The path to understanding diabetes starts here
No matter where you are in your fight, here’s where you need to be
Understanding type 1
Here’s what you need to know about type 1 diabetes. The CDC estimates
that nearly 1.6 million Americans have it, including about 187,000 children
and adolescents. Type 1 diabetes occurs at every age, in people of every
race, and of every shape and size. There is no shame in having it, and you
have a community of people ready to support you. Learning as much as
you can about it and working closely with your diabetes care team can give
you everything you need to thrive.
In type 1 diabetes, the body does not produce insulin. The body breaks
down the carbohydrates you eat into blood sugar that it uses for energy—
and insulin is a hormone that the body needs to get glucose from the
bloodstream into the cells of the body. With the help of insulin therapy and
other treatments, everyone can learn to manage their condition and live
long healthy lives.
Remember: this is a condition that can be managed. By living a healthy
lifestyle filled with exercise and proper diet, you can live a normal life and
do everything you set out to do.
Understanding type 2
A1C does it all- It’s called the A1C test, and it’s a powerhouse
The big picture: monitoring treatment
So, what do the numbers mean?
- If your A1C level is between 5.7 and less than 6.5%, your levels have been in the prediabetes range
- If you have an A1C level of 6.5% or higher, your levels were in the diabetes range
Finally: A1C is also defined as ‘estimated average glucose,’ or eAG
Checking Your Blood Sugar
Blood Sugar and Insulin at Work
The basics of high blood sugar
Diabetes is a problem with your body that causes blood sugar (also called
blood glucose) levels to rise higher than normal. This is also
When you eat, your body breaks food down into sugar and sends it into the blood. Insulin then helps move the sugar from the blood into your cells. When sugar enters your cells, it is either used as fuel for energy right away or stored for later use. In a person with diabetes, there is a problem with insulin. But, not everyone with diabetes has the same problem.
There are different types of diabetes — type 1, type 2, and gestational diabetes. If you have diabetes—type 1, type 2, or gestational—your body either doesn’t make enough insulin, can’t use the insulin well, or both.
So, what affects my blood sugar levels?
- A meal or snack with more food or more carbohydrates than usual
- Side effects of medications
- Infection or other illness
- Changes in hormone levels, such as during menstrual periods
- A meal or snack with less food or fewer carbohydrates than usual
- Extra activity
- Side effects of other medications
- Missing a meal or snack
- Drinking alcoholic beverages (especially on an empty stomach)
Look—we know it can be hard to hear that you have diabetes. You feel overwhelmed and confused. You ask yourself, “What now?”
Getting started with type 2
Take your medicine
- How many pills do | take?
- How often should | take them, and when?
- Should | take my medicine on an empty stomach or with food?
- What if | forget to take my medicine and remember later?
- What side effects could | have?
- What should | do if | have side effects?
- Will my diabetes medicine cause a problem with any of my other medicines?
Living with type 1
Overweight? Know the impact
Extra Weight, Extra Risk
Getting started with weight loss
Weight loss can be hard because it involves changing the way you eat and your physical activity. Losing weight also takes time, which can be frustrating. The good news is that you can lose weight and keep it off, even if you’ve never done it before.
Here’s what has worked for some people who have lost weight and kept it
- Cutting back on calories and fat
- Staying physically active most days of the week
- Eating breakfast every day
- Weighing themselves at least once per week
- Watching less than 10 hours of TV per week
Keep a record
Many people find that writing down everything they eat helps keep them on
target. Give it a try—even for just a week—to see where you stand.
Keep a small notebook with you all day. Write down everything you eat and
drink, including the serving size. There are also many free apps and
websites that can help you do this online.
Make a note of what kind of physical activity you do and for how long. It
may also help to write down other information, like when or where you
exercised, who you exercised with, or how you felt before, during, or after
Check your weight at least once a week and write it down, or consider how
your clothes are fitting as a measure of weight loss.
Your support system
Many people find it helpful to meet with people who are also trying to lose
weight—either online or in person. Think about joining a group for weight
loss, exercise, or general support. Or create your own support network by
talking with friends and family about your successes and your struggles.
You may be surprised at how supportive they will be.
Find a walking buddy or friends who also want to improve their health.
Then you can support each other while working toward your goals.
Need more reasons to quit?
