Diabetes Overview

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What is Diabetes?

In this section:  

Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Sometimes your body doesn’t make enough—or any—insulin or doesn’t use insulin well. Glucose then stays in your blood and doesn’t reach your cells.

Over time, having too much glucose in your blood can cause health problems. Although diabetes has no cure, you can take steps to manage your diabetes and stay healthy.

Sometimes people call diabetes “a touch of sugar” or “borderline diabetes.” These terms suggest that someone doesn’t really have diabetes or has a less serious case, but every case of diabetes is serious.

Diabetes monitor with fruits and vegetables Diabetes affects just about everyone, from the over 110 million Americans with or at risk for the disease to the many more people who care for them.

What are the different types of diabetes?

The most common types of diabetes are type 1, type 2, and gestational diabetes.

Type 1 diabetes

If you have type 1 diabetes, your body does not make insulin. Your immune system attacks and destroys the cells in your pancreas that make insulin. Type 1 diabetes is usually diagnosed in children and young adults, although it can appear at any age. People with type 1 diabetes need to take insulin every day to stay alive.

Type 2 diabetes

If you have type 2 diabetes, your body does not make or use insulin well. You can develop type 2 diabetes at any age, even during childhood. However, this type of diabetes occurs most often in middle-aged and older people. Type 2 is the most common type of diabetes.

Gestational diabetes

Gestational diabetes develops in some women when they are pregnant. Most of the time, this type of diabetes goes away after the baby is born. However, if you’ve had gestational diabetes, you have a greater chance of developing type 2 diabetes later in life. Sometimes diabetes diagnosed during pregnancy is actually type 2 diabetes.

Other types of diabetes

Less common types include monogenic diabetes, which is an inherited form of diabetes, and cystic fibrosis-related diabetes.

How common is diabetes?

As of 2015, 30.3 million people in the United States, or 9.4 percent of the population, had diabetes. More than 1 in 4 of them didn’t know they had the disease. Diabetes affects 1 in 4 people over the age of 65. About 90-95 percent of cases in adults are type 2 diabetes.1

Who is more likely to develop type 2 diabetes?

You are more likely to develop type 2 diabetes if you are age 45 or older, have a family history of diabetes, or are overweight. Physical inactivity, race, and certain health problems such as high blood pressure also affect your chance of developing type 2 diabetes. You are also more likely to develop type 2 diabetes if you have prediabetes or had gestational diabetes when you were pregnant. Learn more about risk factors for type 2 diabetes.

What health problems can people with diabetes develop?

Over time, high blood glucose leads to problems such as

  • heart disease
  • stroke
  • kidney disease
  • eye problems
  • dental disease
  • nerve damage
  • foot problems

You can take steps to lower your chances of developing these diabetes-related health problems.

References

Symptoms & Causes

In this section:

What are the symptoms of diabetes?

Symptoms of diabetes include

  • increased thirst and urination
  • increased hunger
  • fatigue
  • blurred vision
  • numbness or tingling in the feet or hands
  • sores that do not heal
  • unexplained weight loss

Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.

What causes type 1 diabetes?

Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.

What causes type 2 diabetes?

Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes.

Overweight, obesity, and physical inactivity

You are more likely to develop type 2 diabetes if you are not physically active and are overweight or have obesity. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts.

Insulin resistance

Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.

Genes and family history

As in type 1 diabetes, certain genes may make you more likely to develop type 2 diabetes. The disease tends to run in families and occurs more often in these racial/ethnic groups:

  • African Americans
  • Alaska Natives
  • American Indians
  • Asian Americans
  • Hispanics/Latinos
  • Native Hawaiians
  • Pacific Islanders

Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.

What causes gestational diabetes?

Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.

Insulin resistance

Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.

As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or have obesity may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.

Photo of smiling pregnant woman
Hormonal changes, extra weight, and family history can contribute to gestational diabetes.

Genes and family history

Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.

What else can cause diabetes?

Genetic mutations, other diseases, damage to the pancreas, and certain medicines may also cause diabetes.

Genetic mutations

  • Monogenic diabetes is caused by mutations, or changes, in a single gene. These changes are usually passed through families, but sometimes the gene mutation happens on its own. Most of these gene mutations cause diabetes by making the pancreas less able to make insulin. The most common types of monogenic diabetes are neonatal diabetes and maturity-onset diabetes of the young (MODY). Neonatal diabetes occurs in the first 6 months of life. Doctors usually diagnose MODY during adolescence or early adulthood, but sometimes the disease is not diagnosed until later in life.
  • Cystic fibrosis produces thick mucus that causes scarring in the pancreas. This scarring can prevent the pancreas from making enough insulin.
  • Hemochromatosis causes the body to store too much iron. If the disease is not treated, iron can build up in and damage the pancreas and other organs.

Hormonal diseases

Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes.

Damage to or removal of the pancreas

Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells.

