Diabetes medications & treatments

Diabetes is a condition in which the body is unable to properly regulate blood sugar levels. This can be due to either a lack of insulin (Type 1 diabetes) or a resistance to insulin (Type 2 diabetes). Over time, high blood sugar levels can lead to serious health complications, including heart disease, kidney disease, and blindness. Treatment for diabetes typically focuses on managing blood sugar levels through diet, exercise, and medication. With proper treatment, many people with diabetes are able to live long and healthy lives.

What is diabetes?

Diabetes mellitus, usually just called diabetes, is a collection of diseases. They all affect your body’s ability to use glucose in your blood.

When you eat and drink, your digestive system breaks down the food and drink into smaller molecules like fats, proteins, and sugars. Glucose, which is a type of sugar used by your cells for energy, is absorbed into your bloodstream as you digest. It’s then transported around your body in your blood so it can be taken to the cells that need it.

A hormone called insulin then helps your cells absorb glucose from your blood. Insulin is made by your pancreas and is secreted into your bloodstream so it can accompany the glucose.

Diabetes affects this. It can cause you to not produce enough insulin, or for your insulin to not work as well as it should do. In both cases, this limits how much glucose your cells can absorb and can cause your blood glucose levels to be too high.

Having high blood glucose levels can lead to serious health problems, including strokes, heart disease, and organ damage.

Diabetes is a common condition. In the US, an estimated 41.4 million adults have diabetes. This is around 16% of the adult population.

Types of diabetes

Diabetes is a group of diseases. Three types of diabetes are usually recognized, type 1, type 2, and gestational diabetes.

What is type 1 diabetes?

Type 1 diabetes is a long-lasting condition (chronic diabetes). It used to be called juvenile diabetes, as it often emerges during childhood, or insulin-dependent diabetes, as you treat it by taking insulin.

Type 1 diabetes causes you to have high blood glucose levels because your pancreas doesn’t produce enough insulin. It can’t be cured once you develop it, but it can be managed, to limit the damage it can cause.

What is type 2 diabetes?

Type 2 diabetes is a form of diabetes caused by a mixture of both insulin resistance (when insulin doesn’t work as effectively as it should), and your pancreas not producing enough insulin.

Unlike type 1 diabetes, in many cases, type 2 diabetes can be reversed and cured by making lifestyle changes and taking medication. It used to be called adult-onset diabetes, as it most often comes on in adulthood, or non-insulin-dependent diabetes, as you usually don’t need to take insulin if you have it.

What is gestational diabetes?

Gestational diabetes is a form of diabetes that can happen to a mother during pregnancy. It can affect women with no history of diabetes. It’s caused by hormones produced by the pancreas blocking insulin, meaning glucose builds up in the mother’s blood. Gestational diabetes can usually be managed with diet changes and exercise. In severe cases, a mother may need to take insulin. Gestational diabetes usually clears up once the pregnancy is over.

Prediabetes

Prediabetes is a similar condition to type 2 diabetes, which causes high blood glucose levels. It’s a milder condition but is usually seen as an indication that you’re at risk of developing type 2 diabetes.

What is prediabetes?

Prediabetes is a condition where your blood glucose levels are high, but not high enough to count as diabetes.

Normal blood glucose levels are around 70 to 99 milligrams per deciliter (mg/dL). A fasting blood glucose level for someone with diabetes is usually over 126 mg/dL. If you have blood glucose levels between 100 and 125 mg/dL you’re considered to have prediabetes.

Prediabetes is usually viewed as a warning sign that you’re at risk of developing type 2 diabetes.

Prediabetes symptoms

Prediabetes usually doesn’t cause any noticeable symptoms. It can make dark patches form on your skin, usually on your elbows, knees, knuckles, neck, and in your armpits. This doesn’t happen with every case however and may be mistaken for other conditions. Prediabetes is most often diagnosed from blood tests done during routine checkups.

