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By Dr. Donna O'Shea, Chief Medical Officer of Population Health, UnitedHealthcare

 With the persistent spread of COVID-19 in Colorado and across the country, many people may again be wearing masks and avoiding crowds. This is likely especially true for the 56 percent of Americans who have a risk factor linked to an increased chance of COVID-19 complications, such as type 2 diabetes.

 For the 30 million Americans with this disease, along with the 88 million people with prediabetes, it is important to note that type 2 diabetes is a leading cause of medical complications, including heart disease and kidney damage. Type 2 diabetes is also often costly to individuals and the health system more broadly, contributing to $327 billion per year in medical expenses.

Unlike type 1 diabetes, which is generally caused by genetics or environmental factors, type 2 diabetes may in some cases be preventable or put in remission through a combination of lifestyle choices. Importantly, research shows people with existing diabetes whose blood sugar is well controlled may require fewer medical interventions and are more likely to recover from COVID-19. Likewise, the approved COVID-19 vaccines are safe and effective, helping reduce the risk of infection and hospitalization for this disease, including for those with diabetes.  

 To help change type 2 diabetes from a lifelong, chronic disease requiring medications, to a condition that can be put into remission, here are five tips to consider during November's National Diabetes Month and beyond:

Access Public Resources. While preventing or achieving type 2 diabetes remission is possible, it requires a balanced diet (with limited consumption of sugary or processed foods) and a commitment to daily activity. To help with that, the American Diabetes Association (ADA) offers a 12-month online program called Living with Type 2 Diabetes, designed to help people learn about the disease and discover techniques for managing it. Another program called Better Choices for Life brings the ADA's guidelines into stores, which may help people make informed choices about which products to purchase, ranging from food and nutrition to diabetes care.

Monitor Your Body Mass. While body mass index (BMI) has potential shortcomings, especially for muscular athletes, this calculation of height compared to weight may be a helpful measure to monitor. That's because people with moderately elevated BMI levels may have an increased risk of developing complications related to diabetes. To monitor your BMI, check with your primary care physician or use an online calculator. If your BMI indicates a possible risk, a weight loss program may help. In fact, research shows that when overweight people lose just 5 percent of their initial weight, it can reduce the risk of developing type 2 diabetes by more than 50 percent. For support shedding unwanted pounds, check with your employer or health plan for resources, such as online weight-loss programs that focus on helping users build healthier daily habits.

Use Interval Eating. The cliché "you are what you eat" rings true when it comes to preventing or managing obesity and diabetes, but when and how you eat also may be relevant. Also called intermittent fasting or time-restricted eating, interval eating alternates periods of fasting and non-fasting during the day or throughout the week. Lifestyle changes to consider include waiting at least an hour after waking up before eating breakfast and avoiding food within three hours of sleep. Plus, people may give attention to the order in which they eat, starting each meal with a lean protein (chicken, fish or turkey), followed by a vegetable (broccoli, green beans or carrots) and ending with a carbohydrate (brown rice, pasta or sweet potato). This ordered approach may lead to lower post-meal glucose and insulin levels for people with type 2 diabetes. 

Consider After-Meal Walks. People seeking to better control their blood sugar levels and weight may also consider taking short walks after eating meals or snacks, especially those with added sugars such as juice or desserts. Post-meal walks may help the body move sugar from the blood into muscle cells, helping normalize blood sugar levels. Whenever possible, make time for a 15-minute walk after meals, which can reduce the risk of blood sugar spikes.  

Take Advantage of Technology. Smartwatches and activity trackers are potential resources to help monitor various health measures, including daily steps, sleep patterns and blood sugar levels. Recently, some people with diabetes have started using continuous glucose monitors. This technology, which uses a sensor often worn on the abdomen, continuously reads glucose levels and transmits the data to a smartphone. This may give users and health care providers important information in real time, helping reveal relationships between eating, exercise and blood sugar that may be difficult to observe with only test strips and a glucose meter.

The pandemic may be creating stress for many Americans, especially people with chronic health conditions. By considering these tips, these challenging times may serve as a catalyst for people to help improve their health and reduce the possible risk of complications from COVID-19.