Medicines

Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include

  • niacin, a type of vitamin B3
  • certain types of diuretics, also called water pills
  • anti-seizure drugs
  • psychiatric drugs
  • drugs to treat human immunodeficiency virus (HIV)
  • pentamidine, a drug used to treat a type of pneumonia
  • glucocorticoids—medicines used to treat inflammatory illnesses such as rheumatoid arthritis, asthma, lupus, and ulcerative colitis
  • anti-rejection medicines, used to help stop the body from rejecting a transplanted organ

Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.

If you take any of these medicines and are concerned about their side effects, talk with your doctor.

Risk Factors for Type 2 Diabetes

Your chances of developing type 2 diabetes depend on a combination of risk factors. Although you can’t change risk factors related to family history, age, race, or ethnicity, you may be able to avoid some risk factors by maintaining a healthy weight and being physically active.1

Read about risk factors for type 2 diabetes below, and see which ones apply to you. Acting on the factors you can change may help delay or prevent type 2 diabetes.

What are the risk factors for type 2 diabetes?

Black grandfather and grandson playing American football.Diabetes type 2 can affect people at any age.

You can develop type 2 diabetes at any age, even during childhood. You are more likely to develop type 2 diabetes if you1

  • are overweight or have obesity.
  • are age 35 or older. Children and teens can also develop type 2 diabetes, but the risk increases as a person gets older.
  • have a family history of diabetes.
  • are African American, American Indian, Asian American, Hispanic/Latino, or Pacific Islander.
  • are not physically active, because of physical limitations, a sedentary lifestyle, or a job that requires sitting for long periods of time.
  • have prediabetes.
  • have a history of gestational diabetes, a type of diabetes that develops during pregnancy, or gave birth to a baby weighing 9 pounds or more.

Children and teens are also at higher risk of developing type 2 diabetes if, in addition to the previous risk factors, they were born with a low birth weight or if their parent had gestational diabetes while pregnant with the child.1

You are encouraged to talk with a doctor about any of the health conditions listed above that may require medical treatment. Managing health problems may help reduce your chances of developing type 2 diabetes.2 Also, ask your doctor about any medicines you or your child take that might increase your risk. You can also take the Diabetes Risk Test to learn more about your risk for type 2 diabetes.

Does your weight put you at risk for type 2 diabetes?

If you have overweight or obesity, you may be able to prevent or delay type 2 diabetes by losing weight and being more physically active.1

To see if your weight may put you at risk for type 2 diabetes, learn your body mass index (BMI) and waist circumference.

Body mass index

Your BMI can help you tell if you are at a healthy weight or have overweight or obesity.

Most adults with a BMI of 25 or higher are overweight and have a higher risk of developing
type 2 diabetes.2 Asian Americans are overweight if their BMI is 23 or higher,1 while Pacific Islanders are overweight if their BMI is 26 or higher.3,4,5

If you are an adult, use the BMI calculator to learn your body mass index.

BMI for children and teens depends on their sex and age. You can use a different BMI calculator to find out if a child or teen has overweight or obesity.

Waist circumference

Another way to estimate your risk of developing diabetes is to measure your waist circumference. Men have a higher risk of developing diabetes if their waist circumference is more than 40 inches, while women who are not pregnant have a higher risk if their waist circumference is more than 35 inches.6,7

Waist circumference is an indirect measurement of the amount of fat in your abdomen. Having a large waist circumference is a risk factor for diabetes and heart disease, even if you have a normal BMI.

References

Preventing Type 2 Diabetes

Perhaps you have learned that you have a high chance of developing type 2 diabetes, the most common type of diabetes. You might be overweight or have a parent, brother, or sister with type 2 diabetes. Maybe you had gestational diabetes, which is diabetes that develops during pregnancy. These are just a few examples of factors that can raise your chances of developing type 2 diabetes.

Diabetes can cause serious health problems, such as heart disease, stroke, and eye and foot problems. Prediabetes also can cause health problems. The good news is that type 2 diabetes can be delayed or even prevented. The longer you have diabetes, the more likely you are to develop health problems, so delaying diabetes by even a few years will benefit your health. You can help prevent or delay type 2 diabetes by losing a modest amount of weight by following a reduced-calorie eating plan and being physically active most days of the week. Ask your doctor if you should take the diabetes drug metformin to help prevent or delay type 2 diabetes.1

How can I lower my chances of developing type 2 diabetes?

Research such as the Diabetes Prevention Program shows that you can do a lot to reduce your chances of developing type 2 diabetes. Here are some things you can change to lower your risk:

  • Lose weight and keep it off. You may be able to prevent or delay diabetes by losing 5 to 7 percent of your starting weight.1 For instance, if you weigh 200 pounds, your goal would be to lose about 10 to 14 pounds.
  • Move more. Get at least 30 minutes of physical activity 5 days a week. If you have not been active, talk with your health care professional about which activities are best. Start slowly to build up to your goal.
  • Eat healthy foods most of the time. Eat smaller portions to reduce the amount of calories you eat each day and help you lose weight. Choosing foods with less fat is another way to reduce calories. Drink water instead of sweetened beverages.

