Comprehensive Diabetes Management

 

DIABETES MELLITUS

Diabetes is usually a lifelong disease in which there is a high level of sugar in the blood. Diabetes affects more than 20 million Americans. In addition, over 40 million Americans have Pre-diabetes. To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy.

When food is digested, a sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body. Then, an organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.

People with diabetes have high blood sugar because their body cannot move sugar into fat, liver, and muscle cells to be stored for energy. This is because their pancreas does not make enough insulin and/or their cells do not respond to insulin normally. After many years, diabetes can lead to other serious problems. These complications include: eye problems, painful sores and infections of the leg or foot, nerve damage, kidney problems, weakened immune system, and an increased risk heart attack or stroke.

What are the different kinds of diabetes?

There are two main types of diabetes:

Type 1 - Previously known as juvenile onset diabetes, this type occurs when the pancreas makes little or no insulin. The body‘s own immune system may attack and destroy the insulin-producing cells in the pancreas. Most often seen in children and young adults, Type 1 diabetes is treated with daily insulin injections and careful meal planning. Regular exercise is also important in controlling the disease.

Type 2 - Almost at the epidemic stage, type 2 accounts for more than 90% of all cases. In this adult disorder, the body becomes unable to make enough insulin or to use it properly. Treatment involves medications (insulin and other drugs), careful eating and exercise.

 

During pregnancy, some women experience gestational diabetes. Pregnancy hormones tend to make the body resist insulin. This type of diabetes usually goes away soon after the baby is born. Later in life, women who experience gestational diabetes may become diabetic.

 

How does insulin work?

Insulin is a hormone that comes from a gland situated behind and below the stomach (pancreas).

  • The pancreas secretes insulin into the bloodstream.

  • The insulin circulates, enabling sugar to enter your cells.

  • Insulin lowers the amount of sugar in your bloodstream.

  • As your blood sugar level drops, so does the secretion of insulin from your pancreas.

 

What is the role of Glucose in our body? 

Glucose — a sugar — is a source of energy for the cells that make up muscles and other tissues.

  • Glucose comes from two major sources: food and your liver.

  • Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin.

  • Your liver stores and makes glucose.

  • When your glucose levels are low, such as when you haven't eaten in a while, the liver breaks down stored glycogen into glucose to keep your glucose level within a normal range.

 

TYPE 1 DIABETES 

Type 1 diabetes accounts for about 5% of all diagnosed cases of diabetes. Type 1 is usually diagnosed in children and young adults, although it can occur at any time. People with type 1 diabetes must use insulin from an injection or a pump to manage their diabetes.

Type 1 diabetes mellitus is a chronic medical condition that occurs when the pancreas, an organ in the abdomen, produces very little or no insulin. Insulin is a hormone that helps the body to absorb and use glucose and other nutrients from food, store fat, and build up protein. Without insulin, blood glucose (sugar) levels become higher than normal.

 

Type 1 diabetes requires regular blood sugar monitoring and treatment with insulin. Treatment, lifestyle adjustments, and self-care can control blood sugar levels and minimize the risk of disease-related complications. Type 1 diabetes usually develops when the immune system destroys the insulin-producing cells (called the beta cells) in the pancreas. This is called an autoimmune response. The cause of this abnormal immune response is not clearly known and is being studied. This requires the patients to check finger stick blood sugar several times per day, give insulin shots or use an insulin pump. Management of Diabetes also requires one to have good understanding of diet and watch for carbohydrates and see your doctor on a regular basis.

Yes. People with type 1 diabetes are not making enough insulin from their own bodies. Most people inject insulin at least four times a day. However, the insulin pump, or a continuous subcutaneous insulin infusion (CSII), is slowly replacing frequent injections as a preferred delivery system. With the pump, a new catheter is inserted every few days under the skin, and insulin is continuously infused into the body. The pump is not the final word in insulin delivery systems, and there are clinical trials underway testing both a patch and a nasal spray as possible insulin delivery systems.

What causes type 1 diabetes?

The exact cause of type 1 diabetes is unknown. What is known is that your immune system — which normally fights harmful bacteria or viruses — attacks and destroys your insulin-producing cells in the pancreas. This leaves you with little or no insulin. Instead of being transported into your cells, sugar builds up in your bloodstream.

Type 1 is thought to be caused by a combination of genetic susceptibility and environmental factors, though exactly what those factors are is still unclear. Weight is not believed to be a factor in type 1 diabetes.

It isn’t entirely clear what triggers the development of type 1 diabetes. Researchers do know that genes play a role; there is an inherited susceptibility. However, something must set off the immune system, causing it to turn against itself and leading to the development of type 1 diabetes.

What are the risk factors for type 1 diabetes?

There are several risk factors that may make it more likely that you’ll develop type 1 diabetes—if you have the genetic marker that makes you susceptible to diabetes. That genetic marker is located on chromosome 6, and it’s an HLA (human leukocyte antigen) complex. Several HLA complexes have been connected to type 1 diabetes, and if you have one or more of those, you may develop type 1. (However, having the necessary HLA complex is not a guarantee that you will develop diabetes; in fact, less than 10% of people with the “right” complex(es) actually develop type 1.)

 

Other risk factors for type 1 diabetes include:

  • Viral infections

  • Race/ethnicity

  • Geography

  • Family history

  • Early diet (especially cow's milk)

  • Other autoimmune conditions

What are the risk factors for type 1 diabetes?

Although the exact cause of type 1 diabetes is unknown, factors that may signal an increased risk include:

  • Family history. Your risk increases if a parent or sibling has type 1 diabetes.

  • Environmental factors. Circumstances such as exposure to a viral illness likely play some role in type 1 diabetes.

  • The presence of damaging immune system cells (auto antibodies). Sometimes family members of people with type 1 diabetes are tested for the presence of diabetes auto antibodies. If you have these auto antibodies, you have an increased risk of developing type 1 diabetes. But not everyone who has these auto antibodies develops diabetes.

  • Geography. Certain countries, such as Finland and Sweden, have higher rates of type 1 diabetes.

 

How is type 1 diabetes treated?

Type 1 diabetes is treated with a combination of insulin, diet, and exercise.

 

It’s absolutely necessary for people with type 1 diabetes to take insulin because their bodies don’t produce it. There are several types of insulin, and your diabetes treatment team will work with you to figure out the right dosages. Plus, they’ll walk you through all the details of insulin delivery (giving insulin to your body). 

 

Diet and exercise will help you control the effects of type 1 diabetes. Eating a healthy, carb-conscious diet will make it easier for you to control your blood glucose level, and researchers have shown that tight blood glucose control over the years significantly limits the development of long-term complications of diabetes.

 

Similarly, staying physically fit and active has many benefits, including keeping your heart healthy, which can prevent the macro vascular complications associated with diabetes. Exercise also makes it easier to control your blood glucose level. You can read more about exercise and type 1 diabetes in our article that talks about good exercises and how to get started.

Do I need to take insulin for the rest of my life?

Yes. People with type 1 diabetes are not making enough insulin from their own bodies. Most people inject insulin at least four times a day. However, the insulin pump, or a continuous subcutaneous insulin infusion (CSII), is slowly replacing frequent injections as a preferred delivery system. With the pump, a new catheter is inserted every few days under the skin, and insulin is continuously infused into the body. The pump is not the final word in insulin delivery systems, and there are clinical trials underway testing both a patch and a nasal spray as possible insulin delivery systems.

Will exercise help control my diabetes?

In general, exercise can be beneficial in the management of type 1 diabetes, in addition to taking insulin and eating a healthy diet. To exercise safely and reduce the risks, always consult with your doctor about exercise guidelines.

Can I stop taking insulin if I eliminate candy and cookies from my diet?

Even if you eliminate concentrated sources of carbohydrates (foods that turn into sugar in your bloodstream) like candy and cookies, you always need to take insulin when you have type 1 diabetes. Check with your doctor about any insulin dose adjustments that may be required if you change your diet.

Do I need to monitor my blood sugar even when I’m feeling fine?

Feeling fine is no guarantee that your blood sugar levels are in the target range. Remember, symptoms do not appear right away. Without regular blood sugar monitoringserious damage can happen to your eyes, kidneys, feet – even your brain – without your knowing. If your sugar levels are out of line, consult your doctor.

I have type 1 diabetes. Are my children at risk?

Yes, but the risk is low. Although type 1 diabetes is a genetic disease, only about 3% to 6% of children of type 1 diabetics will develop diabetes. The risk varies with age, gender and other factors relating to the parent with diabetes. You can learn more about these odds by having your children undergo certain genetic tests.

What is LADA? What is the difference between LADA & Other forms of Diabetes? 

Latent autoimmune diabetes in adults (LADA) is a slow-progressing form of autoimmune diabetes. Like the autoimmune disease type 1 diabetes, LADA occurs because your pancreas stops producing adequate insulin, most likely from some "insult" that slowly damages the insulin-producing cells in the pancreas. 

But unlike type 1 diabetes, with LADA, you often won't need insulin for several months up to years after you've been diagnosed.

 

Many researchers believe LADA, sometimes called type 1.5 diabetes, is a sub type of type 1 diabetes, while others do not recognize it as a distinct entity. Other researchers believe diabetes occurs on a continuum, with LADA falling between type 1 and type 2 diabetes.

People who have LADA are usually over age 30. Because they're older when symptoms develop than is typical for someone with type 1 diabetes and because initially their pancreases still produce some insulin, people with LADA are often misdiagnosed with type 2 diabetes.

