The path to understanding diabetes starts here

No matter where you are in your fight, here’s where you need to be

Whether you’ve been newly diagnosed, have been fighting against type 1 or type 2 diabetes for a while, or are helping a loved one, you’ve come to the right place. This is the start of gaining a deeper understanding of how you can live a healthier life—with all the tools, health tips, and food ideas you need. Wherever you’re at with this disease, know that you have options and that you don’t have to be held back. You can still live your best life. All you have to do is take action and stick with it.

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

Type 2 diabetes is the most common form of diabetes—and it means that your body doesn’t use insulin properly. And while some people can control their blood sugar levels with healthy eating and exercise, others may need medication or insulin to help manage it. Regardless, you have options— and tools, resources, and support to help you fight. A key part of managing type 2 diabetes is maintaining a healthy diet. You need to eat something sustainable that helps you feel better and still makes you feel happy and fed. Remember, it’s a process. Work to find helpful tips and diet plans that best suit your lifestyle—and how you can make your nutritional intake work the hardest for you. Fitness is another key to managing type 2. And the good news, all you have to do is get moving. The key is to find activities you love and do them as often as you can. No matter how fit you are, a little activity every day can help fight type 2 and put yourself in charge of your life.

Understanding A1C

A1C does it all- It’s called the A1C test, and it’s a powerhouse

It can identify prediabetes, which raises your risk for diabetes. It can be used to diagnose diabetes. And it’s used to monitor how well your diabetes treatment is working over time. It’s also a critical step in forming your game plan to manage diabetes with your diabetes care team.

The big picture: monitoring treatment

This relatively simple blood test can tell you a lot. The test results give you a picture of your average blood sugar level over the past two to three months. The higher the levels, the greater your risk of developing diabetes complications. Your doctor will tell you how often you need the A1C test, but usually you’ll have the test at least twice a year if you’re meeting your treatment goals. If you’re not meeting your goals or you change treatments, you may need to get an A1C test more often.

So, what do the numbers mean?

When it comes to the numbers, there’s no one-size-fits-all target. A1C target levels can vary by each person’s age and other factors, and your target may be different from someone else’s. The goal for most adults with diabetes is an A1C that is less than 7%. A1C test results are reported as a percentage. The higher the percentage, the higher your blood sugar levels over the past two to three months. The A1C test can also be used for diagnosis, based on the following guidelines:
  • 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

Another term you may come across when finding out your A1C is eAG. Your doctor might report your A1C results as eAG.eAG is similar to what you see when monitoring your blood sugar at home on your meter. However, because you are more likely to check your blood sugar in the morning and before meals, your meter readings will likely be lower than your eAG.

Checking Your Blood Sugar

Blood Sugar and Insulin at Work

Understanding how sugar (glucose) and insulin work in your body is the foundation for knowing how diabetes works. By knowing what can affect your blood sugar levels, you can better manage it.

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
called hyperglycemia.

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.

Type 1

In type 1 diabetes, your immune system mistakenly treats the beta cells in your pancreas that make insulin as foreign invaders and destroys them. This can happen over a few weeks, months, or years. When enough beta cells are gone, your pancreas stops making insulin, or makes so little insulin that you need to take insulin to live. Type 1 diabetes develops most often in young people but can also appear in adults.

Type 2

If you have type 2 diabetes, your body does not use insulin properly. This is called insulin resistance. At first, the beta cells make extra insulin to make up for it. But, over time your pancreas can’t make enough insulin to keep your blood sugar at normal levels. Type 2 diabetes develops most often in middle-aged and older adults but can appear in young people. Some people can manage type 2 diabetes with healthy eating and exercise. However, your doctor may need to prescribe oral medications (pills) and/or insulin to help you meet your target blood sugar levels. Diabetes is a progressive disease. Even if you don’t need to treat your diabetes with medications at first, you may need to over time.

Gestational Diabetes

Gestational diabetes is diabetes that develops during pregnancy. For most women, blood sugar levels will return to normal after giving birth. And if you’ve had gestational diabetes, you will need to be tested regularly since you are at much higher risk for developing type 2 diabetes later in life.

So, what affects my blood sugar levels?