Risk factors for prediabetes

The factors that put you at risk of developing prediabetes are the same as those that put you at risk of type 2 diabetes. They include:

• Being overweight
• Having a large waist size and storing fat around your stomach
• A poor diet, particularly one high in sugar, processed food, and red meat
• Smoking tobacco
• Being physically inactive – not taking regular physical exercise and spending large parts of the day sitting still
• Having high blood pressure and/or cholesterol
• Having a family history of prediabetes or type 2 diabetes
• Having obstructive sleep apnea
• Having polycystic ovary syndrome
• Having or previously having gestational diabetes
• Being over 45 years of age
• Having African American, Hispanic, Native American, Asian American, or Pacific Islander ancestry

How to reverse prediabetes?

If prediabetes is left untreated, it has a high likelihood of developing into type 2 diabetes. The good news is that it isn’t inevitable. You can lower your blood glucose levels by making changes to your lifestyle, including:

• Losing excess weight
• Taking regular exercise (the Office of Disease Prevention and Health Promotion recommends 150 minutes of exercise per week for adults)
• Reducing your blood pressure and cholesterol to healthy levels
• Eating a healthy diet. A good diet for prediabetes is high in fruits, vegetables, whole grains, lean meats, and fats that come from plants and nuts

Diabetes symptoms

Whether you have type 1 or type 2 diabetes, your symptoms are caused by having too much glucose in your blood.

Generally, this causes the following symptoms:

• Increased thirst
• Urinating more often
• Increased hunger
• Fatigue
• Sores and cuts on your skin are slow to heal
• Recurring infections
• Blurred vision

Type 1 diabetes symptoms

In addition to the above general diabetes symptoms, type 1 diabetes can also cause:

• Unintended weight loss
• Mood swings

Type 2 diabetes symptoms

As well as the general diabetes symptoms above, type 2 diabetes can cause:

• Recurring infections may be more common

Gestational diabetes symptoms

In some cases, gestational diabetes can give you symptoms that include:

• Increased thirst
• Urinating more frequently

Diabetes causes

In most cases, however, gestational diabetes usually doesn’t cause any noticeable symptoms. It’s usually identified through a routine blood sugar test or a glucose tolerance test carried out during pregnancy.

Diabetes symptoms in men

As well as the general symptoms of diabetes, men may also experience:

• Reduced muscle strength
• Decreased sex drive
• Erectile dysfunction (an inability to get or keep an erection firm enough for sex)

Diabetes symptoms in women

In addition to the general diabetes symptoms, women may experience:

• Vaginal yeast infections
• Urinary tract infections
• Dry and irritated skin

Symptoms of diabetes in children

Type 1 diabetes often starts in childhood. Type 2 diabetes is less common, but as more children are becoming overweight, type 2 diabetes is becoming more prevalent in children.

Knowing the symptoms of type 1 and type 2 diabetes in children can help you recognize it quickly, helping you get your child the treatment they need as fast as possible.

The symptoms of type 1 diabetes in children are broadly the same as in adults, and include:

• Increased thirst
• Urinating more frequently, including wetting the bed when they previously didn’t
• Increased hunger
• Fatigue
• Sores and cuts on the skin are slow to heal
• Getting infections more often
• Blurred vision

The symptoms of type 2 diabetes in children are usually the same. Some children with type 2 diabetes don’t exhibit any symptoms, however, and the condition is only identified through a blood test.

To help you look out for symptoms in children, it is recommended you pay attention to the 4 Ts that can be warning signs of childhood diabetes:

1. Toilet: Heavier diapers in babies, your child using the bathroom more often, and unusual bedwetting
2. Thirsty: Drinking more than usual and not being unable to quench their thirst
3. Tired: Your child feels more tired than usual
4. Thinner: Your child loses weight or looks thinner than usual

When to see your doctor?

If you think you or your child has diabetes, if you notice any of the symptoms or warning signs, contact your doctor as soon as possible. The earlier diabetes is diagnosed, the sooner treatment can begin, and the risk of complications can be reduced.

What causes diabetes?

Diabetes results in you having too much glucose in your blood. This can happen for different reasons with type 1, type 2, and gestational diabetes, but they all involve the hormone insulin. Insulin is secreted by your pancreas and it helps your cells absorb glucose from your blood.

Causes of type 1 diabetes

Type 1 diabetes is an autoimmune disease. It’s caused by your immune system mistakenly attacks the cells in your pancreas (beta cells) that make insulin. This reduces how much insulin you have in your body which limits how much glucose your cells can absorb from your blood.