Win the Fight to Quit Smoking
Step one: Realize the benefits of quitting
Quitting helps your heart and lungs—and it lowers the risk of hurtingyour blood vessels, eyes, nerves and other organs. And quitting smoking can leave you with fewer wrinkles on your face; better-smelling hair, breath,and clothes; and less exposure for your family to secondhand smoke.
Step two: Prepare to quit
- Set a quit date, and tell your friends and family. Make this a time when your life is fairly calm and stress levels are low
- Think of your reasons for quitting, and write them down. Put the list where you’ll see it every day
- Throw away your cigarettes, matches, lighters and ashtrays
- Ask others for their help and understanding. Ask a friend who smokes to consider quitting with you
Step three: Choose a quitting strategy
- Go cold turkey. Quitting all at once works for some people
- Taper off. Quit smoking gradually by cutting back over several weeks
- Throw away your cigarettes, matches, lighters and ashtrays
- Use a nicotine patch, gum, inhaler or spray. Or ask your doctor for a prescription medicine
- Ask your doctor about counseling, acupuncture or hypnosis
High blood pressure risks
Conquer High Blood Pressure
Nearly 1 in 3 American adults has high blood pressure, and 2 of 3 people
with diabetes report having high blood pressure or take prescription
medications to lower their blood pressure. When your blood pressure is
high, your heart has to work harder and your risk for heart disease, stroke, and other problems goes up. The thing you may not know is that high blood pressure won’t go away without treatment. That could include lifestyle and dietary changes and, if your doctor prescribes it, medication.
What is blood pressure?
Blood pressure is the force of blood flow inside your blood vessels. Your
doctor records your blood pressure as two numbers, such as 120/80, which
you may hear them say as “120 over 80.” Both numbers are important.
The first number is the pressure as your heart beats and pushes blood
through the blood vessels. Healthcare providers call this the “systolic”
pressure. The second number is the pressure when the vessels relax
between heartbeats. It’s called the “diastolic” pressure.
Here’s what the numbers mean:
- Healthy blood pressure: below 120/80
- Early high blood pressure: between 120/80 and 140/90
- High blood pressure: 140/90 or higher
The lower your blood pressure, the better your chances of delaying or
preventing a heart attack or a stroke.
When your blood moves through your vessels with too much force, you
have high blood pressure or hypertension.
When your heart has to work harder, your risk for heart disease and
diabetes goes up. High blood pressure raises your risk for heart attack,
stroke, eye problems and kidney disease.
You should always have an idea of what your blood pressure is, just as you
Know your height and weight.
What can I do about high blood pressure?
Here are some easy tips to help reduce your blood pressure:
- Work with your healthcare provider to find a treatment plan that’s right for you
- Eat wholegrain breads and cereals
- Try herbs and spices instead of salt to flavor foods
- Check food labels and choose foods with less than 400 mg of sodium per
- Lose weight or take steps to prevent weight gain
- Limit alcohol consumption and consult your healthcare provider about
whether it is safe to drink alcohol at all
- If you smoke, get help to quit
- Ask your healthcare provider about medications to help reduce high blood
pressure. Samples of these types of medications include ACE inhibitors,
ARBs, beta blockers, calcium channel blockers, and diuretics
To learn more about the link between high blood pressure and diabetes,
The diabetes-cancer link
Know the Diabetes-Cancer Link
Understand the joint risk factors
Type 2 diabetes and certain cancers share some risk factors. The good
news is that some of these risk factors are within your control to manage:
- Age —As you get older, your risk for both type 2 diabetes and cancer goes
- Gender — Overall, cancer occurs more often in men. Men also have a
slightly higher risk of diabetes than women.
- Race/ethnicity — African Americans and non-Hispanic whites are more
likely to develop cancer. African Americans, Native Americans,
Hispanics/Latinos, and Asian Americans/Pacific Islanders are at higher
risk for developing type 2 diabetes.
- Overweight — Being overweight can increase your risk of type 2 diabetes
and certain types of cancer
- Inactivity — Higher physical activity levels lower the risk of type 2 diabetes
and certain types of cancer
- Smoking — Smoking is linked to several types of cancer. Studies suggest
that smoking is a risk factor for the development of type 2 diabetes
- Alcohol — Drinking more than one drink a day for women or two drinks a day for men raises the risk for both diabetes and cancer
Next, lower your risks
- Lose weight — If you are overweight, even losing just 7% of your weight
(15 pounds if you weigh 200 pounds) can make a big difference. Use
the Body Mass Index (BMI) Calculator to find out how much weight you
need to lose
- Eat healthy — Choose a diet with plenty of:
— Fresh vegetables — The best choices are fresh, frozen, and canned
vegetables and vegetable juices without added sodium, fat, or sugar.
