Healing Handbook for Persons with Diabetes

What you weight affects your diabetes. Chapter 4: Non-Insulin Dependent Diabetes Mellitus (NIDDM or Type II Diabetes)

Goals for People with Type II Diabetes 

With Type II diabetes, you can enjoy a healthy, normal life by maintaining control of your condition. Keep the following goals in mind:

  • Learning about your diabetes and how to take care of yourself
  • Keeping your body healthy by achieving your ideal weight
  • Sticking to your meal plan
  • Strengthening your heart and lungs through exercise
  • Minimizing the risk of complications by maintaining good blood sugar levels

If you have Type II (non-insulin dependent) diabetes, your body has a "relative" deficiency of insulin.

The beta cells in your pancreas are producing some insulin, but the insulin is either too little or isn't working properly to let glucose get into your cells to produce energy.

In Type 2 diabetes there is some but not enough insulin. 

If your Type II diabetes is not controlled, excess glucose accumulates in your blood, resulting in hyperglycemia, or high blood sugar. Your symptoms have come on so slowly that you may not have noticed them. You may have experienced some of the following: more tired, increased thirst, frequent urination, dry, itchy skin, blurred vision, slow-healing cuts or sores, more infections than usual, numbness and tingling in feet.

If you ignore these symptoms for several days, dehydration may result, leading to low blood volume.

If Type II diabetes remains uncontrolled for a long period of time, more serious symptoms may result. These include severe hyperglycemia (blood sugar over 600 mg) lethargy, confusion, shock, and ultimately what doctors call "hyperosmolar hyperglycemic nonketotic coma".

These symptoms are more common in elderly people with diabetes and in people suffering from an illness or infection.

You can avoid these symptoms by keeping your Type II diabetes in good control, and by calling your doctor when your blood sugars are persistently high.

When there is not enough insulin, many things can go seriously wrong. 

Controlling Your Type II Diabetes 

To control your Type II diabetes, you need to eat right, stay active, monitor your control, follow your diabetes educator's or doctor's orders, and have regular checkups.

  • Eating right helps you control your weight. Weight is the most important factor in Type II diabetes control. Eat healthy foods, and if you are overweight, follow a meal plan to lose weight. For information on nutrition for people with diabetes, see Chapter 6.
  • Staying active with exercise burns calories to help you control your weight. Exercise also stimulates insulin functioning to make the insulin your body produces work more effectively. For information on exercise programs for people with diabetes, see Chapter 7.
  • Monitoring your control provides the information necessary to design your diabetes care program and remain in good control. For information on monitoring, see Chapter 5 .
You control your Type 2 diabetes best with diet and exercise to keep your weight down. 
  • Following your diabetes educator's or doctor's ordersmeans sticking to your diet, exercise, and blood glucose monitoring instructions every day. Be sure to take prescribed medications at the correct times.
  • At your regular checkups, always have your blood pressure and your feet checked. And have your vision checked at least once a year.

The Weight Factor 

Why is weight such an important factor in Type II diabetes? This scale illustrates how extra body fat affects you. Food is represented by X's and insulin is represented by O's. In people who do not have diabetes, a balance between X's and O's is always achieved.

When your weight is right for you, you are in balance with your insulin. 
When you weigh too much, you are out of balance with your insulin,  In people with Type II diabetes, who are usually overweight, the beta cells cannot produce enough insulin to maintain a balance. There are too many X's (food) for the Os (insulin) to handle. The best treatment is to decrease stored fat (X's) to balance with the available insulin (Os)!

Oral Hypoglycemic Pills 

Your doctor may prescribe oral hypoglycemic pills to stimulate the beta cells in your pancreas to produce more insulin and help the insulin work more effectively. For more information on oral hypoglycemic pills, see Chapter 9.

Sick Days 

How to take care of your Type 2 diabetes when you are sick can be a difficult problem. If you cannot eat, it may be necessary to reduce the amount of medication or oral hypoglycemic pill that you take. This is explained in Chapter 10. As always, the specific course of action to take when you are sick should be discussed with your diabetes educator or physician!

Questions and Answers 

If I lose weight, will my diabetes go away?

  • No. Diabetes cannot be cured, but it can be controlled, sometimes by diet and exercise alone. If you lose weight, your diabetes symptoms may disappear, but you will still have diabetes if your weight goes back up.

If I take oral diabetes pills, do I still have to stay on my diet?

  • Yes. Even oral hypoglycemic pills cannot stimulate insulin production enough or reduce the need for insulin enough to make up for a careless diet.

Will I have to take insulin by injection?

  • There is no guarantee that your diabetes will always be controlled by diet or by diet and oral medications. But weight control and careful attention to diet and exercise increase your chances of staying in good control without insulin injections.

For More Information 

For more information on Type II diabetes, you may want to order a copy of Diabetes Type II from Diabetes Supplies, 8181 North Stadium Drive, Houston, TX 77054; or PARNA Publications, 5623 Matilija Ave, Van Nuys, CA 91401.

REMEMBER: The care of diabetes is a team effort involving you, your physician, and the diabetes education staff where you receive your medical care. This handbook cannot-and was not meant to-replace this team effort. 

This handbook embodies the approach of the diabetes care team at the University of Massachusetts Medical School. Different diabetes care teams may approach some aspects of diabetes care in ways that differ from those in this handbook. While most teams are in close agreement regarding the GENERAL PRINCIPLES of diabetes care, they may differ in the DETAILS. There can be more that one "right" way to approach a specific issue in diabetes management. 

Always remain in touch with your diabetes care team, and bring any questions you may have about the materials in this handbook to their attention! 

Copyright 1995-1999 Ruth E. Lundstrom, R.N. and Aldo A. Rossini, M.D. All rights reserved.
Feedback: send e-mail to Dr. Aldo Rossini