Treatments for Diabetes

Diabetes treatment depends on the type and severity of the diabetes. It also involves the treatment of any complications or other associated conditions related to the diabetes. Consult with your doctor or medical specialists about the many issues of treatment.

Treatment Regimes: The overall plan for treatment depends on various factors, but the main options can be summed up as:

Combinations of these various aspects are common. And diabetes treatment can change over time as the disease progresses to more severe forms. The progression of diabetes can sometimes be greatly slowed or even stopped if a person is successful at addressing lifestyle issues (e.g. weight control, exercise).

Insulin Required? Patients are often most concerned whether insulin injections will be required. It depends on the type of diabetes.

Reversing Diabetes? There are many promises of diabetes reversals and diabetes cures. Weight loss and exercise can have an important impact. However, many promises you will see about various substances, herbs, and alternative treatments are simply false. It is important to discuss all options with your doctor.



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Back to: « Diabetes

Treatments for Diabetes

What are the treatments for diabetes?

There are two main types of treatment for diabetes:

  • Lifestyle changes—These include changing your diet to something healthier and improving your exercise/activity level. More information on lifestyle changes to control diabetes can be found at the National Diabetes Education Program.
  • Medication—Oral medicines and sometimes injections with insulin may be used. For more information on medications to control diabetes, visit the National Diabetes Information Clearinghouse.

Source: NICHD (NIH)1

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Your Blood Sugar Knows Best

Kids out of school, vacations, get-togethers, family reunions. The summer season can throw off your routine, and possibly your diabetes management plan. Check your blood sugar more often to make sure it's in your target range no matter what the summer brings. It's especially important to recognize what low blood sugar feels like and treat it as soon as possible.

Man sitting at table and checking smartphone

Play it safe in the sun with a hat and sunglasses.

Warm-weather wisdom:

  • Drink plenty of water—even if you're not thirsty—so you don't get dehydrated.
  • Avoid alcohol and drinks with caffeine, like coffee and energy or sports drinks. They can lead to water loss and spike your blood sugar levels.
  • Check your blood sugar before, during, and after you're active. You may need to change how much insulin you use. Ask your doctor if you would like help in adjusting your dosage.
  • Wear loose-fitting, lightweight, light-colored clothing.
  • Wear sunscreen and a hat when you're outside. Sunburn can raise your blood sugar levels.
  • Don't go barefoot, even on the beach or at the pool.
  • Use your air conditioner or go to an air-conditioned building or mall to stay cool. In very high heat, a room fan won't cool you enough.

Source: CDC Features2

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What is the treatment for diabetes?

Healthy eating, physical activity, and insulin injections are the basic therapies for type 1 diabetes. The amount of insulin taken must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose testing.

Healthy eating, physical activity, and blood glucose testing are the basic therapies for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication, insulin, or both to control their blood glucose levels.

People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high.

People with diabetes should see a health care provider who will monitor their diabetes control and help them learn to manage their diabetes. In addition, people with diabetes may see endocrinologists, who may specialize in diabetes care; ophthalmologists for eye examinations; podiatrists for routine foot care; and dietitians and diabetes educators who teach the skills needed for daily diabetes management.

The Diabetes Overview fact sheet from the National Diabetes Information Clearinghouse has additional information.

Source: CDC3

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Can I eat sweets and other foods and drinks with added sugars?

Yes, you can eat sweets and other foods and drinks with added sugars. However, you should limit your intake of these high-carbohydrate foods and drinks because they are often high in calories and low in vitamins, minerals, and fiber. Fiber-rich whole grains, fruits, vegetables, and beans are wiser choices.

Instead of eating sweets every day, try eating them in small amounts once in a while so you don’t fill up on foods that are low in nutrition. Ask your dietitian or diabetes educator about including sweets in your eating plan.

Source: NIDDK (NIH)4

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Diabetes Diet, Eating, & Physical Activity

Nutrition and physical activity are important parts of a healthy lifestyle when you have diabetes. Along with other benefits, following a healthy meal plan and being active can help you keep your blood glucose level, also called blood sugar, in your target range. To manage your blood glucose, you need to balance what you eat and drink with physical activity and diabetes medicine, if you take any. What you choose to eat, how much you eat, and when you eat are all important in keeping your blood glucose level in the range that your health care team recommends.

Becoming more active and making changes in what you eat and drink can seem challenging at first. You may find it easier to start with small changes and get help from your family, friends, and health care team.

Eating well and being physically active most days of the week can help you

  • keep your blood glucose level, blood pressure, and cholesterol in your target ranges
  • lose weight or stay at a healthy weight
  • prevent or delay diabetes problems
  • feel good and have more energy

Source: NIDDK (NIH)5

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What foods can I eat if I have diabetes?

You may worry that having diabetes means going without foods you enjoy. The good news is that you can still eat your favorite foods, but you might need to eat smaller portions or enjoy them less often. Your health care team will help create a diabetes meal plan for you that meets your needs and likes.

The key to eating with diabetes is to eat a variety of healthy foods from all food groups, in the amounts your meal plan outlines.

The food groups are

  • vegetables
  • nonstarchy: includes broccoli, carrots, greens, peppers, and tomatoes
  • starchy: includes potatoes, corn, and green peas
  • fruits—includes oranges, melon, berries, apples, bananas, and grapes
  • grains—at least half of your grains for the day should be whole grains ?includes wheat, rice, oats, cornmeal, barley, and quinoa
  • examples: bread, pasta, cereal, and tortillas
  • protein
  • lean meat
  • chicken or turkey without the skin
  • fish
  • eggs
  • nuts and peanuts
  • dried beans and certain peas, such as chickpeas and split peas
  • meat substitutes, such as tofu
  • dairy—nonfat or low fat ?milk or lactose-free milk if you have lactose intolerance
  • yogurt
  • cheese

Learn more about the food groups at the U.S. Department of Agriculture’s (USDA) ChooseMyPlate.gov .

Eat foods with heart-healthy fats, which mainly come from these foods:

  • oils that are liquid at room temperature, such as canola and olive oil
  • nuts and seeds
  • heart-healthy fish such as salmon, tuna, and mackerel
  • avocado

Use oils when cooking food instead of butter, cream, shortening, lard, or stick margarine.