What causes your immune system to attack beta cells in your pancreas isn’t fully understood. Type 1 diabetes runs in families, so it is partly genetic, and several genes have been identified that make you more likely to develop it.

It’s likely that your genetics can make you vulnerable to diabetes, but that events in your life trigger it. Research has shown that viral infections may be triggers and that a protein found in gluten may also be a dietary trigger.

Unlike type 2 diabetes, being overweight and sedentary aren’t causes of type 1 diabetes.

Causes of type 2 diabetes

Type 2 diabetes is caused by your body becoming resistant to insulin, although you may not produce enough insulin too.

Insulin resistance means insulin doesn’t work on your cells as well as it should. This stops your cells from absorbing glucose as effectively, which causes your blood glucose levels to rise. Resistance can happen gradually over time, meaning your blood glucose rises slowly, and symptoms come on gradually.

What makes your cells become resistant to insulin isn’t well understood. Like type 1 diabetes, it’s thought that your genetics can make you vulnerable to developing insulin resistance. Type 2 diabetes is more related to your lifestyle though. You’re more likely to develop type 2 diabetes if you’re overweight, have a poor diet, and have a sedentary lifestyle.

What causes gestational diabetes?

Gestational diabetes can develop in pregnant women. It’s thought to be caused by the placenta releasing hormones that block insulin and stop it from working effectively. This reduces how much glucose is absorbed from the blood, causing blood glucose levels to rise. You’re more likely to develop gestational diabetes if you’re overweight or gain too much weight during pregnancy.

Diabetes risk factors

Each diabetes condition has risk factors that increase your chances of developing it.

Type 1 diabetes risk factors

You’re more likely to develop type 1 diabetes if you:

• Have a parent or sibling with type 1 diabetes
• Have copies of certain genes associated with the condition
• Are between the ages of 4 and 7, and 10 and 14. Although type 1 diabetes can appear at any age, it emerges most often between these ages.

Type 2 diabetes risk factors

You’re more likely to develop type 2 diabetes if you:

• Have a parent or sibling with type 2 diabetes or prediabetes
• Are 45 or older
• Are overweight
• Have a large waist size and store fat around your stomach
• Eat a poor diet, particularly one high in sugar, processed food, and red meat
• Smoke tobacco
• Don’t exercise regularly
• Have high blood pressure, high cholesterol, or high triglycerides (fats in your blood)
• Have obstructive sleep apnea
• Have polycystic ovary syndrome
• Have prediabetes
• Have had gestational diabetes
• Have African American, Hispanic, Native American, Asian American, or Pacific Islander ancestry

Risk factors for gestational diabetes

Your chances of developing gestational diabetes increase if you:

• Are overweight
• Are 25 or older
• Had gestational diabetes in a past pregnancy
• Have previously given birth to a baby weighing over 9 pounds
• Have a parent or sibling with type 2 diabetes or prediabetes
• Have polycystic ovary syndrome

Complications of diabetes

Having high blood glucose levels can harm your body and cause serious health problems. Complications can come on slowly, often over the course of many years. The higher your glucose levels, and the longer you have them, the worse the complications become.

Type 1 diabetes complications and type 2 diabetes complications are broadly the same. Both diseases cause the most harm by damaging blood vessels and nerves in your body. This can then harm the organs that the blood vessels and nerves supply. This can cause:

• Heart disease, particularly coronary heart disease
• Heart attacks
• Strokes (an interruption of the blood supply to your brain)
• Diabetic kidney disease – a type of serious kidney disease that can reduce your kidney function and even cause kidney failure
• Retinopathy – blood vessel damage in your retina that can cause vision loss and blindness. Other diabetic eye complications include a greater risk of developing glaucoma and cataracts
• Hearing loss – damage to the blood vessels and nerves in your inner ear can reduce your hearing and cause deafness

Damage to nerves and blood vessels can also lead to:

• Neuropathy – numbness, tingling, pain, and muscle weakness caused by nerve damage, often in your hands and feet
• Skin damage, like cuts and sores, can be slow to heal, and increases your risk of contracting bacterial and fungal infections in your skin
• Damage to your feet, which can lead to ulcers, and eventually toe, foot, or leg amputations

Other complications include:

• Alzheimer’s disease and dementia – it’s not known how diabetes causes this, but raised blood glucose levels increase your risk of developing these diseases and other cognitive problems
• Depression – people with either type 1 or type 2 diabetes are twice as likely to develop depression than people without it

Gestational diabetes complications

Gestational diabetes can harm both the mother and the baby.

