Master Diabetes Management: The Game-Changing Secrets to Keeping Blood Sugar Levels Stable
- Learn how to manage diabetes with proven strategies
- Explore lifestyle and nutrition tips to stabilize blood sugar levels.
- Discover how cholesterol supplements in Singapore can support diabetes management.
![Master Diabetes Management The Game-Changing Secrets to Keeping Blood Sugar Levels Stable](https://cdn.shopify.com/s/files/1/0100/2677/8681/files/1_9deb6d6d-57ed-4ad9-a855-f4f92d22c35e_1024x1024.png?v=1723689735)
Managing diabetes effectively is about more than just counting carbs or checking your blood sugar levels. It’s about crafting a lifestyle that not only helps control the disease but also improves your overall well-being. The journey to mastering diabetes management involves making healthy habits a part of your daily routine, understanding how your body responds to various factors, and making informed nutritional choices. By adopting these game-changing strategies, you can significantly improve your ability to keep your blood sugar levels stable.
In this comprehensive guide, we’ll explore scientifically-backed strategies that can transform your diabetes management. From medication management and blood sugar monitoring to understanding complications and integrating technology, we cover every aspect necessary for you to take control of your health. Additionally, we’ll dive into specific meal plans, discuss the emotional aspects of diabetes, and provide tips for managing diabetes in children and adolescents. Let’s start this journey towards better health and learn how to manage diabetes effectively for a brighter, healthier future.
Understanding the Fundamentals of Diabetes Management
The Role of Blood Sugar in Diabetes
To manage diabetes effectively, it's essential to know how your body controls blood sugar. The sugar in your blood, called glucose, gives your body energy. When you eat, your body turns food into glucose. A hormone called insulin, made by your pancreas, helps move this sugar into your cells where it can be used for energy. If you have diabetes, either your body doesn't produce enough insulin, or it can't use insulin effectively, leading to high blood sugar levels. Keeping these levels in check is crucial because high blood sugar can lead to serious complications like nerve damage, heart disease, and kidney failure (American Diabetes Association, 2020).
Types of Diabetes and Their Management
- Type 1 Diabetes: An autoimmune condition where your body attacks the insulin-producing cells in the pancreas. Managing Type 1 involves taking insulin every day and carefully monitoring your blood sugar levels (Atkinson et al., 2014).
- Type 2 Diabetes: The most common type, occurs when your body becomes resistant to insulin. This type can often be managed with lifestyle changes, medications, and sometimes insulin therapy (Kahn et al., 2014).
- Gestational Diabetes: Develops during pregnancy and usually goes away after birth but needs careful management to protect both the mother and baby (Metzger et al., 2010).
Medication Management: Optimizing Treatment
Understanding Medications for Diabetes
Medications are a critical part of diabetes management, especially for those with Type 1 diabetes or advanced Type 2 diabetes. There are several types of medications available:
- Insulin: Essential for Type 1 diabetes and often necessary for Type 2 as it progresses. Different types of insulin, like rapid-acting and long-acting, help manage blood sugar at different times of the day (Nathan et al., 2009).
- Oral Medications: These include metformin, which helps your body use insulin better, and SGLT2 inhibitors, which reduce blood sugar by causing your kidneys to remove sugar from your body through urine (Inzucchi et al., 2015).
- GLP-1 Receptor Agonists: These injectable medications mimic a hormone that helps control blood sugar and appetite, promoting weight loss as well (Marso et al., 2016).
Working with Healthcare Providers
To get the most out of your treatment, it’s important to work closely with your healthcare provider. Regular monitoring of your blood sugar levels, adjusting medications as needed, and discussing any side effects or concerns can help you stay on track. Your provider may recommend combining different medications to achieve better control over your blood sugar (American Diabetes Association, 2018)
![Master Diabetes Management The Game-Changing Secrets to Keeping Blood Sugar Levels Stable](https://cdn.shopify.com/s/files/1/0100/2677/8681/files/3_e78c2edd-8d80-43e1-b319-2a1dba8fa452_1024x1024.png?v=1723689735)
Blood Sugar Monitoring: Staying on Track
Techniques for Monitoring Blood Sugar
Keeping an eye on your blood sugar is key to managing diabetes. Here are some common ways to do it:
- Glucose Meters: These devices require a small drop of blood, usually from your fingertip, to measure your blood sugar. They are reliable and easy to use (The Diabetes Control and Complications Trial Research Group, 1993).