Try to eat at least 3-5 daily servings of vegetables, including
asparagus, broccoli, cabbage, carrots, cauliflower, celery, eggplant,
greens, peppers, snap peas and tomatoes. A serving of vegetables is
2 cup of cooked vegetables or vegetable juice; or 1 cup of raw
— Whole grains — A whole grain is the entire grain, which includes the
bran, germ, and endosperm (starchy part). Shop for cereals and
grains that have the first ingredient with a whole grain such as bulgur
(cracked wheat), whole wheat flour, whole oats/oatmeal, whole grain
corn/corn meal, brown rice, or whole rye. Try to include dried beans,
legumes, peas, and lentils into several meals per week. They are a
great source of protein and are loaded with fiber, vitamins and
— Fruits — Eat fruits that are fresh, frozen, or canned without added
sugars. Common fruits include apples, blackberries, blueberries,
cantaloupe, dates, figs, grapes, oranges, pears, and strawberries.
— Choose healthier options for dairy and meat:
— Low-fat or non-fat dairy products — Choose fat-free or low-fat
(1%) milk, non-fat yogurt (without added sugar), and unflavored
— Lean meats — The best choices are cuts of meats and meat
alternatives that are lower in saturated fat and calories. Include
fish and seafood, poultry without the skin, eggs, and choice
grades of meats trimmed of fat.
— Most importantly, be sure to watch portion sizes
- Stay active — Set a goal to exercise five days a week. Thirty minutes of
brisk walking or a similar activity will work. You can even break it up into 3 10-minute blocks if it is easier to fit in your day. The important thing is to keep moving
- Quit smoking — If you smoke, learn how you can quit. Prepare by setting a date to quit, throwing away your cigarettes, or asking others for help. Then choose a strategy, such as going cold turkey, tapering off, or working with your healthcare professional
Get recommended cancer screenings
Preventative screenings are the next step in staying healthy. Work with
your healthcare provider to see what types of cancer screenings you
should have. Your age and gender will help determine the recommended screenings.
With diabetes, you have a lot on your mind
It’s natural to feel angry
- Take a breath
- Take an even deeper breath
- Get a drink of water
- Sit down
- Lean back
- Shake your arms loose
- Work to silence yourself
- Take a walk
Beware of denial
- “One bite won’t hurt.”
- “This sore will heal itself.”
- “I’ll go to the doctor later.”
- “| don’t have time to do it.”
- “My diabetes isn’t serious.”
Depression can sneak up on anybody
- Loss of interest or pleasure
- Change in sleep patterns
- Waking up earlier than normal
- Change in appetite
- Trouble concentrating
- Loss of energy
- Morning sadness
- Suicidal thought
- Withdrawal from friends and activities
- Declining school and work performance
Type 1 diabetes means using insulin
Oral medications: Getting it right
A quick guide to insulin
- If your largest dose is close to the syringe’s maximum capacity, consider buying the next size up in case your dosage changes
- If you need to measure doses in half units, be sure to choose a syringe that has these markings
- If you’re traveling outside of the U.S., be certain to match your insulin strength with the correct size syringe
How it works
When it comes to insulin, you’ll get to know three terms: Onset, peak time,
and duration. The onset is how long it takes for the insulin to start lowering
your blood sugar. The peak time is when it’s at its maximum strength, and
duration is how long it continues to work.
Here’s a quick look at the different types of insulin. If you need a mix of two
types, you can talk to your doctor about getting a premixed supply.
- Rapid-acting insulin begins to work about 15 minutes after injection,
peaks in about 1 hour, and continues to work for 2 to 4 hours
- Regular or short-acting insulin usually reaches the bloodstream within
30 minutes after injection, peaks anywhere from 2 to 3 hours after
injection, and is effective for approximately 3 to 6 hours
- Intermediate-acting insulin generally reaches the bloodstream about 2
to 4 hours after injection, peaks 4 to 12 hours later, and is effective for
about 12 to 18 hours
- Long-acting insulin reaches the bloodstream several hours after
injection and tends to lower glucose levels fairly evenly over a 24-hour