It is important to understand what can make your blood sugar rise or fall, so that you can take steps to stay on target. Things that can make blood sugar rise include:
  • A meal or snack with more food or more carbohydrates than usual
  • Inactivity
  • Side effects of medications
  • Infection or other illness
  • Changes in hormone levels, such as during menstrual periods
  • Stress
Things that can make blood sugar fall include:
  • 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?”

Well, the good news is you have a community to fall back on. You don’t have to maneuver this by yourself. You have the support of countless others who have felt the same shock. Your diagnosis is simply the first step. There are ways you can manage your diabetes—through diet, exercise, medical support and emotional help. Dig in. Take action. And know that we have everything you need to help you live a long, healthy life surrounded by people who know exactly what you’re going through.

Getting started with type 2

To use glucose as energy, your body needs insulin. But with type 2 diabetes, your body doesn’t make enough insulin or doesn’t use it well— and your body’s cells can’t use glucose for the energy it needs. When glucose stays in your blood, it can cause serious problems. While there is no cure for type 2 diabetes, there are ways to manage your condition—through a balanced diet, an active lifestyle and (in some cases) medicine.

Take your medicine

Medicine can be another key to managing your type 2 diabetes. Work with your doctor to see what medicines can help you keep your blood sugar in your target range. Some people take both pills and insulin or insulin by itself. If you’re starting new medicines, ask your doctor, pharmacist or diabetes educator the following questions:
  • 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

If you have type 1 diabetes, it means that your pancreas does not produce insulin. It requires monitoring your blood sugar and administering multiple daily insulin injections with a pen, syringe, or a pump. If you’ve just learned you have type 1 diabetes, know that you have an array of tools at your disposal to help you manage it. Finding ways to manage your blood sugar levels, managing your insulin intake, diet, exercise, and working with your diabetes care team can help you feel healthier and help you stay on top of your condition.
Remember, millions of people live healthy lives with type 1. Find others with type 1 and ask them what they do to stay healthy. You may be curious about an insulin pump, and find someone who uses one. You can get tips and tricks that will make life just a little bit easier. The important thing is to share your feelings with those around you and don’t feel shame in asking for help. Reaching out is key to living a vital life with type 1.


Overweight? Know the impact

If you’re overweight, it impacts more than your risk of developing type 2 diabetes. It leads to unhealthy cholesterol, high blood pressure, heart disease, high blood sugar, and even stroke. The good news? Losing just 10-15 pounds can make a big difference.

Extra Weight, Extra Risk

Being overweight raises your risk for type 2 diabetes, heart disease, and stroke. It can also increase the risk of high blood pressure, unhealthy cholesterol, and high blood glucose (sugar). If you are overweight, losing weight may help you prevent and manage these conditions. And you don’t have to lose a lot to improve your health—even losing 10-15 pounds can make a big difference.

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
Small steps
Most people find it easier to make healthy changes in a few small steps instead of all at once. Set realistic goals within a timeframe that works for you, and don’t let stalls or setbacks throw you off course.

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?

You already know smoking is bad for you. What you may not know is that it reduces the amount of oxygen that reaches your organs and causes a range of issues, from high blood pressure and unhealthy cholesterol to heart attack and stroke.

Win the Fight to Quit Smoking

It is no secret that smoking is bad for your health. Smoking hurts your lungs and your heart. It lowers the amount of oxygen that gets to your organs, raises your bad cholesterol and raises your blood pressure. All of these can raise your risk of heart attack or stroke. If you don’t smoke, that’s great. Make a plan to never start. If you do smoke, there is something you can do: challenge yourself to quit smoking. Here are some steps to help you do it.

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

Quitting is hard work, so approach it like any major project. Before you 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
You can use one of these steps or a combination of them. When you do, you’ll feel healthier right away, and you’ll be healthier for the rest of your life.

High blood pressure risks

lf you have high blood pressure, you’re not alone; it affects nearly 1 in 3 American adults. High blood pressure makes your heart work harder, which raises your risk of heart disease, stroke, and other problems. And you may need medication to get it under control, fast.
Remember, millions of people live healthy lives with type 1. Find others with type 1 and ask them what they do to stay healthy. You may be curious about an insulin pump, and find someone who uses one. You can get tips and tricks that will make life just a little bit easier. The important thing is to share your feelings with those around you and don’t feel shame in asking for help. Reaching out is key to living a vital life with type 1.