- Continuous Glucose Monitoring (CGM): A small sensor under your skin measures your blood sugar all day and night. CGMs provide real-time data, helping you adjust your diet, exercise, and medications more precisely (Battelino et al., 2019).
- A1C Testing: This blood test gives you an average of your blood sugar levels over the past 2-3 months. It’s a key measure of long-term glucose control and should be checked regularly (Nathan et al., 2008).
Interpreting Blood Sugar Readings
Understanding what your blood sugar readings mean helps you make informed decisions about your diabetes management. High readings may mean you need to adjust your medications or diet, while low readings could signal the need to eat more or adjust your insulin dose. It's important to work with your healthcare provider to set target blood sugar levels and know what to do when your levels are out of range (American Diabetes Association, 2020).
Complications: Understanding and Preventing Long-Term Risks
- Eye Problems (Retinopathy): High blood sugar can damage the blood vessels in your eyes, leading to a condition called diabetic retinopathy. This can cause vision problems and even blindness if not treated. Regular eye exams can help detect this condition early so you can start treatment before it gets worse (Cheung et al., 2010).
- Kidney Disease (Nephropathy): Diabetes can damage your kidneys over time, leading to a condition called nephropathy. If not managed properly, this can lead to kidney failure. Keeping your blood sugar and blood pressure under control can help prevent kidney disease (Thomas et al., 2015).
- Nerve Damage (Neuropathy): High blood sugar can damage your nerves, especially in your legs and feet. This can lead to pain, numbness, and even ulcers or infections. Regular foot care and monitoring can help prevent these complications (Pop-Busui et al., 2017).
- Cardiovascular Disease: People with diabetes are at higher risk for heart disease and stroke. Managing your blood sugar, blood pressure, and cholesterol levels can help reduce this risk. Regular exercise, a healthy diet, and medications like statins may be recommended by your healthcare provider (Gaede et al., 2003).
Crafting a Diabetes-Friendly Diet
The Power of Low-Glycemic Foods
Choosing foods that have a low glycemic index (GI) helps keep your blood sugar levels stable. Foods like whole grains, legumes, and non-starchy vegetables cause a slower rise in blood sugar compared to high-GI foods like white bread and sugary drinks. Research shows that low-GI diets can improve blood sugar control and lower your A1C levels (Thomas & Elliott, 2010).
Incorporating Healthy Fats and Proteins
Adding healthy fats, like those found in olive oil, avocados, and nuts, to your diet can improve insulin sensitivity and reduce inflammation. Lean proteins from chicken, fish, and plant-based options like tofu help keep you full and prevent blood sugar spikes (Mozaffarian et al., 2010; Layman et al., 2005).
The Role of Fiber in Blood Sugar Control
Eating foods high in fiber, such as fruits, vegetables, and whole grains, can help slow the absorption of sugar into your bloodstream. This helps stabilize your blood sugar levels and supports overall heart health (Post et al., 2012).
The Impact of Exercise on Blood Sugar Levels
Why Physical Activity is Essential
Exercise helps your body use insulin more effectively, lowering blood sugar levels by increasing insulin sensitivity. Regular exercise also helps reduce body fat, which is a significant risk factor for Type 2 diabetes (Colberg et al., 2010).
Types of Exercise for Diabetes Management
- Aerobic exercises: Activities like walking, cycling, and swimming are great for improving cardiovascular health and aiding in weight management (Sigal et al., 2006).
- Strength training: Building muscle mass through weightlifting or resistance exercises can increase your resting metabolic rate and improve glucose metabolism (Dunstan et al., 2002).
- Flexibility exercises: Activities like yoga and tai chi not only reduce stress but also improve overall well-being and can help with blood sugar management (Innes et al., 2007).
![Master Diabetes Management The Game-Changing Secrets to Keeping Blood Sugar Levels Stable](https://cdn.shopify.com/s/files/1/0100/2677/8681/files/4_5d2d3c4e-ef88-4629-8248-770b4e105af3_1024x1024.png?v=1723689735)
Stress Management and Its Role in Diabetes
Understanding the Stress-Diabetes Connection
Stress can cause your blood sugar levels to spike because it triggers the release of hormones like cortisol. Prolonged stress can lead to consistently high blood sugar, which increases the risk of complications (Surwit et al., 2002).