Ask your health care professional about what other changes you can make to prevent or delay type 2 diabetes.

Most often, your best chance for preventing type 2 diabetes is to make lifestyle changes that work for you long term. Get started with Your Game Plan to Prevent Type 2 Diabetes.

Photo of a young man weighing himself
Losing weight through healthy eating and regular physical activity can help you prevent type 2 diabetes.

What should I do if my health care professional told me I have prediabetes?

Prediabetes is when your blood glucose, also called blood sugar, levels are higher than normal, but not high enough to be called diabetes. Having prediabetes is serious because it raises your chance of developing type 2 diabetes. Many of the same factors that raise your chance of developing type 2 diabetes put you at risk for prediabetes.

Other names for prediabetes include impaired fasting glucose or impaired glucose tolerance. Some people call prediabetes “borderline diabetes.”

About 1 in 3 Americans has prediabetes, according to recent diabetes statistics from the Centers for Disease Control and Prevention. You won’t know if you have prediabetes unless you are tested.

If you have prediabetes, you can lower your chance of developing type 2 diabetes. Lose weight if you need to, become more physically active, and follow a reduced-calorie eating plan.

Get started with Your Game Plan to Prevent Type 2 Diabetes. For more support, you can find a lifestyle change program near you through the National Diabetes Prevention Program.

Photo of two smiling middle-aged women on exercise bikes
Being physically active is one way to help prevent prediabetes from progressing to type 2 diabetes.

If I had gestational diabetes when I was pregnant, how can I lower my chances of developing type 2 diabetes?

Gestational diabetes is a type of diabetes that develops during pregnancy. Most of the time, gestational diabetes goes away after your baby is born. Even if your gestational diabetes goes away, you still have a greater chance of developing type 2 diabetes within 5 to 10 years. Your child may also be more likely to become obese and develop type 2 diabetes later in life. Making healthy choices helps the whole family and may protect your child from becoming obese or developing diabetes.

Photo of mother and young daughter riding bikes
Being physically active together is a great way to lower your own and your child’s chance of developing type 2 diabetes.

Here are steps you should take for yourself and your child if you had gestational diabetes:

  • Get tested for diabetes 6 to 12 weeks after your baby is born. If your blood glucose is still high, you may have type 2 diabetes. If your blood glucose is normal, you should get tested every 3 years to see if you have developed type 2 diabetes.
  • Be more active and make healthy food choices to get back to a healthy weight.
  • Breastfeed your baby. Breastfeeding gives your baby the right balance of nutrients and helps you burn calories.
  • Ask your doctor if you should take the diabetes drug metformin to help prevent type 2 diabetes.1

References

Diabetes Tests & Diagnosis

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Your doctor can diagnose diabetes, prediabetes, and gestational diabetes using blood tests. The blood tests show if your blood glucose level, also called blood sugar, is higher than the range that is healthy for you. Blood tests can also help identify the type of diabetes you have.

Don’t try to diagnose yourself if you think you might have diabetes. Blood testing equipment that you can buy over the counter, such as a blood glucose meter, cannot diagnose diabetes.

Who should be tested for diabetes?

Anyone who has symptoms of diabetes should be tested for the disease. Some people will not have any symptoms but may have risk factors for type 2 diabetes and need to be tested. Most pregnant women should also be tested for gestational diabetes. Testing helps doctors find diabetes sooner, so they can work with their patients to manage the disease and prevent health problems.

If you have Medicare, it may cover the cost of tests if you have certain risk factors for diabetes. If you have different insurance, ask your insurance company if it covers diabetes tests.

A Black health care professional taking blood from the arm of a Black male patient.Blood tests help doctors diagnose diabetes and prediabetes.

Type 1 diabetes

Doctors often diagnose type 1 diabetes in children and young adults when they have diabetes symptoms, such as feeling thirsty and having to urinate more often, or if they may have diabetic ketoacidosis. Symptoms in adults may be less specific.1

Type 1 diabetes can run in families. A study called TrialNet offers free testing to relatives of people with type 1 diabetes, even if the relatives don’t have symptoms.

Type 2 diabetes

Experts recommend routine testing for type 2 diabetes if you have certain risk factors. You may have a higher risk of developing type 2 diabetes if you are

  • age 35 or older
  • American Indian, Black or African American, Asian American, Hispanic/Latino, or Pacific Islander
  • overweight or have obesity and have at least one other risk factor
  • a woman who had gestational diabetes

Take the American Diabetes Association Diabetes Risk Test to see if you are at risk for type 2 diabetes.

Children can also develop type 2 diabetes. Experts recommend testing children and teens between the ages of 10 and 18 who are overweight or have obesity and have at least one more risk factor, such as a low birth weight, a parent who had diabetes while pregnant, or another factor.1

Adults and children with normal diabetes test results should be retested every 3 years.1

If your blood glucose levels are higher than the target range, but not high enough to be diagnosed with diabetes, doctors will diagnose you with prediabetes. Having prediabetes is serious because it raises the chance of developing type 2 diabetes. But developing type 2 diabetes can be prevented. Adults and children diagnosed with prediabetes should be tested for type 2 diabetes every year.

