a mix of medicines to help control blood sugar better. Some common combination medications include Metaglip (Metformin and Glipizide), Janumet (Sitagliptin and Metformin), and Invokamet (Canagliflozin and Metformin).

Your doctor will decide which one is right for you, based on the type of diabetes you have and how your body responds. These medicines often go hand in hand with lifestyle changes like eating well and staying active to help control your blood sugar and stay healthy.

Handouts:

Non-Insulin Medications for Diabetes (ENGLISH)

Medicamentos sin insulina para la diabetes (ESPANOL)

Glucophage (Metformin) (ENGLISH)

Glucophage (Metformina) (ESPANOL)

Insulin 101 – The Basics (ENGLISH)

Principios sobre la insulina – datos básicos (ESPANOL)

Insulin 101 – Blood Sugar (ENGLISH)

Principios sobre la insulina – azúcar en sangre (ESPANOL)

Insulin 101 – Using Insulin (ENGLISH)

Principos sobre la insulina – pautas para el uso de insulin (ESPANOL)

Insulin 101 – Giving Yourself an Insulin Shot (ENGLISH)

Principos sobre la insulina – como administrarse una inyección de insulina (ESPANOL)

Insulin needles and blood glucose lancets are considered “sharps.” Used sharps are hazardous waste. When not discarded properly they can cut and infect others. Protect your community by always discarding your used sharps in a sharps disposal container. Below is a video that explains how you can proactively protect those around you.

How can I save costs on diabetes medications and supplies? 

Even with insurance coverage, diabetes medication and supply costs can add up. There are different ways to get some help with those costs: 

• Make sure you understand your employer benefits and prescription coverage. 
• If you have any questions about your medical and prescription plan benefits, contact your insurance—the phone number is usually on the back of your insurance card. 
• Ask your HR department if your employer has a contract with companies that cover diabetes costs and provide supplies. (e.g. Livongo—ask the HR/Benefits department if your company has this benefit).  
• There are federal and manufacturer-based assistance programs (e.g. Lilly, Sanofi)  that help pay for the medications and supplies.
• When shopping for your diabetes medications and supplies, take the time to compare prices as they can vary from pharmacy to pharmacy. Sometimes using a pharmacy-by-mail may be the most cost-effective choice. Your insurance carrier can verify that for you.  
• Check out the cost savings video below for some patient assistance programs that can help and for more tips! 

Benefits of Physical Activity for People with Diabetes

Physical activity offers many benefits for people with diabetes. Here are some key advantages:

Blood Sugar Control: Regular physical activity can help lower blood sugar levels by making your cells more insulin sensitive or more responsive to insulin. This is important for both Type 1 and Type 2 management.

Heart Health: Physical activity strengthens your heart, helps you manage blood pressure and cholesterol which reduces the risk of heart disease, a common complication of diabetes.

Stress Reduction: Physical activity is a great stress reliever. High stress levels can affect blood sugar, so managing stress through physical activity is important for people with diabetes.

Improved Mood: Physical activity releases feel-good chemicals, which can boost your mood and reduce symptoms of depression and anxiety.

Enhanced Blood Circulation: Physical activity improves blood flow, reducing the risk of complications like neuropathy (nerve damage) and peripheral artery disease.

Better Sleep: Regular physical activity can improve the quality of your sleep, which is essential for your overall well-being and blood sugar control.

Bone Health: Certain physical activities can help maintain strong bones and reduce the risk of fractures and bone-related problems.

Energy Boost: Physical activity can increase your energy levels and stamina, making it easier to do daily activities and enjoy an active lifestyle.

Blood Sugar Management During Physical Activity: Learning how different activities affect your blood sugar and making appropriate adjustments is important. This knowledge helps prevent low blood sugar (hypoglycemia), or even high blood sugar (hyperglycemia), during or after physical activity.

Before you start a physical activity program, especially if you have diabetes, it’s important to talk to a healthcare provider to make sure it’s safe for you. Also, monitor your blood sugar levels before, during (for workouts lasting longer than an hour), and after physical activity and carry some quick-acting carbs, like glucose tablets or snacks, to address any blood sugar issues that might come up during physical activity.