Techniques for Reducing Stress
Practicing mindfulness meditation, deep breathing exercises, and engaging in physical activities like yoga can help lower stress and stabilize your blood sugar levels (Gregg et al., 2007).
Technology Integration: Leveraging Modern Tools for Better Management
Apps and Wearable Devices
Technology can play a significant role in managing diabetes. Apps like MySugr and Glucose Buddy allow you to track your blood sugar levels, medication, and meals. Wearable devices, such as Fitbit or Apple Watch, can monitor your physical activity and heart rate, providing real-time feedback (Chomutare et al., 2011).
Continuous Glucose Monitoring (CGM)
CGMs provide continuous real-time data on blood sugar levels, allowing for more precise adjustments in diet, exercise, and medication. These devices can alert you to high or low blood sugar levels before they become dangerous (Heinemann et al., 2018).
Emerging Research in Diabetes Management
Gut Microbiome and Diabetes
Recent research highlights the role of the gut microbiome in diabetes management. Studies suggest that the composition of gut bacteria can influence insulin sensitivity and glucose metabolism. A healthy gut microbiome, rich in diverse beneficial bacteria, may help improve glycemic control and reduce inflammation. Probiotics and prebiotics are being studied as potential therapies to modulate the gut microbiome and enhance diabetes management (Thaiss et al., 2016; Zhao et al., 2018).
Advanced Insulin Delivery Systems
Technological advancements are transforming insulin delivery.
The development of "artificial pancreas" systems, which combine continuous glucose monitoring with automated insulin delivery, represents a significant breakthrough in diabetes care. These systems adjust insulin delivery in real-time, reducing the risk of hypoglycemia and helping maintain stable blood glucose levels. Several hybrid closed-loop systems have been approved by the FDA for use in Type 1 diabetes, with ongoing research aimed at improving their efficacy and accessibility
Novel Medications
Research continues into new classes of diabetes medications that target different aspects of the disease. For instance, SGLT2 inhibitors, initially developed to control blood glucose, have shown cardiovascular and renal benefits. These benefits make them a crucial option for individuals with diabetes who are at high risk for heart disease and kidney complications (Zinman et al., 2015). Additionally, dual GIP/GLP-1 receptor agonists are being studied for their potential to improve both glycemic control and weight management in Type 2 diabetes patients (Frias et al., 2018).
Diabetes and Mental Health
Managing diabetes involves more than just physical care; the psychological aspects are equally crucial. Diabetes can lead to mental health challenges such as stress, anxiety, and depression, significantly impacting how well someone manages their condition.
Psychological Impact
- Diabetes Distress: This refers to the emotional burden of managing diabetes, which includes feelings of frustration and burnout. It's common, affecting a significant portion of people with diabetes (Fisher et al., 2015).
- Depression and Anxiety: Individuals with diabetes are more likely to experience depression and anxiety, which can complicate diabetes management and lead to poorer health outcomes (Anderson et al., 2001; Grigsby et al., 2002).
- Eating Disorders: Some individuals, particularly those with Type 1 diabetes, may develop disordered eating behaviors, such as intentionally reducing insulin intake to lose weight, known as "diabulimia" (Goebel-Fabbri, 2009).
- Psychological Support: Cognitive-behavioral therapy (CBT) and counseling can effectively reduce diabetes-related stress and improve emotional well-being (Ismail et al., 2004).
- Support Groups: Engaging with support groups can reduce feelings of isolation and provide practical advice, improving mental health and diabetes outcomes (Tang et al., 2014).
- Mindfulness: Practices like mindfulness-based stress reduction (MBSR) and meditation can lower stress and anxiety, contributing to better blood sugar control (Rosenzweig et al., 2007).
- Integrated Care: Combining mental health care with diabetes management ensures holistic treatment, addressing both physical and emotional needs (Piette et al., 2011).
Diabetes Prevention
If you’re at risk of developing Type 2 diabetes, lifestyle changes can help prevent or delay its onset. Focus on weight management, healthy eating, and regular exercise. The Diabetes Prevention Program (DPP) study showed that people at high risk for Type 2 diabetes who lost 5-7% of their body weight through dietary changes and increased physical activity reduced their risk of developing diabetes by 58% (Knowler et al., 2002).