Testing for type 2 diabetes before and during pregnancy

All women who are planning to get pregnant should be tested for type 2 diabetes, especially if they have risk factors.

If you are already pregnant, you should be tested for type 2 diabetes at the first prenatal appointment, or in the first 15 weeks of pregnancy. If you have diabetes, you should receive special care during your pregnancy to avoid problems for you and the baby.

Gestational diabetes

All pregnant women who do not have a previous diagnosis of diabetes should be tested for gestational diabetes between 24 and 28 weeks of pregnancy.1

If you have gestational diabetes, you should get tested after your baby is born to see if you have type 2 diabetes, usually within 12 weeks after delivery.

What tests are used to diagnose diabetes?

Doctors use a variety of tests to diagnose diabetes and prediabetes. Your doctor may recommend different tests depending on whether you have symptoms or not, or whether you are pregnant.

Fasting plasma glucose test

The fasting plasma glucose (FPG) test measures your blood glucose level at a single point in time. For the most reliable results, your doctor will give you the test in the morning after you have fasted for at least 8 hours. Fasting means having nothing to eat or drink except sips of water.

A1C test

The A1C test is a blood test that provides your average levels of blood glucose over the last 3 months. Other names for the A1C test are hemoglobin A1C, HbA1C, glycated hemoglobin, and glycosylated hemoglobin test. You can eat and drink before this test. Before using the A1C test to diagnose diabetes, your doctor will consider factors, such as whether you are in your second or third trimester of pregnancy or whether you have certain types of anemia or another problem with your blood.1 The A1C test might not be accurate in those cases.

Certain types of hemoglobin, called hemoglobin variants, can interfere with measuring A1C levels. Most A1C tests used in the United States are not affected by the most common variants. If your A1C test results and blood glucose levels do not match, your doctor should consider that the A1C test may not be a reliable test for you.

Your doctor will report your A1C test result as a percentage, such as an A1C of 7%. The higher the percentage is, the higher your average blood glucose levels are.

Random plasma glucose test

Sometimes doctors use the random plasma glucose test to diagnose diabetes when you have symptoms of diabetes and they do not want to wait until you have fasted for 8 hours. You may have this blood test at any time.

Glucose challenge test

If you are pregnant, your doctor might test you for gestational diabetes with the glucose challenge test. Another name for this test is the glucose screening test. In this test, a health care professional will take a sample of your blood 1 hour after you drink a sweet liquid containing glucose. You do not need to fast for this test. If your blood glucose level is too high—135 mg/dL to 140 mg/dL or higher—you may need to return for an oral glucose tolerance test while fasting.

Oral glucose tolerance test

The oral glucose tolerance test (OGTT) helps doctors detect type 2 diabetes, prediabetes, and gestational diabetes. However, the OGTT is a more expensive test than the FPG test and the glucose challenge test, and it is not as easy to give.

Before the test, you will need to fast for at least 8 hours. A health care professional will take a blood sample to measure your glucose level after fasting. Next, you will drink a liquid that is high in sugar. Another blood sample is taken 2 hours later to check your blood glucose level. If your blood glucose level is high, you may have diabetes.

If you are pregnant, your blood will be drawn every hour for 2 to 3 hours. If your blood glucose levels are high two or more times during the OGTT, you may have gestational diabetes.

What test results tell me if I have diabetes or prediabetes?

Each test to detect diabetes and prediabetes uses a different measurement. Usually, your doctor will use a second test to confirm you have diabetes.

The table below helps you understand what your test results mean if you are not pregnant.1 If you are pregnant, some tests use different cutoffs. Ask your doctor what your test results mean.

Test results for diagnosis of prediabetes and diabetes

Diagnosis A1C Fasting Plasma Glucose Oral Glucose Tolerance Test* Random Plasma Glucose Test‡
Normal below 5.7% 99 mg/dL or below 139 mg/dL or below N/A
Prediabetes 5.7% to 6.4% 100 to 125 mg/dL 140 to 199 mg/dL N/A
Diabetes 6.5% or above 126 mg/dL or above 200 mg/dL or above 200 mg/dL or above

Which tests help my doctor know what kind of diabetes I have?

Even though the tests described above can confirm you have diabetes, they can’t identify what type you have—type 1, type 2, or a rare type of diabetes called monogenic diabetes. Treatment can depend on the type of diabetes you have, so knowing which type you have is important.

Genetic testing

Genetic testing can diagnose most forms of monogenic diabetes, which is caused by a change—or mutation—in a gene. Anyone can have monogenic diabetes, but it is more common in babies who develop diabetes before they are 6 months old, some teens, and some young adults.