Source: NIDDK (NIH)6

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What foods and drinks should I limit if I have diabetes?

Foods and drinks to limit include

  • fried foods and other foods high in saturated fat and trans fat
  • foods high in salt, also called sodium
  • sweets, such as baked goods, candy, and ice cream
  • beverages with added sugars, such as juice, regular soda, and regular sports or energy drinks

Drink water instead of sweetened beverages. Consider using a sugar substitute in your coffee or tea.

If you drink alcohol, drink moderately—no more than one drink a day if you’re a woman or two drinks a day if you’re a man. If you use insulin or diabetes medicines that increase the amount of insulin your body makes, alcohol can make your blood glucose level drop too low. This is especially true if you haven’t eaten in a while. It’s best to eat some food when you drink alcohol.

Source: NIDDK (NIH)7

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Will supplements and vitamins help my diabetes?

No clear proof exists that taking dietary supplements such as vitamins, minerals, herbs, or spices can help manage diabetes.1 You may need supplements if you cannot get enough vitamins and minerals from foods. Talk with your health care provider before you take any dietary supplement since some can cause side effects or affect how your medicines work.2

Source: NIDDK (NIH)8

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Insulin, Medicines, & Other Diabetes Treatments

Taking insulin or other diabetes medicines is often part of treating diabetes. Along with healthy food choices and physical activity, medicine can help you manage the disease. Some other treatment options are also available.

Source: NIDDK (NIH)9

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What medicines might I take for diabetes?

The medicine you take will vary by your type of diabetes and how well the medicine controls your blood glucose levels, also called blood sugar. Other factors, such as your other health conditions, medication costs, and your daily schedule may play a role in what diabetes medicine you take.

Type 1 diabetes

If you have type 1 diabetes, you must take insulin because your body no longer makes this hormone. You will need to take insulin several times during the day, including with meals. You also could use an insulin pump, which gives you small, steady doses throughout the day.

Type 2 diabetes

Some people with type 2 diabetes can manage their disease by making healthy food choices and being more physically active. Many people with type 2 diabetes need diabetes medicines as well. These medicines may include diabetes pills or medicines you inject under your skin, such as insulin. In time, you may need more than one diabetes medicine to control your blood glucose. Even if you do not take insulin, you may need it at special times, such as during pregnancy or if you are in the hospital.

Gestational diabetes

If you have gestational diabetes, you should first try to control your blood glucose level by making healthy food choices and getting regular physical activity. If you can’t reach your blood glucose target, your health care team will talk with you about diabetes medicines, such as insulin or the diabetes pill metformin, that may be safe for you to take during pregnancy. Your health care team may start you on diabetes medicines right away if your blood glucose is very high.

No matter what type of diabetes you have, taking diabetes medicines every day can feel like a burden sometimes. You may also need medicines for other health problems, such as high blood pressure or high cholesterol, as part of your diabetes care plan. View resources that may help you manage your medication plan.

Source: NIDDK (NIH)10

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What should I know about side effects of diabetes medicines?

Side effects are problems that result from a medicine. Some diabetes medicines can cause hypoglycemia, also called low blood glucose, if you don’t balance your medicines with food and activity.

Ask your doctor whether your diabetes medicine can cause hypoglycemia or other side effects, such as upset stomach and weight gain. Take your diabetes medicines as your health care professional has instructed you, to help prevent side effects and diabetes problems.

Source: NIDDK (NIH)11

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Do I have other treatment options for my diabetes?

When medicines and lifestyle changes are not enough to manage your diabetes, a less common treatment may be an option. Other treatments include bariatric surgery for certain people with type 1 or type 2 diabetes, and an "artificial pancreas" and pancreatic islet transplantation for some people with type 1 diabetes.

Bariatric surgery

Also called weight-loss surgery or metabolic surgery, bariatric surgery may help some people with obesity and type 2 diabetes lose a large amount of weight and regain normal blood glucose levels. Some people with diabetes may no longer need their diabetes medicine after bariatric surgery. Whether and for how long blood glucose levels improve seems to vary by the patient, type of weight-loss surgery, and amount of weight the person loses. Other factors include how long someone has had diabetes and whether or not the person uses insulin.1

Recent research suggests that weight-loss surgery also may help improve blood glucose control in people with type 1 diabetes who are obese.2

Researchers are studying the long-term results of bariatric surgery in people with type 1 and type 2 diabetes.

Artificial Pancreas

The NIDDK has played an important role in developing “artificial pancreas” technology. An artificial pancreas replaces manual blood glucose testing and the use of insulin shots or a pump. A single system monitors blood glucose levels around the clock and provides insulin or a combination of insulin and a second hormone, glucagon, automatically. The system can also be monitored remotely, for example by parents or medical staff.

In 2016, the FDA approved a type of artificial pancreas system called a hybrid closed-loop system. This system tests your glucose level every 5 minutes throughout the day and night, and automatically gives you the right amount of insulin.

You still need to manually adjust the amount of insulin the pump delivers at mealtimes. But, the artificial pancreas may free you from some of the daily tasks needed to keep your blood glucose stable—or help you sleep through the night without the need to wake and test your glucose or take medicine.

The hybrid closed-loop system is expected to be available in the U.S. in 2017. Talk with your health care provider about whether this system might be right for you.

The NIDDK has funded several important studies on different types of artificial pancreas devices to better help people with type 1 diabetes manage their disease. The devices may also help people with type 2 diabetes and gestational diabetes.

Pancreatic islet transplantation

Pancreatic islet transplantation is an experimental treatment for poorly controlled type 1 diabetes. Pancreatic islets are clusters of cells in the pancreas that make the hormone insulin. In type 1 diabetes, the body’s immune system attacks these cells. A pancreatic islet transplant replaces destroyed islets with new ones that make and release insulin. This procedure takes islets from the pancreas of an organ donor and transfers them to a person with type 1 diabetes. Because researchers are still studying pancreatic islet transplantation, the procedure is only available to people enrolled in research studies. Learn more about islet transplantation studies .