If you've been diagnosed with type 2 diabetes and you're lean and physically active or you've recently lost weight without effort, talk with your doctor about whether your current treatment is still the best one for you.

At first, LADA can be managed by controlling your blood sugar with diet, losing weight if appropriate, exercise and, possibly, oral medications. But as your body gradually loses its ability to produce insulin, you'll eventually need insulin shots.

More research is needed before the best way to treat LADA is established. Talk with your doctor about the best LADA treatment options for you. As with any type of diabetes, you'll need close follow-up to minimize progression of your diabetes and potential complications.

 

 

TYPE 2 DIABETES

 

 

What is Type 2 Diabetes?

 

Type 2 Diabetes is the most common form of the diabetes, affecting 90–95% of people with diabetes.

 

In type 2 diabetes, the body is resistant to the action of insulin, meaning it cannot use insulin properly, so it cannot carry sugar into the cells. Although the body makes some insulin, it is not enough to overcome this resistance. This results in a build-up of glucose in the blood. People with diabetes are at risk for developing serious health problems (complications).

 

You are more likely to develop type 2 diabetes if you are overweight, have a family history of diabetes, or have a history of diabetes during pregnancy. Other groups more likely to have the disease are people over age 45 and non-Caucasians. A simple blood test can tell you if you have diabetes.

 

Several studies have shown that healthy eating, regular physical activity, and weight loss used with medication if prescribed, can help control complications from type 2 diabetes or can prevent or delay the onset of type 2 diabetes.

What are the symptoms of diabetes?

  • Being very thirsty

  • Urinating often

  • Feeling very hungry

  • Feeling very tired

  • Losing weight without trying

  • Sores that heal slowly

  • Dry, itchy skin

  • Feelings of pins and needles in your feet

  • Losing feeling in your feet

  • Blurry eyesight

Some people with diabetes don’t have any of these signs or symptoms. The only way to know if you have diabetes is to have your doctor do a blood test.

How is diabetes diagnosed ?

Blood tests

Fasting blood glucose test, hemoglobin A1c test, and oral glucose tolerance test are blood test that can be done to diagnose diabetes.

Urine analysis

A urine analysis may show high blood sugar. But a urine test alone does not diagnose diabetes. Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL. To confirm the diagnosis, one or more of the following tests must be done.

Screening

Screening for type 2 diabetes in people who have no symptoms is recommended for: overweight children who have other risk factors for diabetes (starting at age 10), overweight adults (BMI greater than 25) who have other risk factors, and adults over age 45.

What risk factors increase the likelihood of diabetes?

  • Being overweight or obese

  • Having a parent, brother, or sister with diabetes

  • Being African American, American Indian, Asian American, Pacific Islander, or Hispanic American/Latino heritage

  • Having a prior history of gestational diabetes or birth of at least one baby weighing more than 9 pounds

  • Having high blood pressure measuring 140/90 or higher

  • Having abnormal cholesterol with HDL ("good") cholesterol is 35 or lower, or triglyceride level is 250 or higher

  • Being physically inactive—exercising fewer than three times a week

What can be done to reduce the risk of diabetes?

Research has shown that the following lifestyle modifications can prevent, or at least delay the onset of type 2 diabetes among people at risk of diabetes:

  • Eating fewer high fat and high calorie foods

  • Losing at least 5%-7% of body weight (if overweight)

  • Being physically active for 150 minutes every week

Why do I need to follow a diet if I’m on insulin or taking diabetes medication?

The benefits of diabetes medication and insulin adjustments could be short-lived, and often won’t be achieved, without diet and exercise.

A good diet and exercise may reduce the amount of medications you need and alleviate insulin’s side effects, which include low blood sugars and weight gain. Less medication means fewer side effects, not to mention less cost.

Will exercise help control my diabetes?

In general, exercise can be beneficial in the management of type 1 diabetes, in addition to taking insulin and eating a healthy diet. To exercise safely and reduce the risks, always consult with your doctor about exercise guidelines.

Can I stop taking insulin if I eliminate candy and cookies from my diet?

Even if you eliminate concentrated sources of carbohydrates (foods that turn into sugar in your bloodstream) like candy and cookies, you always need to take insulin when you have type 1 diabetes. Check with your doctor about any insulin dose adjustments that may be required if you change your diet.

Do I need to monitor my blood sugar even when I’m feeling fine?

Feeling fine is no guarantee that your blood sugar levels are in the target range. Remember, symptoms do not appear right away. Without regular blood sugar monitoring, serious damage can happen to your eyes, kidneys, feet – even your brain – without your knowing. If your sugar levels are out of line, consult your doctor.

Once I start taking insulin, does that mean I’ll be on it forever?

It depends on the person and the situation. Starting insulin can be just a temporary measure to fix a short-term problem, or it can be long-term.

The good news is that two-thirds of patients who are newly diagnosed with diabetes and have been started on insulin can revert to other medications as long as they follow a program of diet and exercise.

However, there are people who have had diabetes for many years, have followed a good diet and are using three or more medications to control blood sugar — yet still have high blood sugar. They will probably always need insulin.

Gastric bypass surgery is now an option for overweight people with type 2 diabetes. This procedure may reduce the need for insulin. Diet and exercise both before and after gastric bypass surgery improve your odds of staying off medications, or at least to keep the number down. Both greatly improve the expected benefits of surgery.

Is blood sugar control the most important factor for people with diabetes ?

Blood sugar control is very important, but you need to also consider blood pressure and cholesterol control.

Breaking it down a little more:

  • Controlling blood sugar helps prevent kidney disease and eye complications, particularly diabetic retinopathy – a serious disease that can lead to blindness.

  • Blood pressure control, ideally staying under 130/80 in adults, may slow kidney disease and prevent heart attack and stroke.

  • Keeping cholesterol low, along with good blood pressure control, protects blood vessels – lowering risk of heart attack, stroke and circulation problems in the legs and feet.

Beyond making sure you control your diabetes, don’t neglect your overall health too, with annual physicals and screenings. Your good health improves your quality of life. And that’s the main purpose of any treatment.

What is hemoglobin A1c?

This is a blood test. A hemoglobin A1c percentage is important because it is the main way to know how well patients are controlling their diabetes over time. Based on blood tests taken over a period of two or three months, doctors can estimate patients' average blood sugar levels. The goal for most diabetics is an A1c of less than 7%. This is roughly equivalent to an average blood sugar level of about 150 mg/dl. An A1c of 9% indicates an average blood sugar level of about 210 mg/dl.

Here‘s how the test works. Glucose (blood sugar) circulates in the blood after food is absorbed in the intestine. A small amount normally combines with the hemoglobin molecule (A1c). Hemoglobin is the red-colored protein in red blood cells that carries oxygen to the rest of the body. The glucose remains with the hemoglobin molecule until the individual‘s red blood cells die - usually between two and three months. When the patient‘s blood is analyzed for hemoglobin A1c, the resulting value number provides an estimate of the level of glucose over that time period.

What are the symptoms of low blood sugar?

Signs include shaking, fast heartbeat, sweating, anxiety, dizziness, hunger, impaired vision, weakness/fatigue, headache and irritability.

How do I properly treat a low blood sugar  or Hypoglycemia?

Take these steps to treat a low blood glucose:

Test your glucose. 

 

If it is under 70 mg/dl, eat or drink 15 grams of a fast acting carbohydrate.

  • 4 oz fruit juice

  • ½ can regular soda

  • 8 oz (1 cup) of nonfat milk

  • 5-7 Lifesavers

  • 3-4 glucose tablets

 

Rest 15 minutes

Retest your glucose level.

 

If glucose is less than 80 mg/dl, treat with another 15 g fast acting carbohydrate.

If your glucose level has increased above 80 mg/dl, eat a meal or snack with a carbohydrate/protein (1/2 sandwich with turkey and 1 slice bread, 1 oz cheese and 6-8 crackers)

Chocolate should not be used to treat a low blood glucose because the fat in chocolate prevents your glucose from rising quickly.

 

Why do I have to check my feet every day?

Diabetes often causes poor circulation and damaged in the legs and feet. This is one reason people with diabetes must take special care of their feet. Diabetics are likely to have foot problems, such as fungus, ingrown toenails, infections, bunions and ulcers. Most foot amputations can be prevented with good foot care. Note any changes in your feet, such as cuts, scratches, red areas, corns, cracks, itching or other abnormalities. Any changes should be reported to the podiatrist. To smooth down calluses, use a pumice stone when bathing, and never cut calluses off. Trim or file toenails straight across to reduce the chance of ingrown nails. Make sure shoes fit properly. Pressure from ill-fitting shoes can cause sore areas and lead to ulcers and infections. Lotion can be used around feet but not in between the toes.  Moisture can lead to infections.  Keep your feet clean and dry; once a day, wash your feet with mild soap and water.  See a podiatrist regularly.  

What foods should I avoid to help control my diabetes?

Foods with higher amounts of simple "added" sugars should be avoided, such as fruit juice, regular soda, sport drinks, all other calorie liquids, and candies. With diabetes, it's important to save sweets and desserts for special occasions. But with a little planning, you can still enjoy a small portion of your favorite treat once in a while. Speak with a Registered Dietitian to see how you can incorporate these treats into your meal plan.

What should I check on food labels - sugar or total carbohydrates?

