The 4 M's of Diabetes Management

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By News Team on June 25, 2021

Type 2 diabetes is a serious, chronic illness that is on the rise worldwide. In the U.S., more than one in every 10 adults (20 and older) has diabetes, and in seniors (65 and older) that figure rises to more than one in four.

Diabetes can be easy to ignore because many people generally feel fine, especially in the early stages of the disease. But over time, diabetes can affect many parts of the body and lead to chronic conditions.

“Sometimes I hear people say, ‘Oh, I just have a little sugar,’ but a ‘little sugar’ over a long period of time can lead to some very devastating complications,” said Carilion Clinic’s Mark H. Greenawald, M.D., a family medicine physician who specializes in preventive medicine and wellness.

In fact, Dr. Greenawald notes that by the time many people with type 2 diabetes are diagnosed their blood sugar levels may have been elevated for up to five years, so damage to the most delicate blood vessels, such as those in the eyes, may have already been taking place.

But if you take control of your diabetes and make changes to your lifestyle, you can live a long and healthy life and avoid many long-term complications.

“Diabetes is not a death sentence,” explained Dr. Greenawald. “When people suffer from long-term consequences of diabetes, it is not because they did everything well and had bad luck, but rather it is because they did not take ownership of their disease and take advantage of all the resources available to help them manage their disease.”


Kate Jones, a Carilion Clinic registered dietitian and diabetes educator, says that proper management comes down to what she calls the four M’s:

1. Meals

Contrary to popular belief there is no specific diabetes diet. Jones recommends eating smaller, more frequent meals, and possibly even snacks, to spread out carbohydrates throughout the day and prevent any spikes in blood sugar.

“We encourage our patients to make healthy choices more often and to limit their intake of concentrated sweets and eat moderate portions of carbohydrates, starches, milk products, fruit, etc., but that does not mean that there is not room for a treat from time to time,” said Jones. “You just have to watch your portion size.”

2. Movement

Movement or exercise helps the body utilize insulin more efficiently to keep blood sugar under control and it aids in weight management. Aim for at least 30 minutes of cardiovascular exercise on most days and some sort of resistance training that utilizes all major muscle groups about two to three times per week.

3. Medication

Some people can control their blood sugar with diet and exercise alone, but many also need diabetes medications or insulin therapy. Jones adds that even if someone has been able to control their diabetes for many years, it is very important to continue to have their A1C levels checked regularly as recommended by their health care provider.

4. Monitoring

Depending on your treatment plan, you may check and record your blood sugar level every now and then or multiple times a day. Ask your health care provider how often you should check your blood sugar.

Managing diabetes is a life-long commitment, but you don’t have to do it alone. Jones encourages everyone with diabetes to go through some sort of management program.

“Carilion’s management program provides one-on-one counseling as well as group classes, support groups, and seminars with various specialists to discuss issues that people with diabetes face,” she explained. “There are many opportunities for on-going support, so patients are never on their own.”

Not only will a healthy lifestyle prevent diabetes, you will also feel great! That is the reason to do it.

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