Source: NIDDK (NIH)12

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How is diabetes treated?

Diabetes treatment includes managing your blood sugar levels to control your symptoms. You can help control your blood sugar levels by eating healthy and getting regular physical activity.

With type 1 diabetes, you also will need to take insulin through shots or an insulin pump. Insulin cannot be taken as a pill.

Type 2 diabetes treatment also may include taking medicine to control your blood sugar. Over time, people with type 2 diabetes make less and less of their own insulin. This may mean that you will need to increase your medicines or start taking insulin shots to keep your diabetes in control.

Learn more about controlling diabetes at the National Diabetes Education Program website.

Source: OWH (DHHS)13

Treatments for Diabetes

Low-protein diet: People with certain diseases like diabetes or kidney disease may want to cut back on protein because it can increase the amount of work for the kidney. If you need to follow a reduced-protein diet, make sure to work with a dietitian to ensure adequate nutrition.

Source: NIH News in Health (NIH)14

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Carbo Counting: Carbohydrate counting, also called carb counting, is a meal planning tool for people with type 1 or type 2 diabetes. Carbohydrate counting involves keeping track of the amount of carbohydrate in the foods you eat each day.

Carbohydrates are one of the main nutrients found in food and drinks. Protein and fat are the other main nutrients. Carbohydrates include sugars, starches, and fiber. Carbohydrate counting can help you control your blood glucose, also called blood sugar, levels because carbohydrates affect your blood glucose more than other nutrients.

Source: NIDDK (NIH)15

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Dietician: Dietitians are allied health professionals who use their knowledge of human nutrition to help people manage their health. They provide support and services to both inpatients and outpatients, and can be helpful to people who:

On your first visit, the dietitian will:

  • discuss the reason for your visit and work with you to plan goals and strategies for improving your health
  • take some measurements (including height, weight and waist circumference)
  • ask questions about your medical, social and diet history
  • refer you to additional health services if necessary
  • plan any follow-up appointments.

At follow-up appointments, they may take your measurements again and ask questions to see how much progress you have made, and recommend some new strategies to help you reach your goals.

Source: Queensland Government16

Cure for Diabetes

There’s no cure for diabetes, but there are things you can do to stay well. Support from your friends, wh?nau and health care providers can help.

https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/diabetes

Lifestyle Changes for Diabetes

Lifestyle change has been proven effective in preventing or delaying the onset of type 2 diabetes in high-risk individuals. Based on this, new public health approaches are emerging that may deserve monitoring at the national level. For example, the Diabetes Prevention Program demonstrated that lifestyle intervention had its greatest impact in older adults and was effective in all racial and ethnic groups.

Source: Healthy People (DHHS)17

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Five Lifestyle Factors Lower Diabetes Risk

A new study found that a combination of 5 healthy lifestyle factors may help reduce the chance of developing type 2 diabetes, even if family history puts you at risk for the disease.

People with diabetes have too high levels of glucose, a type of sugar, in their blood. Over time, high levels of glucose can lead to heart disease, stroke, blindness and other problems.

Several lifestyle factors can reduce your risk for type 2 diabetes, the most common form of the disease. A research team led by Dr. Jared Reis of NIH studied 5 factors: having a healthy diet, keeping an ideal body weight, being physically active, not smoking and minimizing alcohol use.

The team used data collected in the mid-1990s from more than 200,000 older adults. They then looked to see who had developed diabetes over the next decade.

The analysis showed that the more healthy lifestyle factors adopted, the lower the risk for diabetes. Men with all 5 healthy lifestyle factors had a 72% lower risk for developing diabetes. Women had an 84% lower risk.

A family history of diabetes is strongly linked to type 2 diabetes. But these results show that you may still be able to prevent or delay the disease by leading a healthy lifestyle.

“Not being overweight or obese led to the greatest protection,” Reis says. “However, we found that overweight or obese adults with a greater number of the other healthy lifestyle factors had a lower risk of developing diabetes. This is good news because it suggests that overweight or obese adults can benefit by adopting other healthy lifestyle behaviors.”

Source: NIH News in Health (NIH)18

Lifestyle Changes for Diabetes

Exercise: Fitting exercise and physical activity into your day can enhance your life in so many ways. Regular physical activity can improve your balance and boost or maintain your strength and fitness. It may also improve your mood and help you manage or lessen the impact of conditions like diabetes, heart disease, osteoporosis and depression.

Source: NIH News in Health (NIH)19

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Food Recipes: Tasty Recipes for People with Diabetes

A newly revised booklet—called Tasty Recipes for People with Diabetes and Their Families—is now available in both Spanish and English.

Tasty Recipes includes healthy food ideas with a Latin American flair. Learn how to make Spanish omelet, Caribbean red snapper, avocado tacos and other healthy dishes.

Each recipe comes with a Nutrition Facts table that lists calories, fat content and other dietary information. The book also includes tips for eating well and managing your diabetes. It’s a terrific addition to any kitchen.

To order a free copy of Tasty Recipes, call NIH’s National Diabetes Education Program toll-free at 1-888-693-6337, or visit http://ndep.nih.gov/publications/PublicationDetail.aspx?PubId=131. A limited number of additional booklets can be purchased for $1 each. You can also download a PDF version to print yourself at no cost.

Source: NIH News in Health (NIH)20

Management of Diabetes

How is the A1C test used after diagnosis of diabetes?

Health care providers can use the A1C test to monitor blood glucose levels in people with type 1 or type 2 diabetes. The A1C test is not used to monitor gestational diabetes.

The American Diabetes Association recommends that people with diabetes who are meeting treatment goals and have stable blood glucose levels have the A1C test twice a year. Health care providers may repeat the A1C test as often as four times a year until blood glucose levels reach recommended levels.

The A1C test helps health care providers adjust medication to reduce the risk of long-term diabetes complications. Studies have demonstrated substantial reductions in long-term complications with the lowering of A1C levels.

When the A1C test is used for monitoring blood glucose levels in a person with diabetes, the blood sample can be analyzed in a health care provider’s office using a POC test to give immediate results. However, POC tests are less reliable and not as accurate as most laboratory tests.