Autoantibodies

If you have diabetes, your doctor may look for certain autoantibodies to see if your diabetes is type 1. Autoantibodies are proteins in your immune system that mistakenly attack your healthy tissues and cells. A health care professional will take a sample of your blood for this test. If autoantibodies for diabetes are found in your blood, you may have type 1 diabetes.1

If you do not have diabetes but your parent or sibling has type 1 diabetes, your doctor might give you this test to see if you have a higher risk of developing type 1 diabetes. You may want to learn about diabetes symptoms and have follow-up testing as recommended by your doctor.1

Reference

Managing Diabetes

You can manage your diabetes and live a long and healthy life by taking care of yourself each day.

Diabetes can affect almost every part of your body. Therefore, you will need to manage your blood glucose levels, also called blood sugar. Managing your blood glucose, as well as your blood pressure and cholesterol, can help prevent the health problems that can occur when you have diabetes.

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:

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

  • you will lower your risk for heart attack, stroke, nerve disease, kidney disease, diabetic eye disease, and amputation
  • your cholesterol and blood pressure levels may improve
  • your blood circulation will improve
  • you may have an easier time being physically active

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 (PDF, 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.

Photo of a smiling middle-aged woman in a swimming pool
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.

Photo of a woman's hands and a blood glucose meter. She is pricking her fingertup with a lancet.
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. Take these records with you when you visit your health care team.

What is continuous glucose monitoring?

Continuous glucose monitoring (CGM) is another way to check your glucose levels. Most CGM systems use a tiny sensor that you insert under your skin. The sensor measures glucose levels in the fluids between your body’s cells every few minutes and can show changes in your glucose level throughout the day and night. If the CGM system shows that your glucose is too high or too low, you should check your glucose with a blood glucose meter before making any changes to your eating plan, physical activity, or medicines. A CGM system is especially useful for people who use insulin and have problems with low blood glucose.

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.

What happens if my blood glucose level becomes too low?

Sometimes blood glucose levels drop below where they should be, which is called hypoglycemia. For most people with diabetes, the blood glucose level is too low when it is below 70 mg/dL.

Hypoglycemia can be life threatening and needs to be treated right away. Learn more about how to recognize and treat hypoglycemia.

What happens if my blood glucose level becomes too high?

Doctors call high blood glucose hyperglycemia.

Symptoms that your blood glucose levels may be too high include

  • feeling thirsty
  • feeling tired or weak
  • headaches
  • urinating often
  • blurred vision

If you often have high blood glucose levels or symptoms of high blood glucose, talk with your health care team. You may need a change in your diabetes meal plan, physical activity plan, or medicines.

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.

Photo of an older woman talking with her doctor. They are looking at a piece of paper.
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.

Cope with your diabetes in healthy ways

Feeling stressed, sad, or angry is common when you live with diabetes. Stress can raise your blood glucose levels, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Consider taking part in a diabetes education program or support group that teaches you techniques for managing stress. Learn more about healthy ways to cope with stress.

Depression is common among people with a chronic, or long-term, illness. Depression can get in the way of your efforts to manage your diabetes. Ask for help if you feel down. A mental health counselor, support group, clergy member, friend, or family member who will listen to your feelings may help you feel better.

Try to get 7 to 8 hours of sleep each night. Getting enough sleep can help improve your mood and energy level. You can take steps to improve your sleep habits. If you often feel sleepy during the day, you may have obstructive sleep apnea, a condition in which your breathing briefly stops many times during the night. Sleep apnea is common in people who have diabetes. Talk with your health care team if you think you have a sleep problem.

Remember, managing diabetes isn’t easy, but it’s worth it.

Insulin, Medicines, & Other Diabetes Treatments

On this page:

Taking insulin or other diabetes medicines is often part of treating diabetes. In addition to making healthy food and beverage choices, getting physical activity, getting enough sleep, and managing stress, medicines can help you manage the disease. Some other treatment options are also available.

What medicines might I take for diabetes?

The medicine you take depends on the type of diabetes you have and how well the medicine controls your blood glucose levels, also called blood sugar levels. Other factors, such as any other health conditions you may have, medication costs, your insurance coverage and copays, access to care, and your lifestyle, may affect what diabetes medicine you take.

What type of diabetes do I have?

Type 1 diabetes

If you have type 1 diabetes, you must take insulin because your pancreas does not make it. You will need to take insulin several times during the day, including when you eat and drink, to control your blood glucose level.

There are different ways to take insulin. You can use a needle and syringe, an insulin pen, or an insulin pump. An artificial pancreas—also called an automated insulin delivery system—may be another option for some people.

Type 2 diabetes

Some people with type 2 diabetes can control their blood glucose level by making lifestyle changes. These lifestyle changes include consuming healthy meals and beverages, limiting calories if they have overweight or obesity, and getting physical activity.

Many people with type 2 diabetes need to take diabetes medicines as well. These medicines may include diabetes pills or medicines you inject, such as insulin. Over time, you may need more than one diabetes medicine to control your blood glucose level. Even if you do not take insulin, you may need it at special times, such as if you are pregnant or if you are in the hospital for treatment.

