Evolution of diabetes management: A holistic approach

Managing diabetes is not just about keeping a tab on your blood sugar levels, it is a full-time job that includes a comprehensive lifestyle change. Here, through this article, we try to explore a multifaceted approach towards managing diabetes effectively keeping in consideration factors beyond traditional methods, and achieving lasting results.

Monitoring lifestyle, and keeping biological influences in consideration, are the pivots of this extensive diabetes management approach, which is quite helpful for people with type-2 diabetes in managing the condition effectively.

Regular screening, the first step Diabetes increases the risk for conditions, including hypertension, heart disease, kidney failures, and issues pertaining to one’s eye health. It is imperative to keep getting regularly investigated and keep a check on your overall health, recommends the American Diabetes Association (ADA)¹.


These investigations include tests for your eyes, feet, blood pressure, cholesterol, A1C, and other blood tests. The good part is that most of these investigations can be done in just a few minutes. This is preventive care and is better than post-treatment care⁴.

Change your lifestyle
Exercise, stress management, and a better sleep schedule are some of the lifestyle changes one needs to incorporate into their lifestyle and are vital to the overall management of diabetes⁵.

Stay fit, exercise
A study by Anjana RM et al underscores the importance of physical activity in managing diabetes²

Daily physical activity and exercise can reduce the Cardiovascular Disease (CVD) risk by up to 80%⁶. Physical workout not only helps in blood glucose regulation but also improve cardiovascular health, a critical factor, since diabetes often coexists with heart disease.

At least 30 minutes of physical activity should be incorporated into the daily routine. It can be in the form of a brisk walk or engaging in activities that enhance physical movement, including Yoga, dance, aerobics or running.

Eight control and diabetes management
Apart from lifestyle and environmental factors, weight management is also integral to diabetes care. Research shows that a weight loss of five to ten per cent can significantly improve insulin sensitivity⁸.

The loss of weight also curbs cardiovascular risk factors, including blood pressure and lipid levels⁷. Attaining long-term weight control calls for a well-rounded strategy that includes regular exercise, dietary adjustments, and medical intervention.

Manage your stress
We often neglect the psychological care that a diabetic person might need to stay healthy and battle the disease effectively. The challenge is to address all psychological factors, including emotional well-being, environmental factors, family complexities and social behaviours.

The need is to integrate care on these levels into the overall diabetes management of the person, along with the routine medical care and delivered using a collaborative, person-centred, and culturally informed approach⁹.

Sleepwell
The importance of a good sleep cycle, and addressing sleep disorders, cannot be emphasised enough, particularly when it pertains to diabetes care.

Sleep disorders are a risk factor for developing type-2 diabetes. People with diabetes across the lifespan often experience sleep disruptions and reduced sleep quality. It is important to counsel people with diabetes to use sleep-promoting routines and practices-- which include¹⁰:

• Establishing a regular bedtime and wakeup time.

• Creating a quiet and dark area for sleeping, with temperature and humidity control. Establishing a pre-sleep routine

• Exercising during the day.

• Avoiding daytime naps.

• Limiting caffeine and nicotine in the evening.

• Avoiding spicy foods at night.

• Avoiding alcohol before bedtime.

• Biological and environmental factors in diabetes management

Genetics and environment are two key factors in the determination of the course of an individual’s health. Research highlights that recognizing the role these two factors play in disease progression, is a significant factor in Type-2 diabetes management. People with a family history of diabetes or certain ethnic backgrounds are at an increased risk of getting the disease which requires tailored management strategies¹¹.

Studies also show that those who live in urban areas with limited access to healthy foods and recreational spaces face higher diabetes prevalence rates¹². Understanding these factors empowers people to take preventative steps, such as seeking community resources or advocating for healthier options.

Diabetes management involves more than just blood sugar control. Individuals with Type-2 diabetes can take charge of their health by learning about the effects of lifestyle, genetics, environment, and weight.

References

1. American Diabetes Association. Standards of Medical Care in Diabetes—2024. Available at Link. Accessed on 11 Nov 2024.
2. Anjana RM, et al. Lancet Diabetes Endocrinol. 2023 Jun 7: S2213-8587(23)00119-5.
3. IDF Diabetes Atlas 10th edition 2021. Available at Link. Accessed on 10 Feb 2023.
4. National Prevention Council. National prevention strategy. Washington (DC): U.S. Department of Health and Human Services, Office of the Surgeon General; 2011
5. Standards of Care in Diabetes-2024. Diabetes Care. 2024 Jan 1;47(Suppl 1):S77-S110.
6. Anderson E et al.. Physical activity, exercise, and chronic diseases: A brief review. Sports Med Health Sci. 2019 Sep 10;1(1):3-10.
7. Brown JD et al.. Effects on cardiovascular risk factors of weight losses limited to 5-10. Transl Behav Med. 2016 Sep;6(3):339-46.
8. Clamp LD et al. Enhanced insulin sensitivity in successful, long-term weight loss maintainers compared with matched controls with no weight loss history. Nutr Diabetes. 2017 Jun 19;7(6):e282.
9. Reference: ADA Professional Practice Committee. Erratum. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2024. Diabetes Care 2024;47(Suppl. 1):S77-S110. Diabetes Care. 2024 Apr 1;47(4):761-762.
10. ADA Professional Practice Committee. Erratum. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2024. Diabetes Care 2024;47(Suppl. 1):S77-S110. Diabetes Care. 2024 Apr 1;47(4):761-762.
11. Moonesinghe R et al. The contribution of family history to the burden of diagnosed diabetes, undiagnosed diabetes, and prediabetes in the United States: analysis of the National Health and Nutrition Examination Survey, 2009-2014. Genet Med. 2018 Oct;20(10):1159-1166.
12. Mezuk B et al. Beyond Access: Characteristics of the Food Environment and Risk of Diabetes. Am J Epidemiol. 2016 Jun 15;183(12):1129-37

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