Handouts:

Diabetes & Exercise – Exercising Safely with Diabetes (ENGLISH)

Diabetes y ejercicio – ejercicio seguro con diabetes (ESPANOL)

Diabetes & Exercise – Sample Exercise Plans (ENGLISH)

Diabetes y ejercicio – ejemplos de planes de ejercicio (ESPANOL)

Diabetes & Exercise – The Basics (ENGLISH)

Diabetes y ejercicio – datos básicos (ESPANOL)

Diabetes & Exercise – Where to Start (ENGLISH)

Diabetes y ejercicio – donde comenzar (ESPANOL)

Nutrition is important for everyone, especially people with diabetes. Here’s why:

Blood Sugar Control: Some foods can raise your blood sugar a lot, while others can help keep it more steady. This is a big deal because steady blood sugar levels within the target range mean better diabetes management and a reduced risk for complications. 

Energy: Food gives you the energy you need to do everyday things like walking, thinking, and even sleeping. When your blood sugar is steady, you have the energy to do the things you enjoy.

Heart Health: Some foods can help lower the risk of heart disease and keep your blood pressure and cholesterol levels in check.

Feeling Good: Good nutrition makes you feel better physically and mentally. It’s like giving your body the best fuel to run smoothly.

Work with your team, health coach, or registered dietitian to create a sustainable plan that fits your needs. They can help you understand what to eat, when to eat, and how to balance your meals. By making the right food choices, you can better manage your diabetes and enjoy a healthier, happier life.

Handouts:

Diabetes & Diet – Traveling Tips (ENGLISH)

Diabetes y dieta – consejos para viajes (ESPANOL)

Gas Station Nutrition (ENGLISH)

Nutrición en las gasolineras (ESPANOL)

Diabetes & Diet – Non-starchy vegetables (ENGLISH)

Diabetes y dieta – verduras sin almidón (ESPANOL)

Diabetes & Diet – The Diabetes Plate Method (ENGLISH)

Diabetes y dieta – el método del plato para la diabetes (ESPANOL)

Diabetes & Diet – Protein (ENGLISH)

Diabetes y dieta – proteina (ESPANOL)

Diabetes & Diet – Snack Guidelines (ENGLISH)

Diabetes y dieta – Información sobre refrigerios (ESPANOL)

Diabetes & Diet – Seven Day Food Journal (ENGLISH)

Diario de alimentación de siete días (ESPANOL)

Diabetes & Diet – Managing your Blood Sugar while Sick (ENGLISH)

Diabetes y dieta – pautas para el control de su azúcar en sangre mientras está enfermo (ESPANOL)

Diabetes & Diet – Carbohydrates (ENGLISH)

Diabetes y dieta – carbohidratos (ESPANOL)

Diabetes & Diet – Party & Holiday Planning (ENGLISH)

Diabetes y dieta – planificación para las fiestas (ESPANOL)

Both sleep and stress can have a big impact on managing diabetes. 

Sleep 

Did you know that sleep (or lack thereof) can affect your ability to control your blood sugar, and that poor blood sugar control can affect how well you can sleep? 

How does sleep deprivation affect blood sugar levels? 

Sleep deprivation can have notable effects on blood sugar levels in people with diabetes, and it’s important to understand these impacts. Here’s how it works:

Insulin Response: Sleep is crucial for your body’s response to insulin. When you don’t get enough sleep, your cells don’t use insulin as effectively, making it harder for them to take in glucose (sugar) from your blood. This can lead to higher blood sugar levels.

Hormonal Changes: Not getting enough sleep can mess with your body’s hunger hormones. You might feel more hungry and have cravings for foods that can quickly raise your blood sugar.

Stress Hormones: Sleep deprivation can lead to higher stress hormone levels like cortisol. This can make your insulin work less effectively and could also lead to emotional eating, especially of sugary or starchy foods, which can impact your blood sugar.