Source: NIDDK (NIH)21

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What A1C target should people have?

People will have different A1C targets depending on their diabetes history and their general health. People should discuss their A1C target with their health care provider. Studies have shown that people with diabetes can reduce the risk of diabetes complications by keeping A1C levels below 7 percent.

Maintaining good blood glucose control will benefit those with new-onset diabetes for many years to come. However, an A1C level that is safe for one person may not be safe for another. For example, keeping an A1C level below 7 percent may not be safe if it leads to problems with hypoglycemia, also called low blood glucose.

Less strict blood glucose control, or an A1C between 7 and 8 percent—or even higher in some circumstances—may be appropriate in people who have

Source: NIDDK (NIH)22

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How can carbohydrate counting help me?

Carbohydrate counting can help keep your blood glucose levels close to normal. Keeping your blood glucose levels as close to normal as possible may help you

You may also need to take diabetes medicines or have insulin shots to control your blood glucose levels. Discuss your blood glucose targets with your doctor. Targets are numbers you aim for. To meet your targets, you will need to balance your carbohydrate intake with physical activity and diabetes medicines or insulin shots.

Source: NIDDK (NIH)23

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When should I eat if I have diabetes?

Some people with diabetes need to eat at about the same time each day. Others can be more flexible with the timing of their meals. Depending on your diabetes medicines or type of insulin, you may need to eat the same amount of carbohydrates at the same time each day. If you take “mealtime” insulin, your eating schedule can be more flexible.

If you use certain diabetes medicines or insulin and you skip or delay a meal, your blood glucose level can drop too low. Ask your health care team when you should eat and whether you should eat before and after physical activity.

Source: NIDDK (NIH)24

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How much can I eat if I have diabetes?

Eating the right amount of food will also help you manage your blood glucose level and your weight. Your health care team can help you figure out how much food and how many calories you should eat each day. Look up how many calories are in what you eat and drink at the USDA’s Food-A-Pedia .

Weight-loss planning

If you are overweight or obese, work with your health care team to create a weight-loss plan.

These tools may help:

  • The Body Weight Planner can help you tailor your plans to reach and maintain your goal weight.
  • The SuperTracker lets you track your food, physical activity, and weight.

To lose weight, you need to eat fewer calories and replace less healthy foods with foods lower in calories, fat, and sugar.

If you have diabetes, are overweight or obese, and are planning to have a baby, you should try to lose any excess weight before you become pregnant. Learn more about planning for pregnancy if you have diabetes.

Meal plan methods

Two common ways to help you plan how much to eat if you have diabetes are the plate method and carbohydrate counting, also called carb counting. Check with your health care team about the method that’s best for you.

Plate method

The plate method helps you control your portion sizes. You don’t need to count calories. The plate method shows the amount of each food group you should eat. This method works best for lunch and dinner.

Use a 9-inch plate. Put nonstarchy vegetables on half of the plate; a meat or other protein on one-fourth of the plate; and a grain or other starch on the last one-fourth. Starches include starchy vegetables such as corn and peas. You also may eat a small bowl of fruit or a piece of fruit, and drink a small glass of milk as included in your meal plan.

You can find many different combinations of food and more details about using the plate method from the American Diabetes Association’s Create Your Plate .

Your daily eating plan also may include small snacks between meals.

Portion sizes

  • You can use everyday objects or your hand to judge the size of a portion.
  • 1 serving of meat or poultry is the palm of your hand or a deck of cards
  • 1 3-ounce serving of fish is a checkbook
  • 1 serving of cheese is six dice
  • 1/2 cup of cooked rice or pasta is a rounded handful or a tennis ball
  • 1 serving of a pancake or waffle is a DVD
  • 2 tablespoons of peanut butter is a ping-pong ball

Carbohydrate counting

Carbohydrate counting involves keeping track of the amount of carbohydrates you eat and drink each day. Because carbohydrates turn into glucose in your body, they affect your blood glucose level more than other foods do. Carb counting can help you manage your blood glucose level. If you take insulin, counting carbohydrates can help you know how much insulin to take.

The right amount of carbohydrates varies by how you manage your diabetes, including how physically active you are and what medicines you take, if any. Your health care team can help you create a personal eating plan based on carbohydrate counting.

The amount of carbohydrates in foods is measured in grams. To count carbohydrate grams in what you eat, you’ll need to

  • learn which foods have carbohydrates
  • read the Nutrition Facts food label, or learn to estimate the number of grams of carbohydrate in the foods you eat
  • add the grams of carbohydrate from each food you eat to get your total for each meal and for the day

Most carbohydrates come from starches, fruits, milk, and sweets. Try to limit carbohydrates with added sugars or those with refined grains, such as white bread and white rice. Instead, eat carbohydrates from fruit, vegetables, whole grains, beans, and low-fat or nonfat milk.

In addition to using the plate method and carb counting, you may want to visit a registered dietitian (RD) for medical nutrition therapy.

Source: NIDDK (NIH)25

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What is medical nutrition therapy?

Medical nutrition therapy is a service provided by an RD to create personal eating plans based on your needs and likes. For people with diabetes, medical nutrition therapy has been shown to improve diabetes management. Medicare pays for medical nutrition therapy for people with diabetes. If you have insurance other than Medicare, ask if it covers medical nutrition therapy for diabetes.

Source: NIDDK (NIH)26

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Why should I be physically active if I have diabetes?

Physical activity is an important part of managing your blood glucose level and staying healthy. Being active has many health benefits.

Physical activity

  • lowers blood glucose levels
  • lowers blood pressure
  • improves blood flow
  • burns extra calories so you can keep your weight down if needed
  • improves your mood
  • can prevent falls and improve memory in older adults
  • may help you sleep better

If you are overweight, combining physical activity with a reduced-calorie eating plan can lead to even more benefits. In the Look AHEAD: Action for Health in Diabetes study,1 overweight adults with type 2 diabetes who ate less and moved more had greater long-term health benefits compared to those who didn’t make these changes. These benefits included improved cholesterol levels, less sleep apnea, and being able to move around more easily.

