If you care for a person with diabetes (PWD), it is important to pay attention to the annually updated standards of care from the American Diabetes Association (ADA). The 2017 ADA updates can be found here: http://care.diabetesjournals.org/content/40/Supplement_1/S4.Healthy Living

This year’s report contains some key updates that will affect caregivers and PWDs who are working to self-manage their disease. Here are some of the highlights:

1. A PWD is an individual! Providers should focus on support that is specific to the PWD’s lifestyle. This means taking into account geography (e.g., urban or rural lifestyle), as well as the food culture and exercise environment in the community. Caretaker recommendations about healthy eating and active living should fit the PWD’s surroundings and available resources! PWDs should be aware of available support from lay health coaches, navigators, or community health workers.

2. Sleep matters. Did you know that poor sleep quality, short sleep, and long sleep were all associated with higher A1C in people with type 2 diabetes? Care providers may do an assessment of sleep pattern and duration as part of a PWD’s medical exam. People who get more or less than 6.5–7.4 hours of sleep per night are at increased risk of high blood glucose.(2)

3. Physical health should not be overlooked. In section 4, the authors describe ways that PWDs can improve their physical well-being. For people who sit for long periods, this includes getting up and moving around every 30 minutes. Movements can including simple stretching, marching in place, arm circles, yoga, going for a walk, etc. It can be helpful to set an alarm as a reminder. The standards also suggest working on balance and flexibility 2–3 times a week. Suggested exercises include balancing on one leg, with the torso straight, head up, and hands on the hips. The “clock exercise” is another helpful technique: the person imagines they are on the face of a clock and first points to midnight, then to 3 o’clock, then circling low and around to 9 o’clock without losing their balance. Yoga poses, such as the warrior pose, are also good for flexibility.

4. Mental health is just as important as physical health. Stress, anxiety or nervousness can all increase blood sugar. Among people who need help, the ADA suggests seeing a mental health professional, such as a social worker or psychologist

These are just some of the highlights. Feel free to read the full report to lean more.
1. http://professional.diabetes.org/sites/professional.diabetes.org/files/media/dc_40_s1_final.pdf
2. http://www.diabetes.org/research-and-practice/patient-access-to-research/too-much-or-too-little-sleep.html?referrer=https://www.google.com/