Glucose Production: Usually, your body makes less glucose during sleep, which keeps your blood sugar steady. But when you’re sleep deprived, your liver makes more glucose, which can lead to higher blood sugar levels, especially in the morning.

Risk of Low Blood Sugar: Oddly enough, even though sleep deprivation can raise blood sugar levels, it can also make you more prone to low blood sugar, especially if you’re taking diabetes medications or insulin. This is because poor sleep can lead to irregular eating patterns and make it harder for you to notice the symptoms of low blood sugar.

Decision-Making: When you’re tired, it’s tougher to make choices that are in line with your goals, especially about food. You might be more likely to eat foods that aren’t great for your blood sugar, overeat, or snack on sugary stuff.

How can diabetes affect one’s sleep? 

High Blood Sugar Nights: If your blood sugar is too high when you sleep, you might find yourself making lots of trips to the bathroom during the night. 

Low Blood Sugar Nights: On the flip side, if your blood sugar drops too low while you’re sleeping, you might wake up feeling shaky, dizzy, and sweaty. That’s not great for getting a good night’s sleep.

Sleep Troublemakers: Diabetes can also bring along some sleep issues you don’t want like sleep apnea (which can make you stop breathing for short moments during sleep), restless leg syndrome (your legs just won’t sit still), and insomnia (struggling to fall asleep or stay asleep).

Taking care of your sleep is really important when you have diabetes. It’s not just about the quantity of sleep but also the quality. Make sure you have a good sleep routine, create a comfortable sleeping environment, and if you have issues like sleep apnea, it’s important to address them. Managing stress and being physically active can also help manage the effects of sleep deprivation on your blood sugar. If sleep problems continue to affect your blood sugar, it’s a good idea to talk to your healthcare provider for more guidance.

Stress 

What about stress?

Stress can significantly impact blood sugar management in individuals with diabetes in several ways:

Hormone Release: When you’re stressed, your body releases stress hormones like cortisol and adrenaline. These hormones can cause blood sugar to rise because they prompt the liver to release extra glucose into the bloodstream.

Insulin Resistance: Stress can make your body’s cells less responsive to insulin, which means your cells have a harder time taking in glucose for energy. This can lead to higher blood sugar levels.

Unhealthy Coping Mechanisms: People under stress might turn to unhealthy coping mechanisms like emotional eating or making food choices that are not in line with their goals. This can cause blood sugar spikes.

Missed Medications: Stress can disrupt your daily routine, making it easier to forget to take medications or insulin. This can lead to fluctuations in blood sugar levels.

Reduced Physical Activity: Stress can sap your energy and motivation, making it less likely that you’ll engage in physical activity. Exercise helps regulate blood sugar, so this lack of activity can contribute to unstable levels.

Stress-Related Illness: People under chronic stress are more vulnerable to illnesses like colds and infections. These illnesses can affect blood sugar control.

Sleep Disturbances: Stress can lead to sleep problems, and poor sleep can affect blood sugar. 

To manage blood sugar effectively, individuals with diabetes should also address stress. Techniques like stress management including relaxation, mindfulness, and regular physical activity can help. It’s important to have a support system, including healthcare providers and counselors, who can assist in developing strategies to cope with stress and its impact on blood sugar.

What if it’s more than stress? 

Hearing from your doctor that you have diabetes (or are prediabetic) brings up questions, concerns, and fears. It can make you feel worried, and that’s normal. Along with learning how to manage your condition, you need to also address how you feel emotionally. 

Anxiety 

Living with diabetes can be a source of anxiety. And that anxiety can change the way you care for yourself, which can affect your diabetes. That cycle shows you why it’s so important to address any anxiety you may be feeling.

Handout:

Anxiety and Diabetes – What to Know

Depression 

Depression and diabetes can also often go hand in hand, and when they do, things can get pretty tough.  When you’re feeling down, taking care of yourself can take a backseat. This means you might forget to check your blood sugar, take your meds, or eat right. As a result, your blood sugar can become a rollercoaster. You might pull away from friends and family even though having people to lean on is super important when you’re dealing with diabetes. 