For the unborn baby, complications can include:

• Premature birth
• A higher than normal rate of growth inside the womb
• Jaundice
• Very low blood sugar at birth
• An increased risk of prediabetes and type 2 diabetes later in life
• An increased risk of stillbirth

Complications in the mother can include:

• A greater chance of birth complications caused by having a large baby, including needing to have a cesarean section
• A condition called preeclampsia that can raise your blood pressure, cause swelling in your hands and feet. Preeclampsia can also lead to other dangerous complications
• An increased risk of gestational diabetes in subsequent pregnancies
• An increased risk of developing prediabetes and type 2 diabetes

Diabetes diagnosis

Diabetes is usually diagnosed using a blood test. Often the test is repeated more than once to make sure the results are representative and accurate.

Tests for type 1 and type 2 diabetes and prediabetes

• Glycated hemoglobin (A1C) test – this is the most common type of diabetes test in the US. Your blood is drawn, then the test calculates how much glucose is attached to your blood cells. This can give a measure of your average blood glucose levels over the previous two to three months.

A result below 5.7 is normal. Between 5.7 and 6.4 is considered prediabetes. If you have a score of 6.5 or above on two separate tests, you have diabetes.

If the A1C test isn’t available or suitable for you, your doctor may use one of these tests instead:

• Fasting blood sugar test – your blood is drawn after you’ve not eaten for some time, usually overnight. The test then measures the amount of glucose in your blood. A score of 100 mg/dL or below is normal. A score between 100 to 125 mg/dL is considered prediabetes. A score of over 125 mg/dL means you have diabetes.

• Random blood sugar test – this is similar to the above test, but you don’t fast before the test, and the blood is taken at random. A score of 100 mg/dL or below is normal. A score between 100 and 120 mg/dL is considered prediabetes. A score of over 120 mg/dL usually means you have diabetes.

• Oral glucose tolerance test – with this test, you first have a fasting blood sugar test. You then drink a sugary drink, and your blood is taken again at repeated intervals. The fasting level measures your blood glucose level when it’s low to give a baseline, then the subsequent blood tests show how your body reacts to the sugary drink.

Generally, after two hours, a score of 140 mg/dL or less is normal. A score between 140 to 199 mg/dL is considered prediabetes. A score over 200 mg/dL suggests you have diabetes.

Type 1 diabetes diagnosis

If a blood test indicates you may have diabetes, and the doctor suspects that it’s type 1 diabetes, you usually then have two other tests. Your doctor might suspect your diabetes is type 1 if your symptoms come on quickly and if you have risk factors for type 1 diabetes.

You’ll likely have a ketone test. Ketones are produced when your body uses fat for energy, rather than glucose or other sugars. People with type 1 diabetes usually have higher ketone levels, as they can’t get enough energy from the glucose in their blood. The test measures the level of ketones in your urine.

You’ll probably also have a blood test that measures the level of immune system antibodies in your blood called autoantibodies. Type 1 diabetes is caused by your immune system damaging beta cells in your pancreas. The presence of autoantibodies in your blood would suggest this is happening.

Type 2 diabetes diagnosis

Whereas the symptoms of type 1 diabetes usually come on quickly, the symptoms of prediabetes and type 2 diabetes can come on much slower. They may be missed or mistaken for something else at first, so it may be some time before you have one of the blood tests above.

Because of this, the American Diabetes Association (ADA) has produced a set of screening guidelines. The ADA recommends diabetes screening for people who:

• Are above the age of 45. The ADA suggests that you be screened at 45, and if your results are normal, you should then be screened every three years.

• Have a body mass index (BMI) over 25 (23 for Asian-Americans), alongside one or more of the other type 2 diabetes risk factors.

• Have prediabetes.