Gestational diabetes

If you have gestational diabetes, you can manage your blood glucose level by following a healthy eating plan and doing a moderate-intensity physical activity, such as brisk walking for 150 minutes, each week. If consuming healthy food and beverages and getting regular physical activity aren’t enough to keep your blood glucose level in your target range, a doctor will work with you and may recommend you take insulin. Insulin is safe to take while you are pregnant.

No matter what type of diabetes you have, taking diabetes medicines every day can feel like a burden sometimes. New medications and improved delivery systems can help make it easier to manage your blood glucose levels. Talk with your doctor to find out which medications and delivery systems will work best for you and fit into your lifestyle.

What are the different types of insulin?

Several types of insulin are available. Each type starts to work at a different speed, known as “onset,” and its effects last a different length of time, known as “duration.” Most types of insulin reach a peak, which is when they have the strongest effect. After the peak, the effects of the insulin wear off over the next few hours or so. Table 1 lists the different types of insulin, how fast they start to work, when they peak, and how long they last.

Table 1. Types of insulin and how they work1,2

Insulin Type How Fast It Starts to Work (onset) When It Peaks How Long It Lasts (duration)
rapid-acting/
ultra rapid-acting
15 minutes 1 hour 2 to 4 hours (rapid)
5 to 7 hours (ultra)
rapid-acting, inhaled 10 to 15 minutes 30 minutes 3 hours
regular, also called short-acting 30 minutes 2 to 3 hours 3 to 6 hours
intermediate-acting 2 to 4 hours 4 to 12 hours 12 to 18 hours
long-acting 2 hours does not peak 24 hours
ultra long-acting 6 hours does not peak 36 hours or longer

Another type of insulin, called premixed insulin, is a combination of insulins listed in Table 1. Premixed insulin starts to work in 15 to 60 minutes and can last from 10 to 16 hours. The peak time varies depending on which insulins are mixed.

Your doctor will work with you to review your medication options. Talk with your doctor about your activity level, what you eat and drink, how well you manage your blood glucose levels, your age and lifestyle, and how long your body takes to absorb insulin.

Follow your doctor’s advice on when and how to take your insulin. If you're worried about the cost, talk with your doctor. Some types of insulin cost more than others. You can also find resources to get financial help for diabetes care.

What are the different ways to take insulin?

The way you take insulin may depend on your lifestyle, insurance plan, and preferences. Talk with your doctor about the options and which one is best for you. Most people with diabetes take insulin using a needle and syringe, insulin pen, or insulin pump. Inhalers and insulin jet injectors are less common ways to take insulin. Artificial pancreas systems are now approved by the U.S. Food and Drug Administration (FDA). Talk with your doctor to see if an artificial pancreas is an option for you.

Needle and syringe

You can give yourself insulin shots using a needle and syringe. You draw up your dose of insulin from the vial—or bottle—through the needle into the syringe. Insulin works fastest when you inject it in your belly, but your doctor may recommend alternating the spot where you inject it. Injecting insulin in the same spot repeatedly could cause the tissue to harden, making it harder to take shots in that area over time. Other spots you can inject insulin include your thigh, buttocks, or upper arm, but it may take longer for the insulin to work from those areas. Some people with diabetes who take insulin need 2 to 4 shots a day to reach their blood glucose targets. Others can take a single shot. Injection aids can help you give yourself the shots.

Two syringes and a vial containing insulin.
Insulin shots involve drawing insulin from a vial into a syringe and then injecting it.

Pen

An insulin pen looks like a writing pen but has a needle for its point. Some insulin pens come filled with insulin and are disposable. Others have room for an insulin cartridge that you insert and replace after use. Many people find insulin pens easier to use, but they cost more than needles and syringes. You may want to consider using an insulin pen if you find it hard to fill the syringe while holding the vial or cannot read the markings on the syringe. Different pen types have features that can help with your injections. Some reusable pens have a memory function, which can recall dose amounts and timing. Other types of “connected” insulin pens can be programmed to calculate insulin doses and provide downloadable data reports, which can help you and your doctor adjust your insulin doses.

An insulin pen
An insulin pen is a convenient way to take insulin.

Pump

An insulin pump is a small machine that gives you steady doses of insulin throughout the day. You wear one type of pump outside your body on a belt or in a pocket or pouch. The insulin pump connects to a small plastic tube and a very small needle. You insert the plastic tube with a needle under your skin, then take out the needle. The plastic tube will stay inserted for several days while attached to the insulin pump. The machine pumps insulin through the tube into your body 24 hours a day and can be programmed to give you more or less insulin based on your needs. You can also give yourself doses of insulin through the pump at mealtimes.

Another type of pump has no tubes. This pump attaches directly to your skin with a self-adhesive pad and is controlled by a hand-held device. The plastic tube and pump device are changed every several days.

A woman holds an insulin pump with the tube connected to a patch on her stomach, where the needle is inserted.
Insulin pumps can be programmed to deliver insulin directly into your body, 24 hours a day or at certain times.

