Dr. Angela Ryan Lee is board certified in cardiology and internal medicine. Her professional interests include preventive cardiology, medical journalism, and health policy.
Kashif J. Piracha, MD, is board-certified in internal medicine and nephrology. He has an active clinical practice at Methodist Willowbrook Hospital in Houston, Texas.
Proper diabetes care can reduce the risk of complications. It’s important to pay attention to both physical needs and mental health when managing diabetes. Read on to learn more about 12 specific actions to stay healthy as you manage diabetes.
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High blood sugar in diabetes contributes to a host of potential complications, so keeping your blood sugar controlled is essential. Checking blood sugar can be done in different ways, from lab tests drawn at your healthcare provider’s office to checking your blood sugar at home.
Controlling diabetes is important, since high blood sugar can lead to the following complications:
Two potentially life-threatening complications of very high blood sugar are diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS).
Your healthcare provider can order a blood test called a hemoglobin A1c to get a sense of your level of blood sugar control over the past three months. Ideally, this number should be less than 7% in people with diabetes, though individualized goals may be recommended by your healthcare provider.
Blood sugar levels can also be checked at home using a blood sugar monitor, called a glucometer. Not everyone with diabetes needs to check blood sugar at home, but those taking certain diabetes medications like insulin are recommended to check blood sugar at home. Your blood sugar is usually checked before meals and at night before bed.
Your healthcare provider will give you a plan on what to do if your blood sugar is high. For example, if you are taking insulin, you may need to give yourself additional insulin. If numbers are consistently high, your medications and/or dosages may need to be changed.
Always discuss any concerns you have about your blood sugar with your healthcare provider. And only make adjustments to your insulin dosing under your provider's supervision.
High blood sugar in diabetes increases the risk of foot ulcers, which can lead to serious infections of the skin, soft tissue, and bones. In severe cases, it may require amputation. It’s important to maintain foot health with diabetes by doing the following:
Since diabetes can damage the nerves in your feet, you may not notice that an injury has occurred or an ulcer is starting. Look closely for the following:
If you have any concerns, let your healthcare provider know.
One of the most important ways to keep your diabetes under control is to eat a diabetes-friendly diet. It doesn’t have to be a bland and restrictive diet, but it does mean cutting down on carbs. Things to avoid include:
In a diabetes-friendly diet, there are still lots of delicious options. Choose low-glycemic-index foods. These foods have carbohydrates that are digested more slowly and are high in fiber:
Dietary changes, along with exercise and weight loss when indicated, can help significantly reduce blood sugar. Some people are even able to put type 2 diabetes into remission this way.
Another important step to controlling blood sugar and managing weight is staying active. Everyone should aim for 150 minutes of physical activity weekly.
Activities to try include:
In addition to helping control diabetes, exercise has benefits for heart health, mood, and muscle and bone health.
Medications are a big part of a diabetes care plan, and for many people with diabetes, they are essential for blood sugar control. Diabetes medication may include pills, injectable medications, and insulin.
Your healthcare provider may recommend medications like statins for cholesterol management, aspirin for the prevention of stroke and heart attack, and blood pressure medications.
Taking your medications as prescribed is one of the best ways to keep your blood sugar, cholesterol, and blood pressure under control.
Depending on how well your diabetes is controlled, you should see your diabetes care provider every three to six months. Those who are working to get their blood sugar under control will need a hemoglobin A1c measured every three months.
Smoking has many harmful effects on the body, and it’s especially important for people with diabetes to quit smoking and avoid secondhand smoke. One of the reasons is that smoke exposure increases your risk of cardiovascular disease, and people with diabetes are already at a higher risk for heart disease and stroke.
In addition, nicotine actually increases blood sugar levels and can lead to type 2 diabetes. Note that when you quit smoking, your blood sugar levels can decrease and your medication requirements may change.
Diabetes and high blood pressure often go hand in hand. Having both conditions drastically increases your risk of cardiovascular disease. About 80% of adults with diabetes also have high blood pressure, and blood pressure should be treated to a goal of less than 130/80 mmHg (millimeters of mercury).