• Have gestational diabetes, in the case of women.

Gestational diabetes diagnosis

If you’re pregnant, you’ll likely be tested for gestational diabetes during your second trimester, usually between 24 and 28 weeks of pregnancy. If you have any gestational diabetes risk factors, you’ll probably be tested earlier, often at your first prenatal visit.

The following tests are common:

• Initial glucose challenge test. You’ll be given a sugary drink, then your blood will be taken one hour later. A score below 140 mg/dL is usually considered normal. If you score above this, it doesn’t mean you necessarily have gestational diabetes, but it does show you’re at a higher risk of developing it. You’ll then be given a second test.

• Follow-up glucose tolerance testing. This time you’ll be asked to fast overnight. Your fasting blood glucose level will be measured with a blood test. You’ll then be given a sugary drink again, and your blood will be taken once every hour for three hours.

This test shows what your “normal” fasting blood glucose level is, and then how your body responds to the sugary drink. If at least two of the three blood tests score over 140 mg/dL, you’ll be diagnosed with gestational diabetes.

Diabetes prevention

Unfortunately, type 1 diabetes isn’t preventable. It’s caused by an immune system problem – currently, there aren’t any known measures you can take to reduce the chances of it happening.

Prediabetes, type 2 diabetes, and gestational diabetes can be prevented. Some risk factors are out of your control, like your genes, your race, and your age, but you can do a lot about the lifestyle risk factors. You can try some or all of the following:

• Lose excess weight and maintain a healthy weight
• Get regular exercise, ideally at least 30 minutes, five times per week
• Eat a healthy, diabetes-friendly diet (see Food for diabetes below)
• Stay on top of your blood pressure and cholesterol – high blood pressure and high cholesterol can increase your risk of prediabetes and type 2 diabetes
• Quit smoking – smoking tobacco has been linked to a greater chance of developing diabetes
• See your doctor regularly – if you think you’re at risk of diabetes, schedule regular check-ups with your doctor to check your blood sugar

Diabetes treatment and prevention

Diabetes is usually treated using a combination of lifestyle adjustments, like eating a diabetes-friendly diet and taking medication.

Blood glucose monitoring

Depending on your condition and treatment plan, you may be asked to monitor your blood glucose levels. This is most likely if you have type 1 diabetes, but may be required too if you have prediabetes, type 2 diabetes, and gestational diabetes, particularly if you take insulin.

Monitoring your glucose levels is most often done using a glucometer. You prick your skin to produce a drop of blood which is then placed onto a test strip. The glucose in your blood reacts with the chemicals on the test strip. The test strip is then put into the glucometer to be read, which tells you your blood glucose level. A doctor or nurse will usually show you how to use your glucometer.

Type 1 diabetes treatment

The main treatment for type 1 diabetes is insulin. Type 1 diabetes is caused by your pancreas not producing enough insulin, so you can increase the amount in your body by injecting more.

There are different types of insulin, but they are all similar to the insulin you naturally produce. There are differences, however, in how quickly the insulin acts and how long it lasts. Broadly, there are four types:

• Rapid-acting insulin starts to work in around five to 30 minutes and lasts for around one to five hours. Examples include:

• • Humalog
  • NovoLog
  • Apidra

• Short-acting insulin starts to work in around 30 minutes to one hour and lasts for around two to eight hours. Examples include:

• • Humulin R
  • Novolin R
  • Velosulin

• Intermediate-acting insulin starts to work in around one to two hours and lasts for around 18 to 24 hours. Examples include:

• • Humulin N
  • Novolin N

• Long-acting insulin starts to work in around one to three hours and lasts from 20 to 48 hours. Examples include:

• • Toujeo Solostar
  • Basaglar
  • Levemir
  • Tresiba

Rapid and short-acting insulin is taken after you’ve eaten a meal. It helps your cells absorb glucose released from the food and drink you’ve consumed. Intermediate and long-acting insulin is usually taken to help you control your blood glucose levels throughout the day and overnight.

You may be advised to take a mix of more than one type of insulin. Often you take an intermediate or long-acting insulin to maintain consistently low glucose levels, combined with a rapid or short-acting insulin taken after meals.