Check the Total Carbohydrates. Total carbohydrates include sugar, starches and dietary fiber. The total amount of carbohydrates is what affects blood glucose levels—not just sugar. 15 grams of carbohydrates = 1 serving. The more fiber the product has, the more satisfied you will feel and glucose will not increase as high after meals. Add more vegetables and whole grain foods to your eating plan.

How much salt or sodium can I have if I am also taking blood pressure medication?

Patients who have diabetes, high blood pressure and take blood pressure medication should limit sodium intake to 1500 mg a day. Most sodium in the American diet comes from processed or prepared foods, not from the kitchen table salt shaker. Foods that have 400 mg per serving are considered high sodium foods. It's no secret that most Americans are consuming too much sodium. The average American takes in about 3,400 mg of sodium per day. Yet the American Diabetes Association guidelines recommend that people with diabetes have 2,300 mg or less per day. One teaspoon of salt contains about 2,300 mg of sodium.

 

What is the recommended daily amount of fiber I should eat?

The recommended amount of fiber is 25 to 30 grams per day. Check for fiber on food labels to help reach this number. Some examples of high fiber foods are fruits, vegetables, legumes and whole grains. Fiber is not completely digested and absorbed in the intestinal system, and it is unavailable as blood sugar. Therefore, a high-fiber meal does not provide as much available carbohydrates as a similar-content low fiber meal. To avoid constipation, increase water intake as more fiber is added to the diet.

Can I reuse the lancets and syringes I use for insulin injections?

We recommend using new lancets and syringes for each injection. Patients run the risk of insulin contamination and infection if the needle is used more than once. Every syringe and lancet should be discarded after use.

What should my blood sugar level be?

The American Diabetes Association recommends the following for adults:

  • Fasting blood glucose 70-130 mg/dl

  • 2 hour after start of meals <180 mg/dl

  • Pre meal glucose: <140 mg/dl

However: Blood glucose goals are individualized based on the duration of diabetes, age/life expectancy, co-morbid conditions, known cardiovascular disease or advance micro vascular complication, hypoglycemia unawareness, and individual patient considerations.  More or less stringent glucose goals may be appropriate for individual patients.

How do I care for my eyes?

Visit the ophthalmologist once a year. For patients with retinopathy, an ophthalmologist should be seen on a routine basis.

 

 

DIABETES RELATED COMPLICATIONS

 

Diabetes increases the risk for many serious complications. Correct treatment and recommended lifestyle changes can help prevent or delay the onset of complications. It is important to keep blood sugar near-normal to reduce your risk of long-term complications including but not limited to cardiovascular disease, which can cause heart attack, chest pain, stroke, and even death. There are various other complications which your physician will discuss at the time of your visit.

 

This risk of complications could be lowered by not smoking, taking a low-dose aspirin every day if advised by your physician, keeping the blood pressure and cholesterol controlled and keeping your A1C under 7 percent or lower. It is important to tightly control blood sugar levels before and during pregnancy to minimize the risk of complications.

Long-term complications of diabetes develop gradually. The longer you have diabetes — and the less controlled your blood sugar — the higher the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening.

 

Possible complications include:

  • Cardiovascular disease. Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis). If you have diabetes, you're more likely to have heart disease or stroke.

  • Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in your legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward.

    Left untreated, you could lose all sense of feeling in the affected limbs. Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, it may lead to erectile dysfunction.

  • Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters (glomeruli) that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.

  • Eye damage (retinopathy). Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.

  • Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can develop serious infections, which often heal poorly. These infections may ultimately require toe, foot or leg amputation.

  • Skin conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.

  • Hearing impairment. Hearing problems are more common in people with diabetes.

  • Alzheimer's disease. Type 2 diabetes may increase the risk of dementia, such as Alzheimer's disease. The poorer your blood sugar control, the greater the risk appears to be. Although there are theories as to how these disorders might be connected, none has yet been proved.

  • Depression. Depression symptoms are common in people with type 1 and type 2 diabetes. Depression can affect diabetes management.

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What long-term problems may affect people with diabetes?

People with diabetes are at risk for long-term problems affecting the eyes, kidneys, heart, brain, feet, and nerves. The best way to prevent or delay these problems is to control your blood sugar and take good care of yourself.

Eyes

It is recommended that people with diabetes see an eye doctor every year for a dilated eye exam. Eye problems that can occur with diabetes include:

  • Cataracts: A clouding of the lens of the eyes

  • Glaucoma: Increased pressure in the eye

  • Retinopathy: Eye changes with the retina in the back of the eye

Symptoms of eye problems include

  • Blurred vision

  • Spots or lines in your vision

  • Watery eyes

  • Eye discomfort

  • Loss of vision

If you have any changes in your vision, call your healthcare provider.

Kidneys

Have your urine checked for protein at least once a year. Protein in the urine is a sign of kidney disease. High blood pressure might also lead to kidney disease. Your blood pressure should be checked when you see your healthcare provider. Symptoms of a kidney problem include:

  • Swelling of the hands, feet, and face

  • Weight gain from edema

  • Itching and/or drowsiness. (This can occur with end stage kidney disease.)

Prompt treatment may slow the changes with kidney disease.

Heart and brain

All people with diabetes have an increased chance for heart disease and strokes. Heart disease is the major cause of death in people with diabetes. It is important to control other risks such as high blood pressure and high fats (cholesterol), as well as blood sugar.

Symptoms of a heart attack include:

  • Shortness of breath

  • Feeling faint

  • Feeling dizzy

  • Sweating

  • Nausea

  • Chest pain or pressure

  • Pain in the shoulders, jaw, and left arm

Warning signs of a stroke include:

  • Sudden numbness or weakness in the face, arm, or leg, usually on one side of the body.

  • Sudden nausea

  • Fever

  • Vomiting

  • Difficulty speaking or understanding words or simple sentences

  • Sudden blurred vision or decreased vision in one or both eyes

  • Difficulty swallowing

  • Dizziness

  • Loss of balance or loss of coordination

  • Brief loss of consciousness

  • Sudden inability to move part of the body (paralysis)

  • Sudden intense headache

Call your doctor or go to an emergency room if any of these signs or symptoms occur.

Feet

High blood sugars can lead to poor blood flow and nerve damage. This can lead to slow healing of sores. You can experience severe pain, but you can also lose feeling in your feet. In serious cases, this may lead to amputation of your toes, foot, or leg.

Nerves

High blood sugars can affect all of the nerve endings in your body. Nerve damage can cause many problems. Symptoms of nerve damage include:

  • Burning pain

  • Numbness

  • Tingling or loss of feeling in the feet or lower legs

  • Constipation and diarrhea

  • Problems with sexual function in both men and women

Neuropathy

Neuropathy is a disorder of the nervous system that can affect people with diabetes. There are different forms of neuropathy, including:

  • Peripheral neuropathy: Damage to the peripheral nervous system

  • Autonomic Type I: Damage to the nerves of internal organs

  • Gastroparesis: Movement of food through the stomach slows or stops

  • Postural hypotension: Drop in blood pressure due to change in body position

  • Uncontrolled diarrhea

If you experience any of the above, talk with your healthcare provider.

 

 

PRE DIABETES 

What is Prediabetes? 

Prediabetes occurs when blood glucose levels are higher than normal, but not high enough for a diabetes diagnosis. Over time, this can increase your risk of heart disease and stroke, as well as your risk of developing type 2 diabetes. Unfortunately, prediabetes symptoms are hard to spot, so many people have the condition without a proper diagnosis. 

 

Who is at risk?

The U.S. Centers for Disease Control indicates that about 79 million American adults over the age of 20 have prediabetes. As the population ages, becomes increasingly overweight and increasingly inactive, the number of adults with symptoms of prediabetes continues to grow. The number of young people with this condition is also increasing.  

 

Common risk factors include: 

  • Being obese or overweight 

  • Not getting enough exercise 

  • A family history of type 2 diabetes 

  • Being 45 or older 

  • Having African-American, Latino/Hispanic or American Indian family background 

  • Personal history of gestational diabetes  

  • Giving birth to a baby weighing more than 9 pounds 

 

What are the symptoms of Prediabetes?

 

Unfortunately, there are almost no symptoms of prediabetes. The only way to know for sure that you have the condition is with a blood test. Three blood tests can be used to diagnose the condition. These include: 

Fasting blood glucose test (FBG) — Blood is drawn after a period of fasting for at least 8 hours. 

Oral glucose tolerance test (OGT) — Requires an 8 hour fast, after which blood is drawn before you drink a sugary solution and again 2 hours later. 

Hemoglobin A1c test (HbA1C) — A blood test that shows an estimate of average blood glucose levels for a period of three months. 

 

Why should you be concerned about prediabetes? 

Every year, one out of ten people with prediabetes will develop type 2 diabetes, and many are not even aware that they are at risk, because they don't have symptoms. If left untreated, diabetes can cause kidney failure, blindness, heart disease, stroke and blindness. Even a slight increase in blood glucose levels in prediabetes can increase your risk for heart disease and stroke. 

 

How do you prevent and treat prediabetes? 

Preventing prediabetes is done with lifestyle changes, including a healthy diet that is high in vegetables and fruits and low in fat and processed foods. Regular physical activity, averaging 30 minutes five days per week, is also important. Maintaining a healthy weight, or losing 5–10% of your weight if you are overweight, can also help. In addition to lifestyle changes, a few drugs have been proven to lower the risk of developing diabetes if you have prediabetes. These drugs do have side effects, and their benefits wear off when you stop taking the drug, making lifestyle change the best option for tackling this problem. 