Inhaler

Another way to take insulin is by breathing powdered insulin into your mouth from an inhaler device. The insulin goes into your lungs and moves quickly into your blood. You may want to use an insulin inhaler to avoid using needles. Inhaled insulin is only for adults with type 1 or type 2 diabetes. Taking insulin with an inhaler is less common than using a needle and syringe.

Jet injector

A jet injector is a device that sends a fine spray of insulin into the skin at high pressure instead of using a needle to deliver the insulin. It is used less commonly than a needle and syringe or a pen.

Artificial pancreas

An artificial pancreas is a system of three devices that work together to mimic how a healthy pancreas controls blood glucose in the body. A continuous glucose monitor (CGM) tracks blood glucose levels every few minutes using a small sensor inserted under the skin that is held in place with an adhesive pad. The CGM wirelessly sends the information to a program on a smartphone or an insulin infusion pump. The program calculates how much insulin you need. The insulin infusion pump will adjust how much insulin is given from minute to minute to help keep your blood glucose level in your target range. An artificial pancreas is mainly used to help people with type 1 diabetes.

What oral medicines treat type 2 diabetes?

You may need to take medicines to manage your type 2 diabetes, in addition to consuming healthy foods and beverages and being physically active. You can take many diabetes medicines by mouth. These medicines are called oral medicines.

Most people with type 2 diabetes start with metformin pills. Metformin also comes as a liquid. Metformin helps your liver make less glucose and helps your body use insulin better. This drug may help you lose a small amount of weight.

Other oral medicines act in different ways to lower blood glucose levels. Combining two or three kinds of diabetes medicines can lower blood glucose levels better than taking just one medicine.

Read about different kinds of diabetes medicines (PDF, 2.8 MB) from the FDA.

What other injectable medicines treat diabetes?

Type 1 diabetes

If you have type 1 diabetes, your doctor may recommend you take other medicines, in addition to insulin, to help control your blood glucose. Some of these medicines work to slow how fast food and beverages move through your stomach. These medicines also slow down how quickly and how high your blood glucose levels rise after eating. Other medicines work to block certain hormones in your digestive system that raise blood glucose levels after meals or help the kidneys to remove more glucose from your blood.

Type 2 diabetes

Besides insulin, other types of injected medicines (PDF, 2.8 MB) are available that will keep your blood glucose level from rising too high after you eat or drink. These medicines, known as glucagon-like peptide-1 (GLP-1) receptor agonists,3 may make you feel less hungry and help you lose some weight. GLP-1 medicines are not substitutes for insulin.

What should I know about side effects of diabetes medicines?

Side effects are problems that result from taking 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. Aim to take your diabetes medicines as your doctor instructs you, to help prevent side effects and diabetes problems.

Diabetes Diet, Eating, & Physical Activity

In this section:

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

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

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.

Photo of avocado, salmon, nuts, seeds, and olive oil.
Choose healthy fats, such as from nuts, seeds, and olive oil.

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.

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.

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.

Weight-loss planning

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

The Body Weight Planner can help you tailor your calorie and physical activity plans to reach and maintain your goal 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.

Photo of a plate with cucumber and spinach on half of the plate, brown rice on one quarter of the plate, and baked chicken on the last quarter.
The plate method shows the amount of each food group you should eat.

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.

Carbohydrate counting is a meal planning tool for people with diabetes who take insulin, but not all people with diabetes need to count carbohydrates. Your health care team can help you create a personal eating plan that will best meet your needs.

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.

Photo of a bag of groceries containing fruit, vegetables, milk, and bread.
Choose healthy carbohydrates, such as fruit, vegetables, whole grains, beans, and low-fat milk, as part of your diabetes meal plan.

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

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.

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

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.

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.

Photo of a man outdoors in exercise clothes drinking from a bottle of water.
Drink water when you exercise to stay well hydrated.

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.

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.

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.

Photo of a smiling woman holding hand weights.
You can do strength training with hand weights, elastic bands, or weight machines.

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.

References

Preventing Diabetes Problems

Diabetes can lead to serious health problems such as heart disease, vision problems, nerve damage, and kidney disease. Learn more about preventing these diabetes problems and managing your diabetes.

Heart Disease & Stroke

Diabetes can damage blood vessels and lead to heart disease and stroke. You can do a lot to prevent heart disease and stroke by managing your blood glucose, blood pressure, and cholesterol levels; and by not smoking.

Low Blood Glucose (Hypoglycemia)

Hypoglycemia occurs when your blood glucose drops too low. Certain diabetes medicines make low blood glucose more likely. You can prevent hypoglycemia by following your meal plan and balancing your physical activity, food, and medicines. Testing your blood glucose regularly can also help prevent hypoglycemia.

Diabetic Neuropathy

Diabetic neuropathy is nerve damage that can result from diabetes. Different types of nerve damage affect different parts of your body. Managing your diabetes can help prevent nerve damage that affects your feet and limbs, and organs such as your heart.