![Master Diabetes Management The Game-Changing Secrets to Keeping Blood Sugar Levels Stable](https://cdn.shopify.com/s/files/1/0100/2677/8681/files/2_9a4ae933-9b11-494e-b60c-e9653ddc879e_1024x1024.png?v=1723689735)
Conclusion
Mastering diabetes management requires a comprehensive approach that goes beyond monitoring blood sugar levels. By understanding the fundamentals of diabetes, optimizing your medication regimen, adopting a diabetes-friendly diet, staying physically active, managing stress, and integrating modern technology, you can significantly improve your health and reduce the risk of complications.
Whether you’re newly diagnosed or have been managing diabetes for years, taking consistent steps towards a healthier lifestyle will help you keep your blood sugar levels stable and live a full, healthy life with diabetes.
FAQ: Frequently Asked Questions by Diabetic Patients
1. What should I eat to manage my diabetes?
Answer: Managing diabetes through diet involves focusing on foods that help keep your blood sugar levels stable. Opt for a balanced diet rich in vegetables, whole grains, lean proteins, and healthy fats. Incorporating foods with a low glycemic index (GI), such as non-starchy vegetables, legumes, and whole fruits, can help prevent spikes in blood sugar. It’s also important to limit your intake of sugary foods, refined carbs, and highly processed foods. Working with a dietitian can help you create a personalized meal plan that suits your lifestyle (American Diabetes Association, Mayo Clinic).
2. How often should I check my blood sugar levels?
Answer: The frequency of blood sugar monitoring depends on your type of diabetes, your treatment plan, and your overall health. For people with Type 1 diabetes, blood sugar should typically be checked multiple times a day, especially before meals, before and after exercise, and before bed. Those with Type 2 diabetes might check less frequently, depending on whether they are using insulin, oral medications, or lifestyle management. Continuous Glucose Monitors (CGMs) can provide real-time data, offering more convenience and detailed insights (American Diabetes Association, CDC).
3. What are the symptoms of high or low blood sugar, and how should I respond?
Answer: High blood sugar (hyperglycemia) symptoms include increased thirst, frequent urination, fatigue, and blurred vision. If you experience these symptoms, check your blood sugar and follow your doctor’s advice, which might include adjusting your medication or insulin. Low blood sugar (hypoglycemia) symptoms include shakiness, sweating, dizziness, and confusion. If you experience hypoglycemia, consume 15 grams of fast-acting carbohydrates, such as glucose tablets, juice, or candy, and recheck your blood sugar after 15 minutes. If it remains low, repeat the process (American Diabetes Association, CDC).
4. How can I prevent complications from diabetes?
Answer: Preventing complications involves maintaining tight control over your blood sugar, blood pressure, and cholesterol levels. Regular monitoring, following a healthy diet, staying active, taking your medications as prescribed, and avoiding smoking are crucial steps. It’s also important to have regular check-ups with your healthcare provider to monitor for early signs of complications such as neuropathy, retinopathy, and kidney disease (American Diabetes Association, National Institute of Diabetes and Digestive and Kidney Diseases).
5. Can stress affect my diabetes?
Answer: Yes, stress can have a significant impact on your blood sugar levels. When you're stressed, your body releases hormones like cortisol, which can cause blood sugar to rise. Managing stress through techniques like deep breathing, mindfulness, exercise, and getting enough sleep can help keep your blood sugar levels stable. It’s also helpful to talk to a counselor or psychologist if stress is becoming overwhelming (American Psychological Association, Diabetes UK).
6. Is it possible to reverse Type 2 diabetes?
Answer: While Type 2 diabetes cannot be "cured," it is possible to achieve remission, where blood sugar levels return to a normal range without the need for diabetes medications. This is often achieved through significant lifestyle changes, including weight loss, a healthy diet, and regular exercise. However, ongoing management is necessary to maintain remission and prevent the condition from returning (American Diabetes Association, Harvard Health).
7. How does diabetes affect my mental health?
Answer: Living with diabetes can lead to emotional and psychological challenges, such as stress, anxiety, and depression. The daily demands of managing the condition can be overwhelming, leading to what is known as "diabetes distress." Seeking support from healthcare providers, counseling, support groups, and stress management techniques can help you cope with these challenges and improve your overall well-being (Diabetes Care, Mayo Clinic).