 

If you’ve been diagnosed with prediabetes, we know that can feel like a lot—like your life has changed and you’ll never be “normal” again. But know that that isn’t the case. You have the power to change things! 

For some people with prediabetes, early treatment can actually return blood sugar levels to a normal range. Ask plenty of questions and listen to the answers you get. Start exercising. Start eating healthy. And your life can be yours again.

 

What it means and what you can do ?

There are no clear symptoms of prediabetes so you may have it and not know it. But before people develop type 2 diabetes, they almost always have prediabetes—blood sugar levels that are higher than normal but not yet high enough to be diagnosed as diabetes. You may have some of the symptoms of diabetes or even some of the complications. Check with your doctor and get tested. If you discover that you do have prediabetes, remember that it doesn’t mean you’ll develop type 2, particularly if you follow a treatment plan and a diet and exercise routine. Even small changes can have a huge impact on managing this disease or preventing it all together.

 

Lifestyle change programs 

 

If you have prediabetes, we recommend you join a CDC-recognized diabetes prevention lifestyle change program. These programs offer scientifically proven and effective lifestyle changes that can prevent or delay type 2 diabetes.  

 

Tools to Know Your Risk

 

Take charge and see for yourself  

If you're at risk of developing type 2 diabetes, there's no better time to turn things around. Start here to learn more about A1C, take a risk test, or find out your Body Mass Index (BMI) 

 

Here's what you need to do! 

1) Understand your risk. 88 million American adults have prediabetes and 85% of them don’t even know it. https://www.diabetes.org/risk-test 

2) Find your A1C. This test can determine your average blood sugar over the past 2 to 3 months. Talk to your doctor to determine if this test is right for you. Understanding A1C. It can identify prediabetes, which raises your risk for diabetes. It can be used to diagnose diabetes. And it's used to monitor how well your diabetes treatment is working overtime. It's also a critical step in forming your game plan to manage diabetes with your diabetes care team. The goal for most adults with diabetes is an A1C that is less than 7%. 

A1C test results are reported as a percentage. The higher the percentage, the higher your blood sugar levels over the past two to three months. The A1C test can also be used for diagnosis, based on the following guidelines: 

  • If your A1C level is between 5.7 and less than 6.5%, your levels have been in the prediabetes range. 

  • If you have an A1C level of 6.5% or higher, your levels were in the diabetes range. 

3) Discover your BMI. Not sure how much weight you need to lose? This tool’s for you. Body Mass Index (BMI) is a simple calculation based on your weight and height. And it’s a great first step on your weight loss journey. 

 

Use the tools below to calculate your BMI: 

  1. Enter your height and click Submit Your Height. 

  2. A slider will appear. Drag the slider along the bar to your current weight. 

https://www.diabetes.org/diabetes-risk/tools-to-know-your-risk/bmi-calculator 

 

 

PREVENTION OF DIABETES

 

 

 

Get smart about risks and diabetes prevention. With early detection and awareness, you can take steps to prevent or delay the onset of type 2 diabetes.

Are you overweight? Know the impact.

If you’re overweight, it impacts more than your risk of developing type 2 diabetes. It leads to unhealthy cholesterol, high blood pressure, heart disease, high blood sugar, and even stroke. The good news? Losing just 10-15 pounds can make a big difference.

Extra Weight, Extra Risk

Being overweight raises your risk for type 2 diabetes, heart disease, and stroke. It can also increase the risk of high blood pressure, unhealthy cholesterol, and high blood glucose (sugar). If you are overweight, losing weight may help you prevent and manage these conditions. And you don't have to lose a lot to improve your health—even losing 10-15 pounds can make a big difference.

 

Getting started with weight loss

Weight loss can be hard because it involves changing the way you eat and your physical activity. Losing weight also takes time, which can be frustrating. The good news is that you can lose weight and keep it off, even if you've never done it before.

Here's what has worked for some people who have lost weight and kept it off*:

  • Cutting back on calories and fat.

  • Staying physically active most days of the week.

  • Eating breakfast every day.

  • Weighing themselves at least once per week.

  • Watching less than 10 hours of TV per week.

 

Small steps

Most people find it easier to make healthy changes in a few small steps instead of all at once. Set realistic goals within a timeframe that works for you, and don’t let stalls or setbacks throw you off course.  

Keep a record

Many people find that writing down everything they eat helps keep them on target. Give it a try—even for just a week—to see where you stand.

Keep a small notebook with you all day. Write down everything you eat and drink, including the serving size. There are also many free apps and websites that can help you do this online.

Make a note of what kind of physical activity you do and for how long. It may also help to write down other information, like when or where you exercised, who you exercised with, or how you felt before, during, or after exercise.

Check your weight at least once a week and write it down, or consider how your clothes are fitting as a measure of weight loss.

 

Your support system

Many people find it helpful to meet with people who are also trying to lose weight—either online or in person. Think about joining a group for weight loss, exercise, or general support. Or create your own support network by talking with friends and family about your successes and your struggles. You may be surprised at how supportive they will be.

Find a walking buddy or friends who also want to improve their health. Then you can support each other while working toward your goals.

What Is Prediabetes?

 

Prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Approximately 88 million American adults—more than 1 in 3—have prediabetes. Of those with prediabetes, more than 80% don’t know they have it. Prediabetes puts you at increased risk of developing type 2 diabetesheart disease, and stroke.

The good news is that if you have prediabetes, the CDC-led National Diabetes Prevention Program can help you make lifestyle changes to prevent or delay type 2 diabetes and other serious health problems.

Is the progression of Prediabetes to Type 2 Diabetes preventable ?

If you have prediabetes, losing a small amount of weight if you’re overweight and getting regular physical activity can lower your risk for developing type 2 diabetes. A small amount of weight loss means around 5% to 7% of your body weight, just 10 to 14 pounds for a 200-pound person. Regular physical activity means getting at least 150 minutes a week of brisk walking or a similar activity. That’s just 30 minutes a day, five days a week.

A lifestyle change program offered through the CDC-led National Diabetes Prevention Program can help you make those changes—and make them stick. Through the program, you can lower your risk of developing type 2 diabetes by as much as 58% (71% if you’re over age 60).

Highlights include:

  • Working with a trained coach to make realistic, lasting lifestyle changes.

  • Discovering how to eat healthy and add more physical activity into your day.

  • Finding out how to manage stress, stay motivated, and solve problems that can slow your progress.

  • Getting support from people with similar goals and challenges.

Ask your doctor or nurse if there’s a CDC-recognized National Diabetes Prevention Program offered in your community. The best time to prevent type 2 diabetes is now.

What Causes Prediabetes?

Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into cells for use as energy. If you have prediabetes, the cells in your body don’t respond normally to insulin. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes—and type 2 diabetes down the road.

 

What are the signs & symptoms of Prediabetes?

You can have prediabetes for years but have no clear symptoms, so it often goes undetected until serious health problems such as type 2 diabetes show up.

 

What are the risk factors for Prediabetes?

 

It’s important to talk to your doctor about getting your blood sugar tested if you have any of the risk factors for prediabetes, which include:

  • Being overweight

  • Being 45 years or older

  • Having a parent, brother, or sister with type 2 diabetes

  • Being physically active less than 3 times a week

  • Ever having gestational diabetes (diabetes during pregnancy) or giving birth to a baby who weighed more than 9 pounds

  • Having poly cystic ovary syndrome

Race and ethnicity are also a factor: African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at higher risk.

 

How is Prediabetes diagnosed?

You can get a simple blood sugar test to find out if you have prediabetes. Ask your doctor if you should be tested.

 

Hypoglycemia

 

Hypoglycemia, also known as low blood sugar, is a fall in blood sugar to levels below normal.

Coming Soon

 

DIABETES & OLD AGE

 

 

 

 

 

 

 

 

 

 

 

 

There is new and emerging information to improve the understanding and treatment for diabetes in older adults. Special considerations should be addressed to support overall health and quality of life. Older adults often have one or more co-existing conditions like cognitive impairment, cardiovascular disease and others, that impact diabetes education and management.  

There are many ways to reduce the risk of diabetes complications, including: keeping your blood sugar and hemoglobin A1C within recommended range, keeping your blood pressure and cholesterol under control, staying active by exercising, eating a healthy diet, avoiding alcohol and cigarette smoking.  

It is important to follow your doctor’s recommendations including seeing an eye specialist and getting your kidney function checked every year. Patients are encouraged to establish personal goals for diabetes management with the help of their physicians and providers.  

Older adults should consider lifestyle changes such as exercise, nutrition, managing blood sugar, limiting alcohol, and avoiding smoking. Progression from prediabetes to diabetes can be slowed with a diabetes prevention program. 

A healthcare provider will assess your overall health and develop the best care plan based on personal goals, functional status, geriatric syndromes, sarcopenia, and other chronic illnesses. Care plans are customized and different for each person. A diabetes prevention program is recommended for people with prediabetes to prevent progression to diabetes. 

If you have diabetes, you might encounter the effects of complications as you move into the latter part of your life. According to the Centers for Disease Control and Prevention, 50 percent of adults age 65 and older have prediabetes and 25 percent have diabetes. Prediabetes is a condition in which blood sugar levels are higher than they should be, but not yet high enough to be diagnosed with diabetes. 

These conditions are caused by multiple factors, including insulin resistance, usually as a result of obesity and inactivity; reduced insulin production from the pancreas; and loss of muscle mass. 