Foot Problems

Diabetes can cause nerve damage and poor blood flow, which can lead to serious foot problems. Common foot problems, such as a callus, can lead to pain or an infection that makes it hard to walk. Get a foot checkup at each visit with your health care team.

Kidney Disease

Diabetic kidney disease, also called diabetic nephropathy, is kidney disease caused by diabetes. You can help protect your kidneys by managing your diabetes and meeting your blood pressure goals.

Eye Disease

Diabetes can damage your eyes and lead to low vision and blindness. The best way to prevent eye disease is to manage your blood glucose, blood pressure, and cholesterol; and to not smoke. Also, have a dilated eye exam at least once a year.

Gum Disease & Other Dental Problems

Diabetes can lead to problems in your mouth, such as infection, gum disease, or dry mouth. To help keep your mouth healthy, manage your blood glucose, brush your teeth twice a day, see your dentist at least once a year, and don’t smoke.

Sexual & Bladder Problems

Sexual and bladder problems are more common in people with diabetes. Problems like erectile dysfunction, loss of interest in sex, bladder leaks, and retained urine can happen if diabetes damages your blood vessels and nerves. Treatments are available to help control symptoms and restore intimacy.

Cancer & Diabetes

Diabetes is linked to some types of cancer. Many risk factors for cancer and for diabetes are the same. Not smoking and getting recommended cancer screenings can help prevent cancer.

Dementia & Diabetes

High blood glucose increases the chance of developing dementia. Tell your doctor if you are forgetful because dementia can make it hard to manage your diabetes.

Depression & Diabetes

Depression is common among people with a chronic, or long-term, illness such as diabetes. Depression can be treated so tell your doctor if you feel sad, hopeless, or anxious.

Sleep Apnea & Diabetes

People who have sleep apnea—when you stop breathing for short periods during sleep—are more likely to develop type 2 diabetes. Sleep apnea also can make diabetes worse. Treatment for sleep apnea can help.

Clinical Trials

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. The NIDDK is the primary institute at the NIH that funds diabetes research, including clinical trials.

What are clinical trials for diabetes?

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Scientists are conducting research to learn more about diabetes, including the following studies

  • The Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) is following more than 5,000 people across the country who have type 2 diabetes to find out which combination of two diabetes medicines is best for blood glucose, also called blood sugar, management; has the fewest side effects; and is the most helpful for overall health in long-term diabetes treatment.
  • TrialNet is conducting research studies around the world, including risk screening for relatives of people with type 1 diabetes, monitoring for people at risk, and innovative clinical trials aimed at slowing down or stopping the disease.

Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.

Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.

What clinical trials for diabetes are open?

Below is a list of selected clinical trials that are currently open and recruiting, but you can expand or narrow your search.

  • Type 1 diabetes—includes studies funded by the NIH or other U.S. Government agencies
  • Type 2 diabetes—includes studies funded by the NIH or other U.S. Government agencies
  • Gestational diabetes—includes studies funded by the NIH; other U.S. Government agencies; and individuals, universities, or other organizations

You can also search www.ClinicalTrials.gov to find studies on other types of diabetes or on specific conditions linked to diabetes.

What have we learned about diabetes from NIDDK-funded research?

The NIDDK has supported many research projects to learn more about diabetes. For example

  • Look AHEAD: Action for Health in Diabetes. The Look AHEAD study showed that people who were overweight or had obesity and had type 2 diabetes can lose weight and maintain that weight loss through a program of healthy eating and increased physical activity. The study also showed that weight loss provides added health benefits, such as better physical mobility and improved blood glucose, blood pressure, and cholesterol levels. The trial has been extended to study the long-term results of weight loss through healthy eating and physical activity programs in older adults with type 2 diabetes.
  • Diabetes Control and Complications Trial (DCCT) and Epidemiology of Diabetes Interventions and Complications (EDIC). The DCCT showed that intensive treatment with insulin to maintain blood glucose levels as close to normal as safely possible greatly lowered participants’ chances of developing eye, nerve, and kidney disease. The EDIC study has continued to follow DCCT participants for the past 20+ years. EDIC has shown that there are long-term benefits of early and intensive blood glucose control for the future development of diabetes-related complications such as heart, kidney, nerve, and eye disease; and that early and intensive control also lengthens life.
  • Diabetes Prevention Program (DPP) and Diabetes Prevention Program Outcomes Study (DPPOS). The DPP showed that people who are at high risk for type 2 diabetes can prevent or delay the disease by making lifestyle changes that include weight loss through dietary changes and increased physical activity. Taking metformin, a safe and effective generic medicine used to treat diabetes, was also found to prevent the disease, although to a lesser degree. The DPPOS has continued to follow DPP participants to see if the lifestyle changes they made during the DPP or taking metformin continues to prevent or delay type 2 diabetes over time. To date, the DPPOS has shown that people can prevent or delay type 2 diabetes for at least 15 years with lifestyle changes or metformin.
Last Reviewed December 2016
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.