Type 1 diabetes can also be treated by making lifestyle changes that can help to lower your blood glucose levels. These include eating a diabetes-friendly diet, maintaining a healthy weight, and getting regular exercise.

Type 2 diabetes treatment

The first treatments recommended for type 2 diabetes are typically lifestyle changes, like losing excess weight, getting regular exercise, and eating a healthier diet.

If lifestyle adjustments don’t work, then you may be prescribed one or more diabetes medications to help lower your blood glucose. A wide variety of diabetes medications are available, these are some of the most common:

• SGLT2 inhibitor medications encourage your body to excrete more glucose in your urine to lower your glucose levels. Examples include:

• • Farxiga
  • Invokana

• DPP-4 inhibitors drugs slow how quickly your body breaks down insulin, keeping it working for longer. Examples include:

• • Januvia
  • Tradjenta
  • Onglyza

• Alpha-glucosidase inhibitors slow how quickly your body releases glucose when you digest food and drink. Examples include:

• • Precose
  • Glyset

• Glucagon-like peptides encourage your pancreas to make more insulin and reduce how much glucose is released into your blood. Examples include:

• • Trulicity
  • Victoza
  • Byetta

• Biguanides/metformin reduces the amount of glucose released into your blood and can keep insulin working for longer. Examples include:

• • Glucophage
  • Glumetza

• Meglitinides encourage your pancreas to make more insulin. Examples include:

• • Starlix
  • Prandin

• Sulfonylureas encourage your pancreas to make more insulin. Examples include:

• • DiaBeta
  • Glucotrol
  • Amaryl

• Insulin – some people with type 2 diabetes may need to take insulin too (see Type 1 diabetes treatment above for more about insulin)

Gestational diabetes treatment

Controlling blood glucose levels during pregnancy is important for your health and for that of the baby. Gestational diabetes is usually treated with lifestyle changes, like eating a more diabetes-friendly diet and getting more exercise. You’ll likely also be asked to monitor your blood glucose levels throughout the day.

If lifestyle adjustments don’t lower your blood sugar enough, you may be prescribed a diabetes medication too. This is usually insulin, as it’s generally safe for unborn babies. See Type 1 diabetes treatment above for more about insulin.

Prediabetes treatment

Prediabetes is usually treated by making changes to your lifestyle, like adopting a more suitable diet, losing excess weight, and taking regular exercise.

If you have conditions that put you at risk of developing type 2 diabetes, like high blood pressure or cholesterol, you may be prescribed medications to treat those conditions too.

In most cases, this will be enough to bring your blood glucose levels down. If your levels don’t change, and if you’re close to developing type 2 diabetes, you may be prescribed a diabetes medication (see Type 2 diabetes treatment above for more on these medications).

Natural remedies for diabetes

Some people claim alternative medicines to help with their diabetes, particularly with type 2 diabetes. Please note that the evidence for alternative remedies is often lacking or contradictory, so these shouldn’t replace medically proven treatments.

You may wish to try some of these alongside your diabetes treatment. But know that dietary supplements and herbal remedies aren’t subjected to the same rigorous FDA tests that medical drugs are, so their safety isn’t guaranteed.

Dietary supplements and herbal remedies can be strong, they can have side effects, and they can interact with other medications. Talk to your doctor before you take any.

Natural remedies that have been claimed to help with diabetes include:

• Apple Cider Vinegar
• Barley
• Chromium (a mineral)
• Zinc (a mineral)
• Cinnamon
• Ginger
• Fenugreek (a seed used as a spice)
• Aloe vera (a gel-like plant extract)
• Milk thistle (a plant extract)
• Gymnema (a plant extract)
• Berberine (a plant extract)
• Nopal (the pads from a prickly pear cactus)

Managing your diabetes

Diabetes management involves making lifestyle changes and developing new routines to help you live with and treat your diabetes. There are two goals of diabetes management:

1. To limit the complications caused by your diabetes (mostly for type 1 diabetes)
2. To reduce blood glucose levels to normal levels to cure diabetes (mostly for type 2 diabetes, gestational diabetes, and prediabetes)

Weight loss for diabetes

Being overweight can increase your chances of developing prediabetes, type 2 diabetes, and gestational diabetes. Particularly, storing fat around your stomach and having a large waist size (over 35 inches in women and 40 inches in men) appears to increase your chances of developing insulin resistance, prediabetes, and type 2 diabetes.