High blood sugar in diabetes can increase your risk of gum disease, tooth decay, and infection. Diabetes results in excess sugar in the saliva, dry mouth, and poor wound healing.
To keep your mouth healthy, follow oral hygiene steps, including:
Diabetes is the top cause of chronic kidney disease. One-third of people with diabetes also have kidney disease. Controlling blood sugar is important to prevent the development and progression of kidney disease in diabetes.
Kidney disease doesn’t cause any symptoms in the early stages. Your healthcare provider will monitor your kidney function with regular blood testing at scheduled visits as part of your diabetes care plan.
High cholesterol is another condition that occurs with diabetes, drastically increasing heart disease risk. There is evidence that the cholesterol medication known as statins improve survival, and reduce the risk of cardiovascular disease in those with diabetes.
Another complication of diabetes is eye disease, which can lead to vision problems and even blindness. In the short term, high blood sugar can cause blurred vision, but over time, high blood sugar can cause the following:
Don’t ignore any eye symptoms like new floaters, flashes of light, or other vision problems. People with diabetes should see an eye care specialist for a dilated eye exam at least once per year.
A diagnosis of diabetes can bring anxiety about complications, side effects from medications, frustration about controlling blood sugar, and feelings of deprivation around dietary changes. Depression is common in people with diabetes, which is a treatable condition with medication and talk therapy. Signs of depression include the following:
Call a helpline or seek medical attention right away if you have thoughts of suicide. Dial 988 to reach the 988 Suicide & Crisis Lifeline. Call 911 if you are in immediate danger.
Diabetes can cause a host of complications from head to toe, including depression, eye disease, dental disease, cardiovascular disease, kidney disease, and diabetic foot ulcers. Paramount to diabetes care is controlling blood sugar, but it’s just as important to identify and treat these potential complications.
A comprehensive diabetes care plan includes attention to possible complications, with regular visits with your healthcare provider for screening and medication management.
A diagnosis of diabetes is life-changing. It can be stressful to keep track of your medication and blood sugar monitoring, as well as making lifestyle changes to avoid complications and to improve your condition.
Know that you’re not in this alone. Your healthcare provider can offer information and advice on ways to start achievable lifestyle modifications, including dietary changes, exercise, and smoking cessation.
Checking blood sugar at home requires a glucose monitor, testing strips, a small needle called a lancet, and alcohol wipes. After washing and drying your hands, place a fresh testing strip into the glucose monitor. Then clean the skin of a finger pad with an alcohol wipe. Use the lancet to prick your finger, and squeeze your finger to bring out a drop of blood. Collect the blood on the testing strip. The monitor will report your blood sugar level. Be sure to dispose of the lancet in an appropriate container.
People with diabetes can develop numbness in their feet due to damage of small nerves, which makes their feet susceptible to injury and infection. Socks and well-fitting shoes should be worn to protect the feet, and feet should be kept clean and nails trimmed regularly. Be sure to examine your feet nightly for any signs of ulcers, injury, or infection. Look for discolored or broken skin, deep cracks, redness, and drainage. Any concerns should be reported to and examined by your diabetes care team or a podiatrist.
Diabetes is typically managed by a primary care team, which includes general internists or family practice physicians along with a team of specialists and nurses. Endocrinologists are internal medicine doctors who undergo additional training to specialize in conditons affecting the endocrine system. They may help manage diabetes along with your primary care team, particularly when complications are present, specialized medications are indicated, or blood sugar is particularly difficult to control.
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Angela Ryan Lee, MD, is board-certified in cardiovascular diseases and internal medicine. She is a fellow of the American College of Cardiology and holds board certifications from the American Society of Nuclear Cardiology and the National Board of Echocardiography. She completed undergraduate studies at the University of Virginia with a B.S. in Biology, medical school at Jefferson Medical College, and internal medicine residency and cardiovascular diseases fellowship at the George Washington University Hospital. Her professional interests include preventive cardiology, medical journalism, and health policy.
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