EFFECTS OF DIABETES AND AGING 

 

  • Life-limiting complications — Having diabetes can result in nerve damage and persistent pain, vision loss, kidney dysfunction, memory changes, urinary incontinence or slow-healing wounds. 

  • Premature death — The likelihood of premature death increases due to co-existing conditions, such as heart disease, high blood pressure or stroke. 

  • Increased falls and injury — Low blood sugar levels, vision or hearing loss, and balance changes from neuropathy may increase your chance of falling and injury. 

  • Medication conflicts — You may be taking multiple medications to treat health conditions, which puts you at increased risk for side effects or drug interactions. 

  • Dexterity and vision loss — Your fingers or hands may not work as well as they used to, or your eyesight may be poor, making it difficult to use insulin or injectable medications. 

  • Financial burden — Medication and testing supplies needed to treat your diabetes can be costly, which could create budget constraints. 

  • Memory loss or function — You may not remember or think as clearly as before and may need assistance from relatives or friends. 

  • Poor nutrition — You may have limited access to healthy food because of finances or lack of transportation. 

  • Depression — Your level of independence may decrease due to changes in vision, mobility or finances, and you may become depressed. 

 

 PARTICIPATION IN YOUR TREATMENT PLAN 

 Early detection and treatment of diabetes and prediabetes can reduce your risk for long-term complications. It’s  important to work with your diabetes care team to individualize your treatment plan, including limiting hypoglycemia, or  low blood sugars, and cardiovascular conditions, such as hypertension, or high blood pressure, and lipid management. 

 Other ways you can be an active participant in your treatment plan include to: 

  • Talk with your health care provider about medication costs, vision loss, dexterity or balance concerns, memory loss or symptoms of depression. 

  • Discuss your diabetes care plan with your endocrinologist or diabetes educator. You also may want to meet with a dietitian to help you with meal plans. 

  • Gather resources from aging and disability resource centers, including information on physical activity, food assistance or other support options. 

  • Schedule a yearly dilated eye exam to closely monitor your eye health for vision problems or eye diseases. 

  • Do exercises that include balance, strength training and cardio to optimize your health. 

  • Use portion control for your meals. Remember to include vegetables, fruits, protein and calcium, while cutting down on sugary beverages and alcohol. 

  • Use assistive devices, such as walkers, to help you be more active if you have balance concerns. 

  • Check your feet and skin daily, and seek out prompt medical help if problems arise. 

  • Check your blood sugars frequently so you can identify changes in your blood sugar pattern. Notify your provider of concerns. 

 

SET YOUR DIABETES GOALS 

Set some realistic personal goals in your diabetes journey. Work with your health care team to promote positive health. Gather support from your family, friends and community to improve your quality of life. 

Remote Management of Diabetes

Fitness & Exercise

 

DIABETES & TECHNOLOGY

DIABETES  TECHNOLOGY ROAD MAP  

 

The goal of glucose management in all types of diabetes is to minimize and/or eliminate the complications of diabetes. Determining the best glucose management system for you can be challenging and an overwhelming task, but your diabetes specialist could help you understand your options and help guide you to what's best fit for you. You will want to take a look at the latest innovations and technologies and  choose the best features to suit your lifestyle.  

 

BLOOD GLUCOSE METER 

Most people with newly diagnosed diabetes first begin monitoring glucose levels with one of these meters, which provides a “snapshot” of your glucose level at a single moment in time. You monitor your blood glucose several times a day by finger prick to get a blood sample on a testing strip used with a blood glucose meter. It generates downloadable data to help you and your doctor determine the amount of insulin you need to inject.  

Choosing the right blood glucose meter - There are more choices than ever, from basic designs to more advanced models that have all the bells and whistles. And fancier isn’t necessarily better. 

Here are some things to consider: 

  • Ease of use–Can you easily read the numbers on the screen? Some meters are made for simpler operation, whether it’s larger buttons, illuminated screens, and audio capabilities. 

  • Cost and insurance coverage–Meters vary in price, and some insurers limit coverage to specific models. Start by checking with your provider to find out what they’ll cover. 

  • Information retrieval–Consider how the meter retrieves your information and whether you can download the data to a computer or mobile device to email it to your doctor. 

  • Flexibility–If you’re tired of finger pricks, there’s an alternative site monitor that lets you draw blood samples from your arm, thigh, or the palm of your hand. 

 

NEWER DEVICES & TECHNOLOGIES 

If you have type 1 or type 2 diabetes, ask your healthcare provider if one of the newer devices or technologies for controlling or monitoring your glucose levels and administering insulin may be right for you. For many years, providers didn’t consider pumps or continuous glucose monitoring for people with type 2 diabetes. That is changing.  

 

•  Terms you should know:  

a.  CLII (Continuous Subcutaneous Insulin Infusion or Insulin Pump)  

b.  RT-CGM (Real Time continuous Glucose Monitoring)  

c.  Analog Insulin (Genetically Engineered Insulin) 

 

Checking Out  the Newer Technologies New technologies are available today that can really help improve your glucose management. They can help you avoid hypoglycemia (low glucose) and hyperglycemia (high glucose). Many of these technologies are becoming more common and may be covered by your insurance. 

 

INSULIN PUMPS (or CLII) 

These are small computerized devices that deliver insulin in a steady measured dose and as a bolus dose at your direction around mealtimes. A flexible plastic tube called a catheter is inserted under the skin via a small needle. You can then program the device worn on your body to provide you with a continuous dose of insulin. “Patch pumps” are those that are worn without a tubing but is attached via the catheter and is worn on the skin.  

 

Pumps may be a good choice for you, if:  

a.  You prefer one needle stick every 2-3 days over multiple daily  insulin injections  

b.  You don’t mind wearing the pump on your body all of the time  

c. You have type 1 diabetes or insulin requiring type 2 diabetes

 

With insulin pumps, it’s your choice. If you need a break from shots, an insulin pump can bring you relief. 

The important thing to know is that a pump gives you options. You can use it continuously or temporarily, like on a vacation or over summer break. You can get a pump, wear it, stop wearing it, restart it—whatever works for you. 

Pumps are an extra piece of hardware attached to your body, either with tubing or attached to your skin. They’re programmed to release small doses of insulin continuously (basal), or as a surge (bolus) dose close to mealtime to control the rise in blood sugar after a meal. They work by closely mimicking your body's normal release of insulin. 

Is a pump right for you? 

If your doctor determines that a pump is a good option for you, it's important to check with your insurance carrier before you buy anything. Most carriers cover pumps, but some don't and it can be expensive.  

Here are some things to consider: 

  • Lifestyle–Pumps can be a great option for people who have active lifestyles. A pump can also work well for women who are planning to become pregnant, or for people with frequent low blood sugar reactions, or those who have delays in absorption of food from the stomach (gastroparesis). 

  • Commitment–Using a pump doesn’t mean you no longer have to check your blood sugar. And it can take some getting used to, from setting it up and putting it in to managing it day-to-day. 

  • Safety–You and/or your caregiver should be ready to do what it takes to use the pump safely. Because the pump only delivers shorter-acting insulin, it’s important to check your blood sugar regularly to ensure it’s working right. 

 

 CONTINUOUS GLUCOSE MONITORING (CGM)  

Fewer finger pricks with CGM 

If you have type 1 or type 2 and just want better glucose control, Continuous Glucose Monitoring (CGM) may be right for you. It’s an advanced way to check glucose readings in real-time or monitor glucose readings over a period of time. 

The CGM system works through a sensor placed on your skin. It transmits readings to a small recording device that sounds an alarm if your blood sugar gets too high or low. Whether you manage your diabetes with a pump, daily injections, or oral medications, CGM can help you take control. 

Using a wire placed under the skin, a real time continuous glucose monitoring (RT-CGM) system measures the glucose level in the fluid under your skin. A transmitter then sends the information to a wireless-receiver. You can program your monitor to sound and alarm if your glucose level goes outside a certain range or there is a rapid change in glucose levels. With some monitors, data can be integrated with your insulin pump, home computer, tablet, or cell phone, and may even forward data directly to your healthcare provider.  

 

This may be a good choice for you, if:  

a.   You want to gain insight and better understand your glucose levels and patterns and see what’s happening between finger pricks  

b.   You and your healthcare provider are interested in obtaining  more data for customizing your insulin dosing, meal planning,  and exercise planning.

 

  Insulin Pens — Each box of insulin pens contains either disposable prefilled pens or durable pens with cartridges for multi-day use that once opened, you may not refrigerate again but must be kept cool or at room temperature. If you have any doubt about how to store your insulin please check with your health care team. You will also get a prescription with pen needles. Each pen has a dose adjustment dial. You will need to use a new needle with each injection. Insulin pens are more convenient than syringes and vials, allow flexibility, and provide more precise insulin dosing. They can work with shorter needles.  

 

This may be a good choice for you, if:  

a. You want the convenience of carrying insulin without a vial and syringe  

b. You want an option for a thinner, shorter needle  

c.  You have low vision and prefer to hear or feel clicks for dosing your insulin.

 •   Analog Insulin — These are genetically engineered types of insulin that are similar to the insulin your pancreas makes, but are changed slightly to allow for slower or faster action. They’re available in multiple forms: rapid acting, longer acting, or a mixture or rapid and long acting insulin. Rapid acting insulin analogs start to act immediately, peak in the first hour after injecting, and last about 4-6 hours. Long acting insulin takes about 2 hours to start acting and is designed to act consistently through the day and last for up to  24 hours or more.  