Even small amounts of physical activity can help. Experts suggest that you aim for at least 30 minutes of moderate or vigorous physical activity 5 days of the week.3 Moderate activity feels somewhat hard, and vigorous activity is intense and feels hard. If you want to lose weight or maintain weight loss, you may need to do 60 minutes or more of physical activity 5 days of the week.3

Be patient. It may take a few weeks of physical activity before you see changes in your health.

Source: NIDDK (NIH)27

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How can I be physically active safely if I have diabetes?

Be sure to drink water before, during, and after exercise to stay well hydrated. The following are some other tips for safe physical activity when you have diabetes.

Plan ahead

Talk with your health care team before you start a new physical activity routine, especially if you have other health problems. Your health care team will tell you a target range for your blood glucose level and suggest how you can be active safely.

Your health care team also can help you decide the best time of day for you to do physical activity based on your daily schedule, meal plan, and diabetes medicines. If you take insulin, you need to balance the activity that you do with your insulin doses and meals so you don’t get low blood glucose.

Prevent low blood glucose

Because physical activity lowers your blood glucose, you should protect yourself against low blood glucose levels, also called hypoglycemia. You are most likely to have hypoglycemia if you take insulin or certain other diabetes medicines, such as a sulfonylurea. Hypoglycemia also can occur after a long intense workout or if you have skipped a meal before being active. Hypoglycemia can happen during or up to 24 hours after physical activity.

Planning is key to preventing hypoglycemia. For instance, if you take insulin, your health care provider might suggest you take less insulin or eat a small snack with carbohydrates before, during, or after physical activity, especially intense activity.4

You may need to check your blood glucose level before, during, and right after you are physically active.

Stay safe when blood glucose is high

If you have type 1 diabetes, avoid vigorous physical activity when you have ketones in your blood or urine. Ketones are chemicals your body might make when your blood glucose level is too high, a condition called hyperglycemia, and your insulin level is too low. If you are physically active when you have ketones in your blood or urine, your blood glucose level may go even higher. Ask your health care team what level of ketones are dangerous for you and how to test for them. Ketones are uncommon in people with type 2 diabetes.

Take care of your feet

People with diabetes may have problems with their feet because of poor blood flow and nerve damage that can result from high blood glucose levels. To help prevent foot problems, you should wear comfortable, supportive shoes and take care of your feet before, during, and after physical activity.

Source: NIDDK (NIH)28

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What physical activities should I do if I have diabetes?

Most kinds of physical activity can help you take care of your diabetes. Certain activities may be unsafe for some people, such as those with low vision or nerve damage to their feet. Ask your health care team what physical activities are safe for you. Many people choose walking with friends or family members for their activity.

Doing different types of physical activity each week will give you the most health benefits. Mixing it up also helps reduce boredom and lower your chance of getting hurt. Try these options for physical activity.

Add extra activity to your daily routine

If you have been inactive or you are trying a new activity, start slowly, with 5 to 10 minutes a day. Then add a little more time each week. Increase daily activity by spending less time in front of a TV or other screen. Try these simple ways to add physical activities in your life each day:

  • Walk around while you talk on the phone or during TV commercials.
  • Do chores, such as work in the garden, rake leaves, clean the house, or wash the car.
  • Park at the far end of the shopping center parking lot and walk to the store.
  • Take the stairs instead of the elevator.
  • Make your family outings active, such as a family bike ride or a walk in a park.

If you are sitting for a long time, such as working at a desk or watching TV, do some light activity for 3 minutes or more every half hour.5 Light activities include

  • leg lifts or extensions
  • overhead arm stretches
  • desk chair swivels
  • torso twists
  • side lunges
  • walking in place

Do aerobic exercise

Aerobic exercise is activity that makes your heart beat faster and makes you breathe harder. You should aim for doing aerobic exercise for 30 minutes a day most days of the week. You do not have to do all the activity at one time. You can split up these minutes into a few times throughout the day.

To get the most out of your activity, exercise at a moderate to vigorous level. Try

  • walking briskly or hiking
  • climbing stairs
  • swimming or a water-aerobics class
  • dancing
  • riding a bicycle or a stationary bicycle
  • taking an exercise class
  • playing basketball, tennis, or other sports

Talk with your health care team about how to warm up and cool down before and after you exercise.

Do strength training to build muscle

Strength training is a light or moderate physical activity that builds muscle and helps keep your bones healthy. Strength training is important for both men and women. When you have more muscle and less body fat, you’ll burn more calories. Burning more calories can help you lose and keep off extra weight.

You can do strength training with hand weights, elastic bands, or weight machines. Try to do strength training two to three times a week. Start with a light weight. Slowly increase the size of your weights as your muscles become stronger.

Do stretching exercises

Stretching exercises are light or moderate physical activity. When you stretch, you increase your flexibility, lower your stress, and help prevent sore muscles.

You can choose from many types of stretching exercises. Yoga is a type of stretching that focuses on your breathing and helps you relax. Even if you have problems moving or balancing, certain types of yoga can help. For instance, chair yoga has stretches you can do when sitting in a chair or holding onto a chair while standing. Your health care team can suggest whether yoga is right for you.

Source: NIDDK (NIH)29

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No matter what type of diabetes you have, taking diabetes medicines every day can feel like a burden sometimes. You may also need medicines for other health problems, such as high blood pressure or high cholesterol, as part of your diabetes care plan. View resources that may help you manage your medication plan.

Source: NIDDK (NIH)30

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How can I manage my diabetes?

With the help of your health care team, you can create a diabetes self-care plan to manage your diabetes. Your self-care plan may include these steps:

Ways to manage your diabetes

  • Manage your diabetes ABCs.
  • Follow your diabetes meal plan.
  • Make physical activity part of your routine.
  • Take your medicine.
  • Check your blood glucose levels.
  • Work with your health care team.
  • Cope with your diabetes in healthy ways.

Manage your diabetes ABCs

Knowing your diabetes ABCs will help you manage your blood glucose, blood pressure, and cholesterol. Stopping smoking if you smoke will also help you manage your diabetes. Working toward your ABC goals can help lower your chances of having a heart attack, stroke, or other diabetes problems.

