How to Manage Diabetes
Whether you’ve been living with diabetes your whole life, you’ve recently received a diagnosis, or you’re caring for a loved one with diabetes, this guide will provide you with a comprehensive overview of how to manage diabetes.
In this guide, you’ll find information about:
If you have diabetes, either your pancreas doesn’t produce insulin or your body doesn’t properly use insulin. Insulin is a hormone that allows your cells to absorb glucose from the blood and use it as energy. Glucose is the main source of fuel for your brain and body.
There are three main types of diabetes: type 1 diabetes, type 2 diabetes, and gestational diabetes. Here are the key differences:
- Type 1 diabetes: If you have type 1 diabetes, your pancreas is unable to make insulin. Approximately 5-10% of people living with diabetes have type 1.
- Type 2 diabetes: If you have type 2 diabetes, your pancreas can produce insulin, but your body doesn’t use insulin effectively. Approximately 90-95% of people living with diabetes have type 2.
- Gestational diabetes: Gestational diabetes is a form of diabetes that can develop during pregnancy in people without pre-existing diabetes. It usually develops around the 24th week of pregnancy. In people with gestational diabetes, the hormones produced during pregnancy have a blocking effect on insulin, making it less effective. This is known as insulin resistance.
Regardless of what type of diabetes you have, you will need to complete several self-care steps each day to keep your blood sugar levels within your optimal range to protect your health and prevent serious health complications such as stroke, heart disease, chronic kidney disease, nerve damage, and vision loss.
To best understand how to manage diabetes, it’s important to learn about the various factors that can cause your blood glucose levels to rise and fall. The biggest factors to keep in mind are diet and physical activity.
Diet is considered the largest factor that influences your blood glucose levels. This is because when you eat, your body breaks down the food into sugars which then enter the bloodstream and elevate your blood glucose levels. Carb-heavy foods, large meals, and beverages containing carbohydrates in the form of simple sugars can cause your blood glucose levels to rise. On the other hand, if you forget to eat a meal or don’t eat enough carbs, your blood glucose levels can drop. If you don’t take steps to bring your levels back to your target range, you may experience hyperglycemia or hypoglycemia.
Physical activity can also have a big impact on your blood glucose levels—most of which are positive impacts. Regular exercise improves blood glucose control, increases insulin sensitivity, helps you maintain a healthy weight, and improves mental wellness.
Other factors, including illness, hormones, hydration, smoking, alcohol, and certain medications, can also impact your blood glucose levels. Checking your blood glucose levels often can enable you to correlate your glucose levels with these types of lifestyle variables.
The goal of diabetes management is to keep your blood glucose levels as close to your target range as possible. While your target range should be determined with the guidance of your healthcare team, the American Diabetes Association recommends the following targets for non-pregnant adults living with diabetes:
- Before a meal (preprandial plasma glucose): between 80-120 mg/dL
- One to two hours after the beginning of a meal (postprandial plasma glucose): less than 180 mg/dL
Because no two people living with diabetes are the same, effective diabetes management may look different for everyone. While there’s no one-size-fits-all approach, there are general guidelines that can help you better understand how to manage your diabetes on a daily basis.
Work with your healthcare team to develop a detailed diabetes management plan. This plan may involve eating a diabetes-friendly diet, exercising regularly, taking insulin or other blood glucose-lowering medications, and monitoring your blood glucose levels.
What you eat (and drink) is one of the biggest factors that can affect your blood glucose levels and ability to manage your diabetes. Eating thoughtfully chosen, well-balanced meals and snacks can help you keep your blood glucose levels, cholesterol, blood pressure, and weight in your target ranges, reducing the risk of diabetes-related health complications. While you should always work with your healthcare team for specific guidance on creating a diabetes-friendly diet, there are general considerations for how to craft healthy meals. One of the easiest ways to throw together a meal is by using the diabetes plate method.
To follow the method, fill half of your 9-inch diameter plate with non-starchy vegetables, a quarter with lean protein, and a quarter with carbs.
Here are some examples of non-starchy vegetables, lean proteins, and carbs as well as healthy beverage options you can use to put together a meal.
|Food and Beverages||Examples|
|Low- and Zero-Calorie Beverages||
Exercise is considered to be a fundamental pillar of diabetes management. It can improve blood glucose control, lower LDL cholesterol (“bad” cholesterol”), lower blood pressure, reduce stress and anxiety, and strengthen your muscles and bones.
The American Diabetes Association recommends 150 minutes of moderate-intensity exercise per week. That’s only about 20 minutes each day—and it doesn’t necessarily mean strenuous cardio workouts. Any movement or activity that gets your heart rate up can be valuable to your diabetes management. Scheduling this time into each day and choosing exercises that bring you joy is a great way to help prioritize movement.
Based on your diabetes type and exercise duration and intensity, your healthcare team can provide you with guidance on the appropriate glucose testing and medication schedules.
Many people living with diabetes need to take insulin or other blood glucose-lowering medications. If you have type 1 diabetes, you will need to take insulin as part of your treatment plan, as your pancreas is unable to produce insulin. If you have type 2 diabetes, you may or may not need to take insulin. In general, approximately 30% of people living with type 2 diabetes require insulin or other blood glucose-lowering medications. Insulin or other medications are used in type 2 diabetes when diet and exercise aren’t enough to keep your blood glucose levels in your target range. Blood glucose-lowering medications may include:
- Alpha-glucosidase inhibitors
- Bile Acid Sequestrants
- Dopamine-2 Agonists
- DPP-4 inhibitors
- SGLT2 Inhibitors
The above classes of medications lower blood glucose levels in different ways and may therefore be used in combination. Consequently, your healthcare team may recommend oral combination therapy, such as biguanide and sulfonylurea.