 

One of these may be a good choice for you, if:  

a. You are on an insulin pump (short acting insulin only)  

b. You are active and need flexibility in eating times and activities  

c. You are prone to low glucose levels, especially during the night 

 

INHALED INSULIN 

 

Reaching Your Goal New technologies for treating diabetes can help you maintain a healthier life, possibly even returning your glucose levels to non-diabetic levels.  Talk with your healthcare provider to learn more.  

 

Additional Information — For more on these and other innovations  and technologies for treating Type 1 and Type 2, diabetes, visit:  

www.hormone.org  

www.dailydiabetes.org  

www.diabetes.org  

www.jdrf.org 

MORE ABOUT DIABETES

STAT

Type 2 Diabetes Statistics and Facts 

Type 2 diabetes is the most common form of diabetes. Read on to learn some of the key facts and statistics about the people who have it and how to manage it. 

Risk factors 

Many risk factors for type 2 diabetes include lifestyle decisions that can be reduced or even cut out entirely with time and effort. Men are also at slightly higher risk of developing diabetes than women. This may be more associated with lifestyle factors, body weight, and where the weight is located (abdominally versus in the hip area) than with innate gender differences.  

Significant risk factors include: 

  • older age 

  • excess weight, particularly around the waist 

  • family history 

  • certain ethnicities 

  • physical inactivity 

  • poor diet  

 

Prevalence  

Type 2 diabetes is increasingly prevalent but also largely preventable. According to the Centers for Disease Control and Prevention (CDC)Trusted Source, type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes in adults. The CDC also gives us the following information: 

In general 

  • Research suggests that 1 out of 3 adults has prediabetes. Of this group, 9 out of 10 don't know they have it. 

  • 29.1 million people in the United States have diabetes, but 8.1 million may be undiagnosed and unaware of their condition. 

  • About 1.4 million new cases of diabetes are diagnosed in United States every year.  

  • More than one in every 10 adults who are 20 years or older has diabetes. For seniors (65 years and older), that figure rises to more than one in four. 

  • Cases of diagnosed diabetes cost the United States an estimated $245 billionTrusted Source in 2012. This cost is expected to rise with the increasing diagnoses. 

In pregnancy and parenting According to the CDCTrusted Source, 4.6 to 9.2 percent of pregnancies may be affected by gestational diabetes. In up to 10 percent of them, the mother is diagnosed with type 2 diabetes just after the pregnancy. The rest of these women have a 35 to 60 percent chance of developing type 2 diabetes within 10 to 20 years. This risk decreases if the woman leads an active lifestyle and maintains an ideal weight. 

A child has a 1 in 7 chance of developing diabetes if one parent was diagnosed before age 50. If the parent was diagnosed after age 50, the child has a 1 in 13 chance. The child's risk may be greater if the mother has diabetes. If both parents have diabetes, the child's risk is about 50 percent.  

In ethnic groups 

 

Certain racial or ethnic groups have higher rates of prediabetes and type 2 diabetes. The risk is higher even after adjusting for other factors. Statistics from The National Institute of Diabetes and Digestive and Kidney Diseases and CDC Trusted Source show the risks for different groups: 

In the United States, type 2 diabetes is more prevalent for certain groups than for Caucasians. These people include: 

  • Native Americans 

  • African Americans 

  • Hispanics 

  • Asian Americans 

 

Compared to non-Hispanic white adults in the United States, Asian Americans have a nine percent higher risk of diabetes. Non-Hispanic Blacks have a 13.2 percent higher risk. Hispanics have a 12.8 percent higher risk, but this varies depending on national lineage. Currently, the rates of diagnosed diabetes are: 

  • 8.5 percent for Central and South Americans 

  • 9.3 percent for Cubans 

  • 13.9 percent for Mexican Americans 

  • 14.8 percent for Puerto Ricans 

American Indian adults in southern Arizona have the world’s highest rate of type 2 diabetes. One in three are currently diagnosed.  

In children 

Type 2 diabetes is rare for children of all racial and ethnic backgrounds. Still, it has higher rates in many minority groups than in Caucasians. This is particularly true for Asian Pacific Islanders ages 10 to 19 years. Across all ethnic groups though, type 2 diabetes is increasing around the age of puberty. 

Age 

The risk of developing type 2 diabetes increases with age.  

The number of children diagnosed with type 2 diabetes is growing due to more overweight youth. Still, it is much less common in children and young adults than it is in older people.  

For example, consider data from the CDCTrusted Source: Among children 10 years and younger, the rate of new cases in 2008–2009 was 0.8 per 100,000. For ages 10 to 19 years, this rate was 11 per 100,000. Comparatively, about 12.3 percent of all adults age 20 or older have diabetes. And 25.9 percent adults 65 years or older have diabetes. That’s much higher than the 0.26 percent of children 19 and under. 

Adults ages 40 to 59 comprise the world’s age group with the highest diabetes rates. According to one study, this is expected to shift to adults ages 60 to 79 by 2030. 

Worldwide 

Type 2 diabetes is on the rise worldwide. The International Diabetes Federation reports that more than 400 million people were living with diabetes as of 2015. The World Health Organization (WHO)Trusted Source estimates that 90 percent of people around the world who have diabetes have type 2. 

In 2012, diabetes caused an estimated 1.5 millionTrusted Source deaths. More than eight of every 10 of them occurred in low- and middle-income countries. In developing nations, more than half of all diabetes cases go undiagnosed. WHO anticipates that worldwide deaths from diabetes will double by 2030. 

 

Prevention 

Both type 2 diabetes and its side effects can often be prevented or delayed. The most cost-effective methods include getting regular physical activity and maintaining a healthy weight. This means following a healthy diet plan. Regular visits to a healthcare provider are also essential. Medication may be necessary as well. Catching complications early allows for intervention, education, and referral to a specialist when needed. 

Weight 

Keeping a healthy weight is important. The Diabetes Prevention ProgramTrusted Source found that weight loss and increased physical activity reduced the chance of prediabetes turning into type 2 diabetes by 58 percent. For people 60 years or older, the reduction was 71 percent. For overweight people, losing five to seven percent of body weight through exercise and healthy eating could prevent the onset of type 2 diabetes. 

Monitoring 

Get regular checks of your blood cholesterol levels, blood pressure, and blood sugar levels. Work to achieve and maintain healthy levels of each. Having healthy levels of these three indicators greatly reduces your risk of diabetes. 

Medication 

The drug metformin was found to reduce the risk of diabetes onset by 31 percent, particularly in younger and heavier prediabetic adults. 

Complications and effects 

Problems from type 2 diabetes are common and can be severe. People with diabetes have twice the risk of death of any cause compared to people of the same age without diabetes. In 2014, diabetes was listed as the seventh leading cause of death in the United States. The contribution of diabetes to death may be underreported on death certificates.  

Side effects of type 2 diabetes can include: 

  • heart disease 

  • stroke 

  • hypertension 

  • blindness and eye problems 

  • kidney disease 

  • nervous system complications 

  • amputations  

  • foot problems 

  • dental disease 

  • pregnancy complications 

  • mental health problems, such as depression 

  • skin issues 

 

Heart problems 

WHO estimates that 50 percentTrusted Source of people with diabetes die of cardiovascular disease, such as heart disease and stroke. The American Diabetes Association reports that more than 71 percent of U.S. adults with diabetes had hypertension or used medication to treat hypertension. 

Eye problems 

There were 7,686 cases of diabetic retinopathy in the United States in 2010. Diabetes is the leading cause of newly diagnosed adult blindness for people between the ages of 20 and 74 years. 

Kidney problems 

Diabetes was also the primary cause of kidney failure in 44 percent of all new cases in 2011. During the same year, it was also reported that 228,924 people began treatment for kidney failure due to diabetes. 

Sensation problems and amputation 

Type 2 diabetes is the most common form of diabetes. Read on to learn some of the key facts and statistics about the people who have it and how to manage it. 

 

Risk factors 

Many risk factors for type 2 diabetes include lifestyle decisions that can be reduced or even cut out entirely with time and effort. Men are also at slightly higher risk of developing diabetes than women. This may be more associated with lifestyle factors, body weight, and where the weight is located (abdominally versus in the hip area) than with innate gender differences.  

 

Significant risk factors include: 

  • older age 

  • excess weight, particularly around the waist 

  • family history 

  • certain ethnicity 

  • physical inactivity 

  • poor diet  

 

Prevalence  

Type 2 diabetes is increasingly prevalent but also largely preventable. According to the Centers for Disease Control and Prevention (CDC)Trusted Source, type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes in adults. The CDC also gives us the following information: 

In general 

  • Research suggests that 1 out of 3 adults has prediabetes. Of this group, 9 out of 10 don't know they have it. 

  • 29.1 million people in the United States have diabetes, but 8.1 million may be undiagnosed and unaware of their condition. 

  • About 1.4 million new cases of diabetes are diagnosed in United States every year.  

  • More than one in every 10 adults who are 20 years or older has diabetes. For seniors (65 years and older), that figure rises to more than one in four. 

  • Cases of diagnosed diabetes cost the United States an estimated $245 billion Trusted Source in 2012. This cost is expected to rise with the increasing diagnoses. 

In pregnancy and parenting, According to the CDC Trusted Source, 4.6 to 9.2 percent of pregnancies may be affected by gestational diabetes. In up to 10 percent of them, the mother is diagnosed with type 2 diabetes just after the pregnancy. The rest of these women have a 35 to 60 percent chance of developing type 2 diabetes within 10 to 20 years. This risk decreases if the woman leads an active lifestyle and maintains an ideal weight. 