A for the A1C test

The A1C test shows your average blood glucose level over the past 3 months. The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be.

B for Blood pressure

The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask what your goal should be.

C for Cholesterol

You have two kinds of cholesterol in your blood: LDL and HDL. LDL or “bad” cholesterol can build up and clog your blood vessels. Too much bad cholesterol can cause a heart attack or stroke. HDL or “good” cholesterol helps remove the “bad” cholesterol from your blood vessels.

Ask your health care team what your cholesterol numbers should be. If you are over 40 years of age, you may need to take a statin drug for heart health.

S for Stop smoking

Not smoking is especially important for people with diabetes because both smoking and diabetes narrow blood vessels. Blood vessel narrowing makes your heart work harder. E-cigarettes aren’t a safe option either.

If you quit smoking

If you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it alone. You can start by calling the national quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to SmokeFree.gov .

Keeping your A1C, blood pressure, and cholesterol levels close to your goals and stopping smoking may help prevent the long-term harmful effects of diabetes. These health problems include heart disease, stroke, kidney disease, nerve damage, and eye disease. You can keep track of your ABCs with a diabetes care record (568 KB). Take it with you on your health care visits. Talk about your goals and how you are doing, and whether you need to make any changes in your diabetes care plan.

Follow your diabetes meal plan

Make a diabetes meal plan with help from your health care team. Following a meal plan will help you manage your blood glucose, blood pressure, and cholesterol.

Choose fruits and vegetables, beans, whole grains, chicken or turkey without the skin, fish, lean meats, and nonfat or low-fat milk and cheese. Drink water instead of sugar-sweetened beverages. Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt. Learn more about eating, diet, and nutrition with diabetes.

Make physical activity part of your daily routine

Set a goal to be more physically active. Try to work up to 30 minutes or more of physical activity on most days of the week.

Brisk walking and swimming are good ways to move more. If you are not active now, ask your health care team about the types and amounts of physical activity that are right for you. Learn more about being physically active with diabetes.

Swimming or water walking is a good way to move more.

Following your meal plan and being more active can help you stay at or get to a healthy weight. If you are overweight or obese, work with your health care team to create a weight-loss plan that is right for you.

Take your medicine

Take your medicines for diabetes and any other health problems, even when you feel good or have reached your blood glucose, blood pressure, and cholesterol goals. These medicines help you manage your ABCs. Ask your doctor if you need to take aspirin to prevent a heart attack or stroke. Tell your health care professional if you cannot afford your medicines or if you have any side effects from your medicines. Learn more about insulin and other diabetes medicines.

Check your blood glucose levels

For many people with diabetes, checking their blood glucose level each day is an important way to manage their diabetes. Monitoring your blood glucose level is most important if you take insulin. The results of blood glucose monitoring can help you make decisions about food, physical activity, and medicines.

Checking and recording your blood glucose level is an important part of managing diabetes.

The most common way to check your blood glucose level at home is with a blood glucose meter. You get a drop of blood by pricking the side of your fingertip with a lancet. Then you apply the blood to a test strip. The meter will show you how much glucose is in your blood at the moment.

Ask your health care team how often you should check your blood glucose levels. Make sure to keep a record of your blood glucose self-checks. You can print copies of this glucose self-check chart(2 MB). Take these records with you when you visit your health care team.

Source: NIDDK (NIH)31

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What are the recommended targets for blood glucose levels?

Many people with diabetes aim to keep their blood glucose at these normal levels:

  • Before a meal: 80 to 130 mg/dL
  • About 2 hours after a meal starts: less than 180 mg/dL

Talk with your health care team about the best target range for you. Be sure to tell your health care professional if your glucose levels often go above or below your target range.

Source: NIDDK (NIH)32

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Work with your health care team

Most people with diabetes get health care from a primary care professional. Primary care professionals include internists, family physicians, and pediatricians. Sometimes physician assistants and nurses with extra training, called nurse practitioners, provide primary care. You also will need to see other care professionals from time to time. A team of health care professionals can help you improve your diabetes self-care. Remember, you are the most important member of your health care team.

Besides a primary care professional, your health care team may include

  • an endocrinologist for more specialized diabetes care
  • a registered dietitian, also called a nutritionist
  • a nurse
  • a certified diabetes educator
  • a pharmacist
  • a dentist
  • an eye doctor
  • a podiatrist, or foot doctor, for foot care
  • a social worker, who can help you find financial aid for treatment and community resources
  • a counselor or other mental health care professional

When you see members of your health care team, ask questions. Write a list of questions you have before your visit so you don’t forget what you want to ask. Watch a video to help you get ready for your diabetes care visit.

When you see your doctor, review your diabetes self-care plan and blood glucose chart.

You should see your health care team at least twice a year, and more often if you are having problems or are having trouble reaching your blood glucose, blood pressure, or cholesterol goals. At each visit, be sure you have a blood pressure check, foot check, and weight check; and review your self-care plan. Talk with your health care team about your medicines and whether you need to adjust them. Routine health care will help you find and treat any health problems early, or may be able to help prevent them.

Talk with your doctor about what vaccines you should get to keep from getting sick, such as a flu shot and pneumonia shot. Preventing illness is an important part of taking care of your diabetes. Your blood glucose levels are more likely to go up when you’re sick or have an infection. Learn more about taking care of your diabetes when you’re sick and during other special times, such as when you’re traveling.

Source: NIDDK (NIH)33

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If you have diabetes, you should have the A1C test at least twice a year. The A1C goal for many people with diabetes is below 7. It may be different for you. Ask what your goal should be. If your A1C result is too high, you may need to change your diabetes care plan.

Source: MedLinePlus (NIH)34

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Managing Diabetes

Once you’ve been told you have diabetes, your doctor will choose the best treatment based on the type of diabetes you have, your everyday routine, and any other health problems you have. Many people with type 2 diabetes can control their blood glucose levels with diet and exercise alone. Others need diabetes medicines or insulin injections. Over time, people with diabetes may need both lifestyle changes and medication.

