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Diabetes Information

Taking Care of Your Diabetes Every Day

Chapter 2 of 7

Do six things every day to take care of your diabetes:

Experts say most people with diabetes should try to keep their blood glucose level as close as possible to the level of someone who doesn't have diabetes. The closer to normal your blood glucose is, the lower your chances are of developing serious health problems.

Check with your doctor about the right range for you. The Blood Glucose Targets table shows target blood glucose ranges.

Your health care team will help you learn how to reach your target blood glucose range. Your team may include a doctor, a nurse, a dietitian, and others.

Drawing of a male patient talking with a female health care provider. On the table in front of them are a blood glucose meter, a booklet, and a coffee cup.
When you see your health care provider, ask lots of questions. Before you leave, be sure you understand everything you need to know about taking care of your diabetes.

A diabetes educator is a health care worker who teaches people how to manage their diabetes. Your educator may also be a nurse, a dietitian, or other kind of health care worker.

A dietitian is someone who's specially trained to help people plan their meals. For more information about these health care providers, and for help in finding them see "Where to Get More Help with Your Diabetes".

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Follow your meal plan

You should have your own meal plan. Ask your doctor to give you the name of a dietitian who can work with you to develop a meal plan. Your dietitian can help you plan meals that include foods that you and your family like to eat and that are good for you too. Ask your dietitian to include foods that are heart-healthy to reduce your risk of heart disease.

Your diabetes meal plan will include breads, cereals, rice, and grains; fruits and vegetables; meat and meat substitutes; dairy products; and fats. People with diabetes don't need to eat special foods. The foods on your meal plan are good for everyone in your family! Making wise food choices will help you

  • reach and stay at a weight that's good for your body
  • keep your blood glucose, blood pressure, and cholesterol under control
  • prevent heart and blood vessel disease

Action Steps
If You Use Insulin


  • Follow your meal plan.
  • Don't skip meals, especially if you've already taken your insulin, because your blood glucose may go too low. See "What You Need to Know about High Blood Glucose" for information about how to handle low blood glucose, also called hypoglycemia.

Printer-friendly version of the "Action Steps If You Use Insulin"

Action Steps
If You Don't Use Insulin


  • Follow your meal plan.
  • Don't skip meals, especially if you take diabetes medicines, because your blood glucose may go too low. Eat several small meals during the day instead of one or two big meals.

Printer-friendly version of the "Action Steps If You Don't Use Insulin"

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Be Physically Active

Physical activity helps you stay healthy. Try walking, swimming, dancing, riding a bicycle, playing baseball, or bowling. You can even get exercise when you clean your house or work in your yard. Physical activity is especially good for people with diabetes because it

  • helps keep weight down
  • helps insulin work better to lower blood glucose
  • is good for your heart and lungs
  • gives you more energy

Before you begin exercising, talk with your doctor. Your doctor may check your heart and your feet to be sure you have no special problems. If you have high blood pressure or eye problems, some exercises like weightlifting may not be safe. Your health care team can help you find safe exercises.

Drawing of a man playing with a dog outside. The dog is chasing a disc.
Being active helps you stay healthy.

Try to be active almost every day for a total of about 30 minutes. If you haven't been very active lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day.

If you use insulin or take diabetes pills that help your body make insulin, you may need to eat a snack before you exercise. Check your blood glucose before you exercise. If your blood glucose is below 100, have a snack before you exercise.

Action Steps
If You Use Insulin


  • See your doctor before starting a physical activity program.
  • Check your blood glucose before, during, and after exercising. Don't exercise when your blood glucose is high and you have ketones in your blood or urine. See "Tests for Ketones" for information about ketones.
  • Don't exercise right before you go to sleep because it could cause low blood glucose during the night.

Printer-friendly version of the "Action Steps If You Use Insulin"

Action Steps
If You Don't Use Insulin


  • See your doctor before starting a physical activity program.
  • Ask your doctor about whether you need to eat before you exercise.

Printer-friendly version of the "Action Steps If You Don't Use Insulin"

When you exercise, carry glucose tablets or a carbohydrate snack with you in case you have low blood glucose. Wear or carry an identification tag or card that says you have diabetes.

The groups listed on "How to Find Programs about Diabetes" and "How to Get More Information about Diabetes" have more information about diabetes and physical activity.

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Take Your Diabetes Medicines Every Day

Three kinds of diabetes medicines can help you reach your blood glucose targets: pills, insulin, and other injectable medicines.

Drawing of a woman standing at a kitchen counter drinking from a glass. A pill bottle is on the counter next to her.
Many people with type 2 diabetes take pills to help keep blood glucose in their target range.

If You Take Diabetes Pills

If your body makes insulin but the insulin doesn't lower your blood glucose enough, you may need diabetes pills. Some pills are taken once a day, and others are taken more often. Ask your health care team when you should take your pills. Be sure to tell your doctor if your pills make you feel sick or if you have any other problems.

Sometimes, people who take diabetes pills may need insulin for a while. If you get sick or have surgery, the diabetes pills may no longer work to lower your blood glucose.

You may be able to stop taking diabetes pills if you lose weight. Always check with your doctor before you stop taking your diabetes pills. Losing 10 or 15 pounds can help you reach your target blood glucose levels.