A child has a 1 in 7 chance of developing diabetes if one parent was diagnosed before age 50. If the parent was diagnosed after age 50, the child has a 1 in 13 chance. The child's risk may be greater if the mother has diabetes. If both parents have diabetes, the child's risk is about 50 percent.  

In ethnic groups 

Certain racial or ethnic groups have higher rates of prediabetes and type 2 diabetes. The risk is higher even after adjusting for other factors. Statistics from The National Institute of Diabetes and Digestive and Kidney Diseases and CDCTrusted Source show the risks for different groups: 

In the United States, type 2 diabetes is more prevalent for certain groups than for Caucasians. These people include: 

  • Native Americans 

  • African Americans 

  • Hispanics 

  • Asian Americans 

Compared to non-Hispanic white adults in the United States, Asian Americans have a nine percent higher risk of diabetes. Non-Hispanic Blacks have a 13.2 percent higher risk. Hispanics have a 12.8 percent higher risk, but this varies depending on national lineage. Currently, the rates of diagnosed diabetes are: 

  • 8.5 percent for Central and South Americans 

  • 9.3 percent for Cubans 

  • 13.9 percent for Mexican Americans 

  • 14.8 percent for Puerto Ricans 

 

American Indian adults in southern Arizona have the world’s highest rate of type 2 diabetes. One in three are currently diagnosed.  

 

In children 

Type 2 diabetes is rare for children of all racial and ethnic backgrounds. Still, it has higher rates in many minority groups than in Caucasians. This is particularly true for Asian Pacific Islanders ages 10 to 19 years. Across all ethnic groups though, type 2 diabetes is increasing around the age of puberty. 

 

Age 

The risk of developing type 2 diabetes increases with age.  

The number of children diagnosed with type 2 diabetes is growing due to more overweight youth. Still, it is much less common in children and young adults than it is in older people.  

For example, consider data from the CDCTrusted Source: Among children 10 years and younger, the rate of new cases in 2008–2009 was 0.8 per 100,000. For ages 10 to 19 years, this rate was 11 per 100,000. Comparatively, about 12.3 percent of all adults age 20 or older have diabetes. And 25.9 percent adults 65 years or older have diabetes. That’s much higher than the 0.26 percent of children 19 and under. 

Adults ages 40 to 59 comprise the world’s age group with the highest diabetes rates. According to one study, this is expected to shift to adults ages 60 to 79 by 2030. 

Worldwide 

Type 2 diabetes is on the rise worldwide. The International Diabetes Federation reports that more than 400 million people were living with diabetes as of 2015. The World Health Organization (WHO)Trusted Source estimates that 90 percent of people around the world who have diabetes have type 2. 

In 2012, diabetes caused an estimated 1.5 millionTrusted Source deaths. More than eight of every 10 of them occurred in low- and middle-income countries. In developing nations, more than half of all diabetes cases go undiagnosed. WHO anticipates that worldwide deaths from diabetes will double by 2030.  

Prevention 

Both type 2 diabetes and its side effects can often be prevented or delayed. The most cost-effective methods include getting regular physical activity and maintaining a healthy weight. This means following a healthy diet plan. Regular visits to a healthcare provider are also essential. Medication may be necessary as well. Catching complications early allows for intervention, education, and referral to a specialist when needed. 

 

Weight 

Keeping a healthy weight is important. The Diabetes Prevention ProgramTrusted Source found that weight loss and increased physical activity reduced the chance of prediabetes turning into type 2 diabetes by 58 percent. For people 60 years or older, the reduction was 71 percent. For overweight people, losing five to seven percent of body weight through exercise and healthy eating could prevent the onset of type 2 diabetes. 

Monitoring

Get regular checks of your blood cholesterol levels, blood pressure, and blood sugar levels. Work to achieve and maintain healthy levels of each. Having healthy levels of these three indicators greatly reduces your risk of diabetes.

 

Medication 

The drug metformin was found to reduce the risk of diabetes onset by 31 percent, particularly in younger and heavier prediabetic adults. 

Complications and effects 

Problems from type 2 diabetes are common and can be severe. People with diabetes have twice the risk of death of any cause compared to people of the same age without diabetes. In 2014, diabetes was listed as the seventh leading cause of death in the United States. The contribution of diabetes to death may be under reported on death certificates.  

Side effects of type 2 diabetes can include: 

  • heart disease 

  • stroke 

  • hypertension 

  • blindness and eye problems 

  • kidney disease 

  • nervous system complications 

  • amputations  

  • foot problems 

  • dental disease 

  • pregnancy complications 

  • mental health problems, such as depression 

  • skin issues 

 

Heart problems 

WHO estimates that 50 percentTrusted Source of people with diabetes die of cardiovascular disease, such as heart disease and stroke. The American Diabetes Association reports that more than 71 percent of U.S. adults with diabetes had hypertension or used medication to treat hypertension. 

 

Eye problems 

There were 7,686 cases of diabetic retinopathy in the United States in 2010. Diabetes is the leading cause of newly diagnosed adult blindness for people between the ages of 20 and 74 years. 

 

Kidney problems 

Diabetes was also the primary cause of kidney failure in 44 percent of all new cases in 2011. During the same year, it was also reported that 228,924 people began treatment for kidney failure due to diabetes. 

Sensation problems and amputation

 

Diabetes causes mild loss of sensation in the extremities in as many as 70 percent of adults who have it. Amputations of lower extremities may eventually be necessary, especially for people with blood vessel disease. More than 60 percent of all nontraumatic amputations of lower limbs occur in people with diabetes. Approximately 73,000 lower-limb amputations were performed in diabetics age 20 and older. 

Birth defects 

Uncontrolled diabetes during pregnancy can increase the chance of: 

  • birth defects 

  • large babies 

  • other issues that can be dangerous to the baby and the mother 

Mental health effects 

People with diabetes are twice as likely to suffer from depression as people without diabetes. 

LIFESTYLE FAQ

(Prediabetes & Diabetes) 

 

Q: If you’re overweight, will you always develop type 2 diabetes? 

A: Being overweight is a risk factor for developing diabetes, but other risk factors such as how much physical activity you get, family history, ethnicity, and age also play a role. Unfortunately, many people think that weight is the only risk factor for type 2 diabetes, but many people with type 2 diabetes are at a normal weight or only moderately overweight. 

 

Q: Do sugary drinks cause diabetes? 

A: Research has also shown that drinking sugary drinks is linked to type 2 diabetes. The American Diabetes Association recommends that people avoid drinking sugar-sweetened beverages and switch to water whenever possible to help prevent type 2 diabetes. 

Sugary drinks also raise blood sugar and can provide several hundred calories in just one serving. Just one 12-ounce can of regular soda has about 150 calories and 40 grams of sugar, a type of carbohydrate (carb). This is the same as 10 teaspoons of sugar. 

Sugar-sweetened beverages include beverages like: 

  • Regular soda 

  • Fruit punch 

  • Fruit drinks 

  • Energy drinks 

  • Sports drinks 

  • Sweet tea 

  • Sweetened coffee drinks 

  • Other sugary drinks 

 

Q: Is diabetes a serious disease? 

A: Yes. Diabetes causes more deaths per year than breast cancer and AIDS combined and having diabetes nearly doubles your chance of having a heart attack. The good news is that managing your diabetes can reduce your risk for diabetes complications. 

 

Q: Do people with diabetes need to eat special foods? 

 

A: No, you don’t need special food. Packaged foods with special “diabetes-friendly” claims may still raise blood glucose levels, be more expensive, and/or contain sugar alcohols that can have a laxative effect. 

A healthy meal plan for people with diabetes is generally the same as healthy eating for anyone. In fact, there are a lot of different eating plans that can help you manage your diabetes. In general, a healthy eating plan for diabetes will include lots of non-starchy vegetables, limit added sugars, swap refined grains for whole grains and prioritize whole foods over highly processed foods when possible. 

Want to add more veggies and whole foods, but don’t know where to start? 

Q: If you have diabetes, can you eat starchy foods, such as bread, potatoes, and pasta?

A: Starchy foods can be part of a healthy meal plan, but portion size is key. These foods tend to have more carbs and eating them will raise your blood sugar. 

Q: Do people with diabetes need to avoid carbs? 

A: There is no evidence to suggest that people with diabetes need to avoid carbs, though some people choose eating plans that avoid them. In fact, the evidence suggests that including the right amounts of carbs, protein, and fat can help manage your blood glucose levels. Working with your health care team can help you find the right balance for you. 

 

Q: Not sure where to start…? 

 

A: Aim for a portion no bigger than a quarter of a 9-inch plate. 

 

Q: Can people with diabetes eat sweets or chocolate? 

 

A: If eaten as part of a healthy meal plan sweets and desserts can be eaten by people with diabetes. The key to sweets is to have a very small portion and save them for special occasions so you focus your meals on healthier foods. Working with a Registered Dietitian Nutritionist (RDN) or Certified Diabetes Educator (CDE) will help you determine an individualized meal plan that takes into account your goals as well as your likes and dislikes. 

 

Q: Can you catch diabetes from someone else? 

 

A: No. Although we don't know exactly why some people develop diabetes and others don’t, we know diabetes is not contagious. It can't be caught like a cold or flu. 

 

Q: Are people with diabetes more likely to get colds and other illnesses? 