You can keep control of your diabetes by:

  • Tracking your glucose levels. Very high glucose levels or very low glucose levels (called hypoglycemia) can be risky to your health. Talk to your doctor about how to check your glucose levels at home.
  • Making healthy food choices. Learn how different foods affect glucose levels. For weight loss, check out foods that are low in fat and sugar. Let your doctor know if you want help with meal planning.
  • Getting exercise. Daily exercise can help improve glucose levels in older people with diabetes. Ask your doctor to help you plan an exercise program.
  • Taking your diabetes medicines even when you feel good. Tell your doctor if you have any side effects or cannot afford your medicines.

Your doctor may want you to see other healthcare providers who can help manage some of the extra problems caused by diabetes. He or she can also give you a schedule for other tests that may be needed. Talk to your doctor about how to stay healthy.

Here are some ways to stay healthy with diabetes:

  • Find out your average blood glucose level. At least twice a year, get the A1C blood test. The result will show your average glucose level for the past 3 months.
  • Watch your blood pressure. Get your blood pressure checked often.
  • Check your cholesterol. At least once a year, get a blood test to check your cholesterol and triglyceride levels. High levels may increase your risk for heart problems.
  • Stop smoking. Smoking raises your risk for many health problems, including heart attack and stroke.
  • Have yearly eye exams. Finding and treating eye problems early may keep your eyes healthy.
  • Check your kidneys yearly. Diabetes can affect your kidneys. A urine and blood test will show if your kidneys are okay.
  • Get flu shots every year and the pneumonia vaccine. A yearly flu shot will help keep you healthy. If you’re over 65, make sure you have had the pneumonia vaccine. If you were younger than 65 when you had the pneumonia vaccine, you may need another one. Ask your doctor.
  • Care for your teeth and gums. Brush your teeth and floss daily. Have your teeth and gums checked twice a year by a dentist to avoid serious problems.
  • Protect your skin. Keep your skin clean and use skin softeners for dryness. Take care of minor cuts and bruises to prevent infections.
  • Look at your feet. Take time to look at your feet every day for any red patches. Ask someone else to check your feet if you can’t. If you have sores, blisters, breaks in the skin, infections, or build-up of calluses, see a foot doctor, called a podiatrist.

Source: NIA (NIH)35

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Be Prepared

Make sure you always have at least 3 days’ worth of supplies on hand for testing and treating your diabetes in case of an emergency.

Source: NIA (NIH)36

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I Have Diabetes.

If you are living with diabetes or have a loved one with the disease, it's important to work together to manage diabetes to stay healthy and prevent complications. Managing diabetes is not easy, but support from family members can make it much easier. The NDEP has resources for making healthy lifestyle choices that not only help people with diabetes manage the disease, but also help keep the whole family healthy!

Source: MedLinePlus Magazine (NIH)37

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Step 2: Know Your Diabetes ABCs

Talk to your health care team about how to manage your A1C (blood glucose or sugar), Blood Pressure, and Cholesterol. This will help lower your chances of having a heart attack, a stroke, or other diabetes problems. Here's what the ABCs of diabetes stand for:

A for the A1C test.

The A1C test shows you what your blood glucose has been over the last three months. The A1C goal for many people is below 7. High blood glucose levels can harm your heart and blood vessels, kidneys, feet, and eyes.

B for Blood Pressure.

Your blood pressure goal should be below 140/80 unless your doctor helps you set a different goal. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.

C for Cholesterol.

Ask what your cholesterol numbers should be. LDL or "bad" cholesterol can build up and clog your blood vessels. It can cause a heart attack or a stroke. HDL or "good" cholesterol helps remove cholesterol from your blood vessels.

Diabetes HealthSense

Find tools and programs that can help you with making lifestyle and behavior changes. Diabetes HealthSense also includes research articles on lifestyle changes and behavioral strategies. http://ndep.nih.gov/resources/diabetes-healthsense/

Source: MedLinePlus Magazine (NIH)38

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Step 3: Manage Your Diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves. Work with your health care team to reach your ABC goals (A1C, Blood Pressure, Cholesterol): Use this self-care plan.

  • Use your diabetes meal plan. If you do not have one, ask your health care team about one.
  • Make healthy food choices such as fruits and vegetables, fish, lean meats, chicken or turkey without the skin, dry peas or beans, whole grains, and low-fat or skim milk and cheese.
  • Keep fish and lean meat and poultry portion to about 3 ounces (or the size of a deck of cards). Bake, broil, or grill it.
  • Eat foods that have less fat and salt.
  • Eat foods with more fiber such as whole-grain cereals, breads, crackers, rice, or pasta.
  • Get 30 to 60 minutes of physical activity on most days of the week. Brisk walking is a great way to move more.
  • Stay at a healthy weight by using your meal plan and moving more.
  • Ask for help if you feel down. A mental health counselor, support group, member of the clergy, friend, or family member who will listen to your concerns may help you feel better.
  • Learn to cope with stress. Stress can raise your blood glucose (blood sugar). While it is hard to remove stress from your life, you can learn to handle it.
  • Stop smoking. Ask for help to quit.
  • Take medicines even when you feel good. Ask your doctor if you need aspirin to prevent a heart attack or stroke. Tell your doctor if you cannot afford your medicines or if you have any side effects.
  • Check your feet every day for cuts, blisters, red spots, and swelling. Call your health care team right away about any sores that do not go away.
  • Brush your teeth and floss every day to avoid problems with your mouth, teeth, or gums.
  • Check your blood glucose (blood sugar). You may want to test it one or more times a day.
  • Check your blood pressure if your doctor advises.
  • Report any changes in your eyesight to your doctor.
  • Talk with your health care team about your blood glucose targets. Ask how and when to test your blood glucose and how to use the results to manage your diabetes.

Discuss how your self-care plan is working for you each time you visit your health care team.

Source: MedLinePlus Magazine (NIH)39

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Step 4: Get Routine Care to Avoid Problems

See your health care team at least twice a year to find and treat any problems early. Ask what steps you can take to reach your goals.