Being overweight and having excess belly fat can also worsen your type 1 diabetes by making you more resistant to what insulin you do produce.

What’s more, being overweight can make some of the complications of type 1 and type 2 diabetes more likely too, like heart disease, heart attacks, and stokes.

Shedding excess fat and maintaining a healthy body weight can help improve and even resolve prediabetes and type 2 diabetes. It can also protect you from complications of diabetes. But losing weight and keeping it off over the long term can be difficult, you may need to experiment with different approaches to see what works for you.

Whatever approach you pick, losing weight will involve making changes to your diet and taking regular exercise. You should also talk to your doctor to get their advice on how to lose weight effectively.

Exercise for diabetes

Leading a sedentary lifestyle with little exercise is one of the major risk factors of developing prediabetes and type 2 diabetes. Exercise can also help you manage your blood glucose levels if you have type 1 or gestational diabetes (exercise can temporarily lower blood glucose levels).

Regular exercise can be effective at helping you lower your blood glucose levels, as:

1. In the short-term it causes your muscles to absorb glucose from your blood using a process that doesn’t require insulin
2. In the long-term, it can help you reduce your weight and improve your sensitivity to insulin

The US Office of Disease Prevention and Health Promotion recommends adults get at least 150 minutes of exercise a week. To meet this, aim for at least 30 minutes of exercise on five days per week.

Ideally, you should do a mixture of aerobic exercise, like running, cycling, or swimming, and resistance training, like lifting weights. Other options include dancing, exercise classes, team sports, and playing active video games. Perhaps the most important part of choosing exercises for diabetes is finding those that you enjoy. The more you enjoy your exercise routine, the more likely you are to stick to it.

Make sure you talk to your physician before starting an exercise program.

Food for diabetes

At its core, diabetes is all about how your body deals with the food and drink you consume. Changing your diet can help to reduce how much glucose is released into your blood at a time, and it can help and even reverse insulin resistance.

Diet and type 1 diabetes

In the past, people with type 1 diabetes were put on restrictive diets, but this was often because insulin was in short supply. If you follow your treatment plan and take your insulin, you can eat a normal diet and there are no foods you need to avoid.

Eating a healthy diet and keeping your weight down can lessen the risk of diabetes complications though, like heart disease and strokes.

Diet and prediabetes, type 2 diabetes, and gestational diabetes

Changing your diet can be an effective way to control prediabetes, type 2 diabetes, and gestational diabetes, and can help resolve it.

Eating a poor diet can increase your weight, your blood pressure, and your cholesterol. A diet high in fat, sugar, and refined carbohydrates may also contribute to insulin resistance. Making the right food choices can have a substantial effect on your condition.

Gestational diabetes, prediabetes, and type 2 diabetes food list:

Try to eat a diet that includes:

• Wholegrain versions of carbohydrates, like wholegrain bread, pasta, and rice
• Other carbohydrate-rich foods that are broken down slowly in your body, like sweet potatoes, corn, lentils, and beans and legumes
• Oats and oatmeal
• Vegetables
• Fruits
• Low-fat milk
• Low-fat and low-sugar dairy products, like natural yogurt
• Fats that come from plants, like olive oil, nuts, seeds, and avocado
• Lean meats, like chicken, turkey, fish, and other seafood

What foods to avoid with diabetes

If you have prediabetes, type 2 diabetes, or gestational diabetes, you should avoid sugary food, foods that release sugar into your blood quickly, or foods high in animal fats, like:

• High sugar foods, like chocolate, candy, and sugary cereal
• Sugary drinks, including soda and fruit juices
• Jam, jelly, and preserves
• Processed foods, like cakes and pastries
• Carbohydrate-rich foods that are broken down quickly, like white bread, white pasta, and white rice
• Canned fruit in syrup
• Dried fruit
• Fatty dairy products, like whole milk and full-fat cheeses
• Sugary yogurts
• Fried meats
• Pork bacon
• Red meat

Other ways to manage your diabetes

As well as maintaining a healthy body weight, exercising regularly, and eating a good diet, there are other actions you can take to help manage your diabetes:

• See your physician regularly. Make sure you attend your regular diabetes checkups, but also schedule yearly health checkups, to ensure you stay on top of possible complications.