 

A: You are no more likely to get a cold or another illness if you have diabetes. People with diabetes are advised to get flu shots. This is because any illness can make diabetes more difficult to control, and people with diabetes who get the flu are more likely than others to go on to develop serious complications. 

 

Q: If you have type 2 diabetes and your doctor says you need to start using insulin, does it mean you're failing 

to take care of your diabetes properly? 

 

A: Using insulin to get blood glucose levels to a healthy level is a good thing, not a bad one. For most people, type 2 diabetes is a progressive disease. When first diagnosed, many people with type 2 diabetes can keep their blood glucose at a healthy level with a combination of meal planning, physical activity, and taking oral medications. But over time, the body gradually produces less and less of its own insulin, and eventually, oral medications may not be enough to keep blood glucose levels in a healthy range. 

TYPE 2 DIABETES MELLITUS

We encourage people with diabetes and their loved ones to learn as much as possible about the latest medical therapies and approaches, as well as healthy lifestyle choices. This, plus good communication with a team of experts, can help you feel in control and better able to respond to changing needs. 

Maybe you’ve just been diagnosed with type 2 diabetes. Or maybe you’ve been living with it for a while.  

Here’s the thing: your journey is unique and it starts fresh every day !  

No matter where you are with type 2 diabetes, there are some things you should know. It's the most common form of diabetes. Type 2 means that your body doesn't use insulin properly. And while some people can control their blood sugar levels with healthy eating and exercise, others may need medication or insulin to manage it. Regardless, you have everything you need to fight it. 

A key part of managing type 2 diabetes is maintaining a healthy diet. You need to eat something sustainable that helps you feel better and still makes you feel happy and fed. Remember, it’s a process. Work to find helpful tips and diet plans that best suit your lifestyle—and how you can make your nutritional intake work the hardest for you. 

Fitness is another key to managing type 2. And the good news, all you have to do is get moving. The key is to find activities you love and do them as often as you can. No matter how fit you are, a little activity every day can help fight type 2 and put yourself in charge of your life. 

 

A huge part of managing type 2 diabetes is developing a healthy diet. It’s all about finding the right balance that works for you. 

You need to eat something sustainable that helps you feel better and still makes you feel happy and fed. Remember, it’s a process. Work to find helpful tips and diet plans that best suit your lifestyle—and how you can make your nutritional intake work the hardest for you.  

When you’re managing diabetes, you're eating plan is a powerful tool. But figuring out what to eat can feel like a hassle, right? Well, it doesn't have to because there are easy things you can do to add flavor to your daily routine—including healthy twists on your favorite foods. 

 

The one key to feeling your best lies in the food you eat—so don't give up. You can start by working with a dietitian or registered dietitian nutritionist (RDN) to make an eating plan that works for you. Be sure to include foods you like and don’t be afraid to try something new. 

Most importantly, remember that eating well—and adding activity to your daily routine (moving more)—are important ways you can manage diabetes. And we’re here to help you every step of the way. 

Get moving with a fitness plan 

Fitness is a key part of managing type 2. And the good news, all you have to do is get moving. You don’t have to become an ultra-marathoner. You can start slowly with a walk around the block or a simple bike ride. The key is to find activities you love and do them as often as you can. 

 

Here’s how you can get started: 

  • Work with your doctor to determine what level of physical activity you should engage in 

  • Figure out how much time per day you can devote to exercise 

  • Set fitness goals—having clear goals can help you stay motivated 

  • Consider where you’ll start working out—the gym, in your neighborhood, in a park? 

  • Build different activities into your daily routine 

  • Start slowly and allow for recovery time 

  • Keep track of what you do and stay focused on your goals 

  • Listen to your body 

 

Move to feel better 

Exercise for diabetes and get a leg up. Regular exercise can help put you back in control of your life. 

If you’re not into regular exercise, putting together an exercise plan can be a bummer. 

But remember, along with your diet and medications, regular physical activity is an important part of managing diabetes or dealing with prediabetes. Because when you’re active, your cells become more sensitive to insulin so it works more effectively. And you just feel better. And look better. 

So, however you want to do it—taking regular walks around the block, going for a run, or signing up for a marathon—getting started is the most important part. 

 

Get started. But get started safely. 

It doesn’t matter where you are physically. If you’ve never set foot in a gym, that’s okay—as long as you start doing something now. If you haven’t been very active or are worried about your health, it’s important to consult your doctor and start slowly.

 

Light walking is a great place to start—and a great habit to incorporate into your life. Walk with a loved one or just by yourself while listening to an audio book. Set goals every day and meet them and you’ll start feeling like you’re back in control of your life. 

Even little changes make a big difference 

If you’re still struggling with getting started or feeling overwhelmed by the idea of starting a more active life, take heart: every change, no matter how small, makes a difference in your ability to manage diabetes. Even losing 10-15 pounds can have a significant impact on your health. The power to change is firmly in your hands—so get moving today. 

Diabetes is a disease in which levels of glucose (sugar) in the bloodstream are too high. The body produces glucose from the foods you eat. The liver also releases sugars when you are not eating. The pancreas produces the hormone insulin, which allows glucose from the bloodstream to enter the body’s cells where it is used for energy. In type 2 diabetes, too little insulin is produced, or the body cannot use insulin properly, or both. This results in a build-up of glucose in the blood.  

People with diabetes are at risk for developing serious health problems (complications). If your blood glucose level stays too high for too long, complications can include: 

 

Blindness 

Kidney Disease and Fat 

Many people with type 2 diabetes can control their blood glucose levels with diet, exercise, oral medications (pills), insulin, and other injectable diabetes medicines, such as GLP-1 medications. Others may need insulin shots. 

Both type 1 and type 2 diabetics have high blood glucose levels, the reason for those high levels differs. 

Type 1 diabetics have high blood glucose levels because the body is attacking essential cells within the pancreas, the organ responsible for creating insulin. This attack results in the body's inability to create and/or use the insulin that is produced. 

Type 2 diabetics have a pancreas that is able to produce insulin, but their bodies are unable to use or process the insulin that is produced. Over time, the pancreas may stop creating insulin altogether, but type 2 diabetes starts with the inability to process the insulin that is made. 

Other differences between type 1 and type 2 diabetes include: 

  • Age of diagnosis. Type 1 is typically diagnosed in children, while type 2 is diagnosed in adults and occasionally children. 

  • Treatment options. 

  • Hypoglycemia. Blood sugar levels can drop to dangerously low levels in type 1 diabetics, while type 2 diabetics rarely have to deal with this issue unless they are on certain medications or taking insulin. 

  • Preventability. Type 1 diabetes cannot be prevented, type 2 diabetes can be prevented or symptoms delayed with lifestyle changes. 

 

Risk Factors for type 2 Diabetes mellitus: Being older (over 45) and overweight are the greatest risk factors for developing diabetes. Other factors that increase the chances of developing high blood glucose include: 

  • Having a parent or sibling with diabetes 

  • Having an African American, Latino/Hispanic, or American Indian family background 

  • Having had gestational diabetes (diabetes during pregnancy) or giving birth to a baby weighing more than 9 pounds 

  • Having high blood pressure (140/90 mm Hg or higher) 

  • Having low levels of HDL (good) cholesterol (below 35 mg/dL in men or 45 mg/dL in women) or high levels of triglycerides (above 250 mg/dL) 

  • Having polycystic ovary syndrome (PCOS) 

  • Being physically inactive

A blood test is needed to confirm the diagnosis of diabetes. The A1C test is one of the blood test used to diagnose diabetes and to aid in its management. The test measures your average blood glucose over the past two to three months and shows how well your treatment plan is working overall. A level of 6.5% or more indicates diabetes.  

The A1C test does not take the place of daily blood glucose measurements. Blood glucose levels change throughout the day depending on what and when you eat, whether or not you exercise, and which medications you may be taking.  Fingerstick blood glucose levels show the level of glucose in your blood at that moment. 

If tests show you have high blood glucose, you should talk with your doctor about the best way to manage your condition. The choice of treatment depends on whether you have diabetes or Prediabetes and how well you respond to treatment. For many people, weight loss through diet and exercise is enough to bring blood glucose levels back to normal. If diet and exercise alone don’t work, several medications are available to manage the disease. Getting screened is an important first step. Knowing your blood glucose levels and working with your doctor to keep your levels as close to normal as possible will help you to enjoy a long and healthy life. 

Lifestyle is a very important part of your care. It's very important to eat a good balance of foods every day and to get regular exercise. Managing your diabetes also means taking medicine, if needed, and testing your blood glucose levels each day. 

You must take medicine as prescribed and on time every day. If you are on Insulin then try not skipping a dose of Insulin or other medicines. 

Test your blood for glucose as directed by your doctor. Some people only test once a day or even less frequent (2-4 times a week if you are on oral medications only) Those who take insulin may need to test four or more times a day. Talk to your doctor about how often you should test your blood glucose. 

 

Most diabetics should get Hemoglobin A1C test every three to six months. This blood test gives us a blood glucose levels over the past three months. The goal for most diabetics is to keep A1c less than 6.5% (per AACE guidelines) aAsk your doctor if you have questions about your A1C test results. You should have a normal result if most of your blood glucose levels are near 100 mg/dL. 

The good news about being diagnosed with diabetes is it can be a wake-up call to make lifestyle changes, and with proper management, you can live a long, active, happy, healthy lifestyle despite diabetes. It's important to know that what you do does make a difference, and diabetes and related complications are not inevitable. 

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