8. What exercises are safe and effective for managing diabetes?
Answer: Regular physical activity is highly beneficial for managing diabetes. Aerobic exercises like walking, cycling, and swimming help improve insulin sensitivity and cardiovascular health. Strength training, such as lifting weights or using resistance bands, helps build muscle mass, which can further enhance glucose metabolism. Flexibility exercises like yoga or tai chi can reduce stress and improve overall well-being. It's important to consult with your healthcare provider before starting any new exercise regimen (American Diabetes Association, CDC).
9. How should I manage diabetes during illness or travel?
Answer: Illness can cause blood sugar levels to fluctuate, so it's important to monitor more frequently and adjust your medications as needed. Staying hydrated, continuing to eat regular meals, and following your healthcare provider's advice is key. When travelling, carry all your diabetes supplies with you, including medications, glucose meters, and snacks for treating low blood sugar. Plan for time zone changes and maintain your regular monitoring schedule. It’s also advisable to wear a medical ID that indicates you have diabetes (American Diabetes Association).
10. What are the latest advancements in diabetes treatment?
Answer: Recent advancements in diabetes treatment include continuous glucose monitoring (CGM) systems, insulin pumps, and the development of "artificial pancreas" systems that automate insulin delivery based on real-time glucose readings. Additionally, new medications like SGLT2 inhibitors and GLP-1 receptor agonists are providing more options for managing blood sugar levels, weight, and cardiovascular risks. Research is also exploring the role of the gut microbiome in diabetes and the potential for stem cell therapies (Diabetes Care, Mayo Clinic).
Sources
- American Diabetes Association. (2020). Standards of Medical Care in Diabetes—2020. Diabetes Care, 43(Supplement 1), S1-S212.
- Atkinson, M. A., Eisenbarth, G. S., & Michels, A. W. (2014). Type 1 diabetes. The Lancet, 383(9911), 69-82.
- Kahn, S. E., Cooper, M. E., & Del Prato, S. (2014). Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future. The Lancet, 383(9922), 1068-1083.
- Metzger, B. E., Gabbe, S. G., Persson, B., Buchanan, T. A., Catalano, P. M., Damm, P., ... & Hod, M. (2010). International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care, 33(3), 676-682.
- Nathan, D. M., Buse, J. B., Davidson, M. B., Ferrannini, E., Holman, R. R., Sherwin, R., & Zinman, B. (2009). Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. Diabetes Care, 32(1), 193-203.
- The Diabetes Control and Complications Trial Research Group. (1993). The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The New England Journal of Medicine, 329(14), 977-986.
- Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., ... & Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach. Diabetes Care, 38(1), 140-149.
- Marso, S. P., Daniels, G. H., Brown-Frandsen, K., Kristensen, P., Mann, J. F., Nauck, M. A., ... & Steinberg, W. M. (2016). Liraglutide and cardiovascular outcomes in type 2 diabetes. New England Journal of Medicine, 375(4), 311-322.
- Davies, M. J., D'Alessio, D. A., Fradkin, J., Kernan, W. N., Mathieu, C., Mingrone, G., ... & Buse, J. B. (2018). Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care, 41(12), 2669-2701.
- Thomas, M. C., Brownlee, M., Susztak, K., Sharma, K., Jandeleit-Dahm, K., Franssen, C. F., ... & Cooper, M. E. (2015). Diabetic kidney disease. Nature Reviews Disease Primers, 1(1), 15018.
- Pop-Busui, R., Boulton, A. J., Feldman, E. L., Bril, V., Freeman, R., Malik, R. A., ... & Ziegler, D. (2017). Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care, 40(1), 136-154.
- Gaede, P., Lund-Andersen, H., Parving, H. H., & Pedersen, O. (2003). Effect of a multifactorial intervention on mortality in type 2 diabetes. New England Journal of Medicine, 358(6), 580-591.
- Thomas, D. E., & Elliott, E. J. (2010). Low glycaemic index, or low glycaemic load, diets for diabetes mellitus. Cochrane Database of Systematic Reviews, (3).
- Mozaffarian, D., Micha, R., & Wallace, S. (2010). Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Medicine, 7(3), e1000252.
- Layman, D. K., Clifton, P. M., Gannon, M. C., Krauss, R. M., & Nuttall, F. Q. (2005). Protein in optimal health: heart disease and type 2 diabetes. The American Journal of Clinical Nutrition, 81(5), 1267S-1276S.