Sometimes, people with depression think about hurting themselves, and this can lead to risky behaviors, like skipping diabetes treatments. 

If you’re dealing with both conditions, it’s important to get help. Your healthcare team, like primary care providers and therapists, can help you tackle both the physical and emotional sides of your health. Support groups and therapy can help you handle the emotional stress that comes with having diabetes and depression.

Handout:

Depression and Diabetes: What to Know

Why are vaccines important for people with diabetes? 

Diabetes, even if well managed, can make it harder for your immune system to fight infections. If you have diabetes, you may be at risk for more serious complications from an illness compared to people without diabetes. Vaccines are one of the safest ways for you to protect your health, even if you’re taking prescription medications to control your diabetes. A vaccine is made from very small amounts of weak or dead germs that can cause diseases. Vaccines prepare your body to fight the disease faster and more effectively so you won’t get sick.

Handout:

Diabetes Education – Vaccinations (ENGLISH)

Información sobre diabetes – vacunas (ESPANOL)

How can diabetes affect one’s eyes? 

Diabetes can lead to several serious eye conditions like diabetic retinopathy, cataracts, and glaucoma. This is due to higher levels of glucose circulating in your blood, affecting the nerves and blood vessels that lead to your eyes. By lowering your blood sugar to target levels through diet, exercise, and medications, most people with diabetes can avoid these problems. Take a peek at the video below that discusses these eye conditions and how you can protect your vision!

Handout:

Diabetes Education – Eye Health (ENGLISH)

Información sobre diabetes – salud ocular (ESPANOL)

Why is foot care so important? 

People with diabetes can develop many different problems with their feet. Even ordinary problems can get worse and lead to serious complications. 

Problems with the feet most often happen when there is nerve damage, called neuropathy. Neuropathy can cause tingling, pain (burning or stinging), or weakness in the feet. It can also cause a loss of feeling in the feet, which can be dangerous because if someone can’t feel their feet, they can experience an injury and not know it. Poor blood flow or changes in the shape of one’s feet or toes may also cause problems.

Blood sugar levels in the target range can reduce the likelihood of developing foot complications. High blood sugars can delay healing, making it hard for the body to fight an infection. Check out our video and handouts for tips on how to take care of your feet.

Handouts:

Diabetes Education – 10 Steps toward Foot Health (ENGLISH)

Informacion sobre diabetes – 10 pasos para una buena salud de los pies (ESPANOL)

Footwear for People Living with Diabetes (ENGLISH)

Cazaldo para personas con diabetes (ESPANOL)

Oral health is important for people with diabetes because it’s closely tied to overall well-being. High blood sugar levels can make gum disease more likely, and gum disease can, in turn, make it harder to control blood sugar. It’s an unfortunate cycle. Taking good care of your teeth and gums through regular brushing, flossing, and dental check-ups can help break this cycle. Plus, it’s just better for your health all around. Poor oral health can lead to infections and other problems that might affect how well you manage your diabetes. So, keeping a healthy mouth can make it easier to keep your diabetes in check.

Handout:

Diabetes Education – Diabetes & Oral Health

Información sobre diabetes – salud oral dental y bucal

Smoking or using tobacco can make diabetes management much harder. The chemicals in tobacco can lead to insulin resistance, making your body less responsive to insulin, which can cause high blood sugar. Smoking also damages blood vessels, increasing the risk of heart and kidney problems, which are common diabetes complications. Kicking the tobacco habit is like giving your body a better chance to keep blood sugar in check and reduce the risk of other health issues related to diabetes.

For more information on how to quit, visit our Tobacco Cessation Page.

Your Crossover Care Team is here to help. Primary Care is here to help you understand and manage your health. We have coaches who can help you make a plan so you know where to start. Our Mental Health Team can talk you through any stress or anxiety. Our Physical Therapy Team can help you recover from injury with safe movement. Wherever and whenever you’re ready to begin, just connect with your Crossover Care Team. We want you to be well.