If you have diabetes…

Source: MedLinePlus Magazine (NIH)40

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Managing Diabetes

People with diabetes are living longer and healthier lives. They now have a much lower chance of developing kidney failure, heart disease, and amputation than they did in the past, thanks to advances in controlling blood glucose, blood pressure, and cholesterol, and greater prevention and education efforts. Now, more than ever, it is important to see your healthcare providers regularly to treat diabetes effectively. They will check your cholesterol, blood sugar, blood pressure, and weight. You may be asked to take medicines. A healthy lifestyle, especially watching how much you eat and exercising every day, can help prevent heart attack and stroke. A daily 30-minute walk can help you manage diabetes and lower your chances of developing problems associated with diabetes, such as heart attack and stroke.

People with diabetes who keep their blood glucose (sugar) as close to normal as possible soon after they are diagnosed have fewer heart attacks later in life and far fewer problems with their eyes, nerves, and kidneys.

A blood test called the A1C test shows what your average blood glucose has been over the previous two to three months.

Now, for people with type 2 diabetes, there are many choices of diabetes medicines. Your healthcare provider may ask you to take a medicine called an ACE inhibitor or a different medicine, called an ARB, or other medicines for high blood pressure or kidney problems. You also may be asked to take a medicine called a statin to keep your cholesterol down and an aspirin to prevent heart attacks.

Source: MedLinePlus Magazine (NIH)41

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What You Can Do to Help Yourself

Follow a meal plan that is planned for you with your healthcare team.

Look for recipes that are low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars. Experiment with recipes that include fruits and vegetables, fish, lean meats, chicken or turkey without the skin, dried peas or beans, and low-fat or nonfat milk and cheese. Other healthy ingredients are foods high in fiber, such as whole grain cereals, breads, crackers, rice, and pasta.

Limit your portion sizes:

Use the plate method; make half your plate vegetables and fruit, one quarter of the plate a lean protein food, and one quarter of the plate a whole grain food.

Exercise safely every day:

Talk to your healthcare provider before starting any exercise program, and take small steps until you can build up to at least 30 minutes most days of the week. A brisk walk is excellent exercise. Find ways to add in extra walking as you go about your daily activities.

Do not smoke cigarettes or use any tobacco products.

Tobacco, whether smoked or chewed, has a very bad effect on the entire body and can make diabetes complications worse. Talk with your doctor or nurse if you need help quitting. There are many programs to help you quit.

Take your medicines the way your healthcare provider asks you to.

Make sure that you are taking your medicines on time, without skipping them, which is very important to successfully manage your diabetes and its complications. If you can't afford your medications, ask if you can switch to less expensive medicines.

Take care of your feet.

Check your feet every day to see if there are any cuts, sores, or other skin problems. Use a mirror to look at the bottoms of your feet. Protect your feet by wearing comfortable shoes and socks, and avoid walking barefoot. Ask your healthcare provider to check your feet to see if you have nerve damage and should be taking especially good care of your feet.

Have your eyes checked regularly.

People with diabetes should see an eye care specialist, an ophthalmologist, at least once a year to check for damage to their retinas.

See your health professional.

Everyone with diabetes should see their primary health provider or diabetes doctor at least twice a year, and more often if you are not meeting your treatment goals. At these visits your healthcare provider may:

  • Ask you about your blood sugar levels
  • Check your blood pressure
  • Check the skin and feeling in your feet, sores, and blood circulation
  • Dilate your eyes

Send you to the laboratory for blood and urine tests to:

  • Make sure your kidneys are working well (every year)
  • Make sure your cholesterol and triglyceride levels are healthy (every year)
  • Check your A1C level to see how well your blood sugar is controlled (every 3-6 months)

Source: MedLinePlus Magazine (NIH)42

Complication Treatments: Diabetes

Hospital procedures for diabetes complications

There are no diabetes specific hospital procedures. Lower-limb amputation is one of the procedures often associated with diabetes.

Source: Australian Institute of Health and Welfare43

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References

  1. Source: NICHD (NIH): nichd.nih.gov/ health/ topics/ diabetes/ conditioninfo/ Pages/ treatment.aspx
  2. Source: CDC Features: cdc.gov/ features/ DiabetesHeatTravel/ 
  3. Source: CDC: cdc.gov/ diabetes/ basics/ diabetes.html
  4. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ diet-eating-physical-activity/ carbohydrate-counting
  5. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ diet-eating-physical-activity
  6. ibid.
  7. ibid.
  8. ibid.
  9. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ insulin-medicines-treatments
  10. ibid.
  11. ibid.
  12. ibid.
  13. Source: OWH (DHHS): womenshealth.gov/ a-z-topics/ diabetes
  14. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2008/ March/ docs/ 01features_01.htm
  15. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ diet-eating-physical-activity/ carbohydrate-counting
  16. Source: Queensland Government: qld.gov.au/ health/ staying-healthy/ diet-nutrition/ dietitians
  17. Source: Healthy People (DHHS): healthypeople.gov/ 2020/ topics-objectives/ topic/ diabetes
  18. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ issue/ oct2011/ capsule1
  19. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ issue/ dec2011/ capsule1
  20. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2009/ August/ capsules.htm
  21. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ tests-diagnosis/ a1c-test
  22. ibid.
  23. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ diet-eating-physical-activity/ carbohydrate-counting
  24. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ diet-eating-physical-activity
  25. ibid.
  26. ibid.
  27. ibid.
  28. ibid.
  29. ibid.
  30. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ insulin-medicines-treatments
  31. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ managing-diabetes
  32. ibid.
  33. ibid.
  34. Source: MedLinePlus (NIH): medlineplus.gov/ a1c.html
  35. Source: NIA (NIH): nia.nih.gov/ health/ diabetes-older-people
  36. ibid.
  37. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ fall14/ articles/ fall14pg14.html
  38. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ fall14/ articles/ fall14pg15.html
  39. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ fall14/ articles/ fall14pg16.html
  40. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ 
  41. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ fall12/ articles/ fall12pg12.html
  42. ibid.
  43. Source: Australian Institute of Health and Welfare: aihw.gov.au/ reports/ diabetes/ diabetes-compendium/ contents/ hospital-care-for-diabetes

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Note: This site is for informational purposes only and is not medical advice. See your doctor or other qualified medical professional for all your medical needs.