• Schedule regular eye exams. You should also have periodic assessments of your eye health if this isn’t part of your regular diabetes checkups. You should be checked for retina damage or signs of cataracts and glaucoma.

• Get your yearly flu shot. Diabetes can weaken your immune system. Getting a flu shot each year can help give you extra protection. Also, talk to your physician about getting a pneumonia shot.

• Care for your teeth. Diabetes can cause gum disease and make you more vulnerable to gum infections. Make sure you have good dental care and have regular check-ups with your dentist.

• Take care of your feet. Blood vessel and nerve damage can harm your feet and make it harder for them to heal. Clean and care for your feet every day, and look out for cuts, blisters, sores, or any redness or swelling. See a doctor if these take longer than expected to heal.

• Control your blood pressure and cholesterol. High blood pressure and high cholesterol can worsen the complications of diabetes. Keeping your weight down, exercising, and eating a healthy diet can lower both. You may need medication if these lifestyle measures aren’t effective.

• Quit smoking. Smoking, or using other tobacco products, can increase your risk of diabetes complications. Talk to your physician about help to quit smoking.

• Limit how much alcohol you drink. Alcohol can cause your blood sugar to both fall and rise and can also increase your risk of diabetes complications. Try not to drink excessively, and limit how often you drink.

How to spot a diabetic emergency?

Diabetes can cause emergency problems that may need urgent medical attention. If you have diabetes, you should be aware of these problems and how to spot them. Look out for:

• Diabetic hyperglycemia (high blood glucose). This is a rise in blood glucose to dangerous levels. It puts you at greater risk of the harm that diabetes can cause. Symptoms include urinating more, feeling thirstier, dry mouth, fatigue, feeling sick, and blurred vision. Very high levels of blood glucose may require urgent medical attention.

• Hyperglycemic hyperosmolar nonketotic syndrome. This is an extreme form of high blood glucose (with levels over 600 mg/dL), where your blood can thicken and turn syrupy. Look out for extreme thirst, drowsiness, confusion, fever, vision losses, and hallucinations. Seek urgent medical attention if you think you have a hyperglycemic hyperosmolar nonketotic syndrome.

• Diabetic hypoglycemia (low blood glucose). Your blood glucose levels falling too low can also be dangerous. It can cause problems thinking, confusion, seizures, and even loss of consciousness, and death. Diabetic medications, not eating enough, and being unusually physically active can all cause your blood glucose levels to fall too low.

Look out for weakness, shaking, sweating, dizziness, headaches, heart palpitations, drowsiness, slurred speech, confusion, fainting and seizures. Diabetic hypoglycemia can be treated by eating foods that quickly release glucose, like fruit, bread, fruit juice, or glucose tablets. Severe cases may require urgent medical attention.

• Diabetic ketoacidosis. If your cells can’t get enough glucose, they can switch to using fat for energy instead. When your body breaks down fat, it produces a toxic by-product called ketones. These are lost through urination, but if your body breaks down too much fat, ketones can build up inside you. This can cause harm to your liver, kidneys, and brain.

Look out for weakness, a lack of appetite, vomiting, stomach pain, fever, and a sweet smell on your breath. You can buy over-the-counter ketones tests. If a test shows you have ketones in your urine, you should seek medical attention.

Diabetes Support

Living with diabetes isn’t easy. It can affect all areas of your life, and it can be frustrating, time-consuming, restricting, and at times, overwhelming and frightening.

Sometimes it helps to talk to someone, and you have options about how you do this. You could:

• Talk to a mental health professional one-on-one
• Attend a support group with other people who have diabetes
• Chat online to other people who have diabetes or use forums

You can talk to your physician about being referred to a mental health professional and finding a local support group. You can also try the American Diabetes Association or the Juvenile Diabetes Research Foundation:

American Diabetes Association – call 800-DIABETES (800-342-2383)

Juvenile Diabetes Research Foundation – call 800-533-CURE (800-533-2873)