Your Role in Diabetes Management

Whether you have type 1 diabetes or type 2 diabetes, you share one crucial responsibility from your diagnosis going forward — doing your part. In simple terms, you must now become an active helper in your body’s metabolism, and the better helper you become, the less likely you are to experience the damage that diabetes can do to your body.

Type 1 diabetes results when your capacity to produce insulin is lost. Type 2 diabetes is related more to your natural insulin being unable to do its job effectively. If you were a car and insulin was gasoline, type 1 diabetes is having an empty tank, and type 2 diabetes is more like lost efficiency from clogged fuel injectors.

Managing type 1 diabetes requires constantly adding gasoline; type 2 diabetes requires that you get your fuel injectors to work better. The real story is a little more complicated.

Losing glucose homeostasis

Your body needs to keep a certain concentration of glucose circulating in your blood — a normal blood glucose level. Glucose is the favorite fuel of your trillions of cells, and some really important cells — your brain cells — can’t get their energy from anything else. Glucose in your bloodstream is all about energy — it’s delivered right to the doorstep of every cell that needs it.

Because glucose enters your blood after you eat carbohydrate foods, causing your blood glucose levels to rise, your body has a way to return those levels back to normal by storing the excess for later. The stored glucose can be released back into the blood when glucose levels drop between meals, keeping a constant supply available for your brain. This kind of balance in a biological system is called homeostasis.

The hormone responsible for escorting glucose into storage is insulin, and insulin is automatically released from special cells on your pancreas when blood glucose levels are going higher after eating. If insulin isn’t available or isn’t working properly, blood glucose can’t be stored, and blood glucose levels remain high. High blood glucose levels not only upset glucose homeostasis, but begin to damage cells and tissue.

Chronic high blood glucose levels is diabetes — literally. In the simplest terms, having diabetes means your blood glucose levels go up after eating and don’t come down to normal levels in a normal amount of time.

Type 1 diabetes results when insulin production capacity is destroyed, and no insulin is available to facilitate glucose homeostasis. Type 2 diabetes begins when the cells that normally store excess glucose stop responding to insulin. So, even though insulin may be available, blood glucose levels remain high.

The long-term damage caused by high blood glucose, in either case, can progress to very serious consequences like heart attack, stroke, vision loss, nerve damage, kidney failure, and more. These secondary conditions are called complications of diabetes, and avoiding these outcomes is one reason that lowering blood glucose levels is so important.

High glucose levels not only mean that excess glucose can’t get into cells to be stockpiled, but glucose can’t get into cells to properly fuel energy needs. That means your microscopic cells, like the muscle cells you need to move, don’t have access to their favored fuel, and must turn to plan B or plan C for generating energy.

Plan B and plan C are ordinarily temporary plans for times of shortage — generating energy without glucose is inefficient, and even produces toxic waste products. Diabetes upsets your entire energy balance.

Taking your place in glucose metabolism

Treating diabetes is not like treating an infected cut, where the problem goes away after a week or two. In fact, diabetes treatment is called diabetes management, hinting at a responsibility that requires continuous oversight. And, that’s exactly what diabetes management is — continuous oversight.

Managing diabetes is like managing anything where the goal is to achieve and sustain a certain level of performance. The manager works to provide the best environment and materials for success, looks at performance indicators, sets priorities, makes adjustments to improve efficiency, tries to avoid disruptions, and always keeps a focus on surviving and prospering over the long term.

Effective management is a key to success in business, sports, lawn care, and diabetes. But, while the management responsibilities for businesses, sports teams, and even lawn care can be delegated to professional experts, the extraordinarily important job of managing your diabetes has suddenly fallen on you — diabetes self-management.

Fortunately, if you’re willing to take this responsibility seriously, there is a proven plan that can turn you into a successful manager of your body’s metabolism. And, as daunting as this might sound, with some dedication and practice you’ll be managing your metabolism like a pro, and enjoying the rest of your life’s activities even more than before.

How’s that? Well, like any good manager, success is a little bit of participating, but a whole lot of setting up a system where success is possible.

You can’t actually fix your glucose metabolism. You can, however, provide the best environment and materials for success, look at performance indicators, set priorities, make adjustments to improve efficiency, try to avoid disruptions, and always keep a focus on surviving and prospering over the long term.

That sort of management strategy lets your natural metabolism work as well as it possibly can, and that’s effective diabetes self-management at its best. And, you can do it.

Eating a healthy diet and managing your carbohydrate consumption is essential to your long- term health with diabetes. Taking your medication as directed, exercising regularly, getting adequate rest, reducing stress, and not smoking also have important, sometimes critical, roles in your long- term health, but there’s no separating diabetes health from food.

Although you may think this challenging part of managing diabetes effectively mostly involves your pancreas, your stomach, or some other food-related organ, you might be surprised.

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