If your treatment plan involves insulin, your healthcare team will likely give you the option of multiple daily injections (MDI) therapy or insulin pump therapy. MDI therapy can be accomplished via a needle and syringe or an insulin pen. Both MDI and insulin pump therapy work by mimicking the natural secretion of insulin by the body experienced by people without diabetes.
Monitor Your Blood Glucose Levels
For people living with diabetes, regularly checking and tracking blood glucose levels provides you and your healthcare team with important insights. This includes:
- Whether or not your blood glucose levels are currently in your target range
- How medication, diet, and exercise affect your blood glucose levels
- How well your treatment plan is working and whether or not any adjustments are needed.
To check your glucose levels, your healthcare team will likely give you several options to choose from. This may include a blood glucose monitor (BGM), an automatic blood glucose monitor (ABGM), or a continuous glucose monitor (CGM). Here are the key differences:
A BGM is a handheld device that allows you to check your blood glucose levels whenever you want or need to. It requires you to manually load the test strip into the device, load the lancet into the lancing device, lance, and accurately place the blood on the test strip.
An ABGM, like the POGO Automatic® Monitor, is different from a BGM in that it has lancets and test strips integrated into cartridges that are loaded into the device. To check blood glucose levels with an ABGM, simply turn the monitor on and place your finger on the test port. The monitoring system will automatically lance, collect blood, and move the blood to the test area.
A CGM is a wearable device that continuously takes glucose readings from interstitial fluid, the fluid in the spaces around cells, rather than blood. Finger prick blood tests are required only during the calibration and ramp-up period or when your CGM reading doesn’t align with how you’re feeling (e.g. during times of rapid glucose changes after injecting insulin). CGMs measure glucose anytime the sensor is worn and provide results every few minutes on your monitor. After the sensor is inserted, no action is required from you until you need to insert a new sensor.
At the end of the day, how you choose to monitor your glucose levels is up to you and your healthcare team. What’s important is you find a monitoring solution that helps you check as often as your healthcare team recommends and that works for your unique needs, lifestyle, and preferences.
Stress can affect everyone—your job, marriage, friendships, financial pressures, and parenting can all cause stress. People with diabetes may also experience additional stressors, such as diabetes distress and burnout. Finding ways to manage stress is important not only for your mental health but also for your physical health. Research has demonstrated that emotional distress in people with diabetes is associated with poor glycemic control, poor self-care, and adverse diabetes outcomes. Additionally, stress can cause some people with diabetes to skip or forget meals, eat too much or too little, forget to take medication, or avoid exercise—all of which can make it more difficult to manage your diabetes.
The good news is there are plenty of ways to relieve stress. You may consider:
- Talking to someone you trust about your stress
- Making time to meditate, work on deep breathing exercises, or practice yoga
- Talking to other people who are living with diabetes
- Working with your healthcare team to find ways to simplify your day-to-day diabetes management
- Taking a step back and doing one thing at a time
- Making time each day to do something you enjoy
Identifying the source of your stress can be very helpful. If you can’t seem to identify the cause of your stress, consider keeping a stress journal. Take notes on when you are feeling stressed and try to determine a pattern. From here, find ways to reduce your triggers.
People living with type 1 and type 2 diabetes are at an elevated risk of serious health conditions including heart, kidney, and eye disease. Because of this, it’s important to regularly get tests done by your healthcare team. The American Diabetes Association recommends the following health screenings for people living with diabetes. The target zones listed below are based on their Standards of Medical Care in Diabetes. Be sure to ask your healthcare team about your specific target zones.
|Health Check||Description||Target Number||Frequency|
|Average Blood Glucose (A1C)||A blood test that measures your average blood glucose levels over the past three months||<7% (or eAG below 154 mg/dL)||
|Albumin-to-Creatinine Ratio (ACR)||A urine test that measures how much albumin is in your urine to identify kidney damage or disease||<30mg/g||Once a year (if you have type 2 diabetes or have had type 1 diabetes for at least five years)|
|Blood Pressure||A measurement of the force that your heart uses to pump blood through your body||<140/90 mmHg||At every visit with your healthcare team|
|Cholesterol and Triglycerides||Several blood tests that measure your LDL (“bad”), HDL (“good”), and total cholesterol and triglycerides||Consult with your healthcare team||Consult with your healthcare team|
|Body Mass Index (BMI)||A measurement of body fat based on height and weight||18.5-24.9||At every visit with your healthcare team|
|Dilated Eye Exam||An exam to check for signs of diabetes-related eye disease (e.g., diabetic retinopathy)||n/a||Type 1 diabetes: within five years of diagnosis, and every one to two years after Type 2 diabetes: at diagnosis, and every one to two years after|
|Bone Mineral Density||A test that measures how much calcium and other types of minerals are in an area of your bone (usually the hip and spine)||T-score of -1.0 or greater||
The Power of Diabetes Education
Learning about how to manage diabetes is essential to your ability to effectively manage your diabetes and support your mental and physical health—both now and in the future. Learning about how to eat a healthy diet, get enough exercise, monitor glucose levels, manage stress, and care for your health is the foundation of your diabetes management. From here, all that’s left is finding ways to implement these healthy habits into your day-to-day life. Your journey to confidently managing your diabetes begins here. You’ve got this.
All content on this website is for educational purposes only and does not replace the guidance of your healthcare practitioner. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.