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

Researchers are continuing to explore the link between type 2 diabetes and certain cancers. The two share some risk factors, from age, gender, and ethnicity to lifestyle factors like inactivity, smoking, and alcohol.

Know the Diabetes-Cancer Link

Researchers are still trying to learn more about the link between type 2 diabetes and certain cancers, including:
  • liver
  • pancreas
  • uterus
  • colon
  • breast
  • bladder

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

    soy milk.

    — 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

Tracking your blood sugar levels, dosing insulin, planning your meals, staying active—it’s a lot to think about. It can leave you feeling run down, emotionally drained and completely overwhelmed. It’s called diabetes burnout. And that’s why it’s important to stay in touch with your emotions as you manage your diabetes. What are you feeling? Stressed out? Angry? Sad? Scared? Take time to take inventory of your emotions and reach out to those around you to talk honestly and openly about how you feel. Better yet, find a mental healthcare provider to guide you through the emotional terrain around your disease. With diabetes, feeling physically good is half the battle. Feeling mentally good is the other half.

It’s natural to feel angry

It can start with your diagnosis. It can go from “why me?” to pure rage at your disease. Anger is an important part of your journey toward accepting your life with diabetes. And while it can feel good and empowering, out-of- control anger can be harmful to you and those around you—and it can lead to depression and stress. The key to dealing with your anger starts with being able to identify what’s making you angry. Is it fear? Is it loss of control? Is it anger at yourself? As you find yourself getting angry, try to identify its root cause—and then work to transcend it. When you feel anger, there are a number of things you can do to short circuit it:
  • 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

As with pretty much every emotion you feel when you’re diagnosed with diabetes, denial is natural. Everyone feels that sense of, “not me,” or “I don’t believe it,” or “there must be some mistake.” But at some point, you have to accept your diagnosis and take action. By continuing to deny it, you run the risk of not taking action to fight the disease and keep yourself healthy. An important part of steering out of denial is recognizing how it sounds in your head—and how it makes you avoid critical care. If you catch yourself saying or thinking any of the following phrases, you may be in 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.”
Everyone goes into denial from time to time—tbut there are things you can do to make sure you don’t stay there. Work with your diabetes care team to make a plan and set your goals. Ask your diabetes educator for help and be accountable to them. And tell your family and friends how they can help you stick to your treatment plan.

Depression can sneak up on anybody

Sometimes, there’s a sadness or an emotional flatness that just won’t go away. Sometimes, you just feel hopeless—and have no idea what comes next. However it shows up, depression can be hard to detect and can wreak havoc with your self care. Spotting depression is important—and it’s important to check for these symptoms:
  • Loss of interest or pleasure
  • Change in sleep patterns
  • Waking up earlier than normal
  • Change in appetite
  • Trouble concentrating
  • Loss of energy
  • Nervousness
  • Guilt
  • Morning sadness
  • Suicidal thought
  • Withdrawal from friends and activities
  • Declining school and work performance
If you feel like you might be depressed, talk with your doctor. See if it makes sense to talk to a psychotherapist or counselor and then work to overcome it. It takes time for depression to lift, but once you have the proper emotional tools in place, you can learn to recognize the symptoms and act fast.

Type 1 diabetes means using insulin

However, if you have type 2 diabetes, treatment plans can change depending on who you are. Some people can manage it with healthy eating and exercise, or with oral medications, while others may also need to use insulin. It’s common for your medication needs to change over time. And that’s a good thing. The most important thing is to get to feeling your best.

Oral medications: Getting it right

There are many different types of drugs that can work in different ways to lower your blood sugar. Sometimes one medication will be enough, but in other cases, your doctor may prescribe a combination of medications. Talking to your doctor to understand what is being prescribed and how it works can be helpful. And keeping an open mind helps, too.

A quick guide to insulin

There are many different types of drugs that can work in different ways to lower your blood sugar. Sometimes one medication will be enough, but in other cases, your doctor may prescribe a combination of medications. Talking to your doctor to understand what is being prescribed and how it works can be helpful. And keeping an open mind helps, too.
  • 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
More Information