If You Use Insulin

You need insulin if your body has stopped making insulin or if it doesn't make enough. Everyone with type 1 diabetes needs insulin, and many people with type 2 diabetes do too. Some women with gestational diabetes also need to take insulin.

Drawing of a woman holding a bottle of insulin and looking at it.
You may need insulin to control your blood glucose.

Your doctor can tell you which of these ways to take insulin is best for you.

  • Taking shots, also called injections. You'll use a needle attached to a syringe-a hollow tube with a plunger-that you fill with a dose of insulin. Some people use an insulin pen, a pen-like device with a needle and a cartridge of insulin.

  • Using an insulin pump. A pump is a small device, worn on a belt or in a pocket, that holds insulin. The pump connects to a small plastic tube and a very small needle. The needle is inserted under the skin and stays in for several days.

  • Using an insulin jet injector. This device sends a fine spray of insulin through the skin with high-pressure air instead of a needle.

  • Using an insulin infuser. A small tube is inserted just beneath the skin and remains in place for several days. Insulin is injected into the end of the tube instead of through the skin.

If You Use Other Injectable Medicines

Some people with diabetes use other injectable medicines to reach their blood glucose targets. These medicines are not substitutes for insulin.

If You Don't Use Pills, Insulin, or Other Injectable Medicines

Many people with type 2 diabetes don't need diabetes medicines. They can take care of their diabetes by using a meal plan and exercising regularly.

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Check Your Blood Glucose as Recommended

You'll want to know how well you're taking care of your diabetes. One way to find out is to check your blood to see how much glucose is in it. If your blood has too much or too little glucose, you may need a change in your meal plan, physical activity plan, or medicines.

Drawing of a man looking at his blood glucose meter.
Checking your blood glucose will help you see if your diabetes treatment plan is working.

Ask your doctor how often you should check your blood glucose. Some people check their blood glucose once a day. Others do it three or four times a day. You may check before and after eating, before bed, and sometimes in the middle of the night.

Your doctor or diabetes educator will show you how to check your blood using a blood glucose meter. Your health insurance or Medicare may pay for the supplies and equipment you need.

Your health care team should also check your blood glucose levels with a lab test called the A1C test. See "The A1C Test" more information about the A1C test.

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Take Other Tests for Your Diabetes

Tests for Ketones

You may need to check your blood or urine for ketones if you're sick or if your blood glucose is above 240. Your body makes ketones when you burn fat instead of glucose for energy. Ketones can make you very sick. If you have ketones, you are at risk for having a serious condition called ketoacidosis. If ketoacidosis isn't treated, it can cause death. Signs of ketoacidosis are vomiting, weakness, fast breathing, and a sweet smell on the breath. Ketoacidosis is more likely to develop in people with type 1 diabetes.

Your doctor or diabetes educator will show you how to test for ketones.

The A1C test

Another test for blood glucose, the A1C, also called the hemoglobin A1C test, shows what your average blood glucose was for the past 2 to 3 months. The doctor does this test to see what your blood glucose is most of the time. Have this test done at least twice a year.

Ask your doctor what your A1C test showed. A result of below 7 usually means that your diabetes treatment is working well and your blood glucose is under control. If your A1C is higher, your blood glucose may be too high. You'll then have a greater risk of having diabetes problems, like kidney damage. You may need a change in your meal plan, physical activity plan, or diabetes medicines.

Talk with your doctor about what your target should be. Your personal target may be lower or higher than the target shown below. Even if your A1C is higher than your target, remember that every step toward your goal helps reduce your risk of diabetes problems.

A1C results

Target for most people with diabetes below 7
Time to change my diabetes care plan 8 or above
My last result __________
My target below __________

Printer-friendly version of A1C results form

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Keep Daily Records

Make copies of the daily diabetes record page. Then write down the results of your blood glucose checks every day. You may also want to write down what you ate, how you felt, and whether you exercised.

By keeping daily records of your blood glucose checks, you can tell how well you're taking care of your diabetes. Show your blood glucose records to your health care team. They can use your records to see whether you need changes in your diabetes medicines or your meal plan. If you don't know what your results mean, ask your health care team.

Action Steps
If You Use Insulin


Keep a daily record of

  • your blood glucose numbers
  • the times of the day you took insulin
  • the amount and type of insulin you took
  • whether you had ketones in your blood or urine

Printer-friendly version of the "Action Steps If You Use Insulin"

Things to write down every day in your record book are

  • results of your blood glucose checks
  • your diabetes medicines: times and amounts taken
  • if your blood glucose was very low-see "When Your Blood Glucose Is Too High or Too Low"
  • if you ate more or less food than you usually do
  • if you were sick
  • if you found ketones in your blood or urine
  • what kind of physical activity you did and for how long

Action Steps
If You Don't Use Insulin


Keep a daily record of

  • your blood glucose numbers
  • the times of the day you took your diabetes medicines
  • your physical activity

Printer-friendly version of the "Action Steps If You Don't Use Insulin"

This sample of a daily record page shows blood glucose and medicine recorded for each day of the week. In the last column notes can be added.
Sample of a record page for a person who doesn't use diabetes medicines.

Printer-friendly version of sample record page

Printer-friendly version of blank record page

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From the NDIC
October 2008
http://diabetes.niddk.nih.gov/dm/pubs/type1and2/daily.aspx


 

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