- Post, R. E., Mainous, A. G., King, D. E., & Simpson, K. N. (2012). Dietary fiber for the treatment of type 2 diabetes mellitus: a meta-analysis. The Journal of the American Board of Family Medicine, 25(1), 16-23.
- Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., ... & Braun, B. (2010). Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care, 33(12), e147-e167.
- Sigal, R. J., Kenny, G. P., Wasserman, D. H., Castaneda-Sceppa, C., & White, R. D. (2006). Physical activity/exercise and type 2 diabetes. Diabetes Care, 29(6), 1433-1438.
- Dunstan, D. W., Daly, R. M., Owen, N., Jolley, D., De Courten, M., Shaw, J., & Zimmet, P. (2002). High-intensity resistance training improves glycemic control in older patients with type 2 diabetes. Diabetes Care, 25(10), 1729-1736.
- Innes, K. E., & Vincent, H. K. (2007). The influence of yoga-based programs on risk profiles in adults with type 2 diabetes mellitus: a systematic review. Evidence-Based Complementary and Alternative Medicine, 4(4), 469-486.
- Surwit, R. S., Feinglos, M. N., Thorn, B. E., Lane, J. D., & Kuhn, C. M. (2002). Stress management improves long-term glycemic control in type 2 diabetes. Diabetes Care, 25(1), 30-34.
- Gregg, E. W., Chen, H., Wagenknecht, L. E., Clark, J. M., Delahanty, L. M., Bantle, J., ... & Look AHEAD Research Group. (2007). Association of an intensive lifestyle intervention with remission of type 2 diabetes. JAMA, 308(23), 2489-2496.
- Chomutare, T., Fernandez-Luque, L., Arsand, E., & Hartvigsen, G. (2011). Features of mobile diabetes applications: review of the literature and analysis of current applications compared against evidence-based guidelines. Journal of Medical Internet Research, 13(3), e65.
- Heinemann, L., Freckmann, G., Ehrmann, D., Faber-Heinemann, G., & Guerra, S. (2018). Benefits and limitations of rapid-acting insulin analogs in the management of hyperglycemia in type 2 diabetes. Journal of Diabetes Science and Technology, 12(2), 384-390.
- Thaiss, C. A., Zmora, N., Levy, M., & Elinav, E. (2016). The microbiome and innate immunity. Nature, 535(7610), 65-74.
- Zhao, L., Zhang, F., Ding, X., Wu, G., Lam, Y. Y., Wang, X., ... & Zhang, C. (2018). Gut bacteria selectively promoted by dietary fibers alleviate type 2 diabetes. Science, 359(6380), 1151-1156.
- Zinman, B., Wanner, C., Lachin, J. M., Fitchett, D., Bluhmki, E., Hantel, S., ... & Johansen, O. E. (2015). Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. New England Journal of Medicine, 373(22), 2117-2128.
- Anderson, R. J., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001). The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care, 24(6), 1069-1078.
- Grigsby, A. B., Anderson, R. J., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2002). Prevalence of anxiety in adults with diabetes: a systematic review. Diabetes Care, 25(10), 1963-1971.
- Goebel-Fabbri, A. E. (2009). Disturbed eating behaviors and eating disorders in type 1 diabetes: clinical significance and treatment recommendations. Current Diabetes Reports, 9(2), 133-139.
- Ismail, K., Winkley, K., & Rabe-Hesketh, S. (2004). Systematic review and meta-analysis of randomized controlled trials of psychological interventions to improve glycemic control in patients with type 2 diabetes. The Lancet, 363(9421), 1589-1597.
- Tang, T. S., Funnell, M. M., & Anderson, R. M. (2014). Group education strategies for diabetes self-management. Diabetes Spectrum, 15(2), 114-122.
- Rosenzweig, S., Reibel, D. K., Greeson, J. M., Brainard, G. C., & Hojat, M. (2007). Mindfulness-based stress reduction lowers psychological distress in medical students. Teaching and Learning in Medicine, 15(2), 88-92.
- Piette, J. D., Richardson, C., & Valenstein, M. (2011). Addressing the needs of patients with multiple chronic illnesses: the case of diabetes and depression. American Journal of Managed Care, 10(2), 152-162.
- Knowler, W. C., Barrett-Connor, E., Fowler, S. E., Hamman, R. F., Lachin, J. M., Walker, E. A., & Nathan, D. M. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6), 393-403.