Living with Diabetes: Managing the Condition and Preventing Complications

Introduction

If you are managing diabetes, the daily steps you take can lower your risk of long term problems and help you feel better right now. You do not have to do everything at once. Small, steady changes in food choices, activity, medicines, and checkups add up. This guide brings together trusted recommendations on how to manage diabetes and prevent complications in your heart, eyes, kidneys, nerves, and feet.

What diabetes management means day to day

You and your care team can build a plan that fits your life. Most plans focus on the ABCs of diabetes
A is A1C which reflects average blood glucose over about three months
B is blood pressure
C is cholesterol

Keeping these in a healthy range lowers the risk of heart disease, stroke, kidney disease, vision loss, and nerve damage. Regular follow up and education also matter. Diabetes self management education and support is recommended at diagnosis and again at key times such as when treatment goals are not met, when new complications or life changes occur, and during care transitions. An Understood Care advocate can help with appointments, care coordination, lower costs by analyzing bills, and arranging transportation so your ABCs stay on track; for support call (646) 904-4027 or book at https://app.understoodcare.com/.

Know your numbers and goals

Blood glucose and A1C

For many adults who are not pregnant, an A1C goal of less than seven percent is common, though your individual target may differ. Typical day to day glucose targets for many adults include premeal levels around eighty to one hundred thirty milligrams per deciliter and less than one hundred eighty milligrams per deciliter about one to two hours after starting a meal. Your care team may suggest continuous glucose monitoring if you use insulin or if frequent checks help guide treatment.

Blood pressure

If you have diabetes and high blood pressure, many adults benefit from a target below one hundred thirty over eighty millimeters of mercury when it can be achieved safely. Work with your clinician to choose a goal that reflects your overall health and risk.

Cholesterol

Because diabetes raises the risk for heart disease and stroke, many adults are advised to use statin therapy along with lifestyle changes. Your plan should consider age, overall risk, and any history of heart disease. Ask your clinician what intensity is right for you and whether you need additional medicines for triglycerides or other lipid concerns.

Healthy eating that works in real life

A balanced plate is a simple way to plan meals without complex math. Fill half your plate with nonstarchy vegetables such as greens, broccoli, peppers, or green beans. Use one quarter for lean protein such as chicken, fish, eggs, beans, or tofu. Use the last quarter for carbohydrate foods such as whole grains, beans, fruit, or starchy vegetables. Choose water or unsweetened beverages more often. Spread carbohydrates evenly through the day, and pair them with protein and fiber to help steady glucose.

If you take insulin or medicines that can cause low blood sugar, ask how to time meals and snacks safely. A registered dietitian nutritionist or diabetes educator can help you personalize your plan for culture, budget, and preferences.

Physical activity for better glucose, heart, and mood

Aim for at least one hundred fifty minutes each week of moderate aerobic activity such as brisk walking, swimming, or cycling. Add resistance training on two to three days each week to maintain strength. If you sit for long periods, try to stand or move briefly at least every thirty minutes. Start slowly if you are new to activity and build up as you feel safe. Ask your clinician if you should check glucose before and after activity, especially if you use insulin or medicines that can cause low blood sugar.

Medicines and technology

Take medicines as prescribed. If side effects or costs are a barrier, tell your care team so you can adjust the plan. Some people benefit from continuous glucose monitoring, smart insulin pens, or insulin pumps. These tools can improve time in range and lower the risk for lows. Your team can help you decide what fits your needs and insurance.

Preventing common diabetes complications

Heart disease and stroke

Keep your ABCs on target. Do not smoke or vape. Stay up to date on vaccines. Ask whether you need a statin, whether aspirin is appropriate for you for cardiovascular protection, and how often to check cholesterol and kidney function. Make a plan for stress, sleep, and mental health since these affect glucose and heart risk.

Eye health

Schedule a comprehensive, dilated eye exam with an ophthalmologist or optometrist who is experienced with diabetes care. People with type 2 diabetes usually need an eye exam at diagnosis. People with type 1 diabetes usually need a first exam within five years of diagnosis. If no retinopathy is found and glucose and blood pressure are well managed, follow up may be every one to two years as advised by your eye specialist. If any retinopathy is present, annual or more frequent exams are needed.

Kidney health

Ask your clinician about yearly urine albumin to creatinine ratio and estimated glomerular filtration rate blood testing. These simple tests can detect problems early when treatment protects kidney function. Blood pressure control, glucose control, and medicines that protect the kidneys are central parts of care.

Nerve and foot health

Check your feet every day for cuts, blisters, redness, swelling, or areas of warmth. Moisturize the tops and bottoms, but not between toes. Trim nails straight across. Wear well fitting shoes and clean, dry socks. Ask for a basic foot check at every visit and a comprehensive foot exam at least once a year. Get seen sooner if you notice numbness, burning pain, a sore that does not heal, or a change in color or temperature.

Vaccinations that protect you

Vaccines lower the risk of severe illness that can throw glucose off balance. Adults with diabetes should receive routine vaccines recommended for their age and health, including influenza every year, updated COVID vaccines, pneumococcal vaccines based on age and risk, hepatitis B, Tdap, and shingles at age fifty or older. Your clinician can use the adult schedule to tailor a plan for you.

Build your care team and support

Diabetes self management education and support helps at diagnosis and at key moments such as when your plan changes or new complications arise. Many people also benefit from help with care coordination, transportation to appointments, and understanding insurance and billing. Family, friends, support groups, and community health workers can make day to day care easier.

Sick day planning

Illness can raise glucose and increase the risk of diabetic ketoacidosis for people who are insulin deficient. Before you get sick, create a written sick day plan with your clinician. It should cover how often to check glucose, when to check for ketones, how to adjust insulin or other medicines, what to drink and eat, and when to call the clinic or go to urgent care. Call promptly if you have persistent vomiting or diarrhea, high fever, signs of dehydration, large ketones, very high glucose that does not come down, or any warning signs of severe low blood sugar.

When to seek urgent care

Seek emergency help for severe chest pain, trouble breathing, confusion, seizures, signs of stroke, or signs of diabetic ketoacidosis such as rapid breathing, fruity breath, severe abdominal pain, or large ketones. Severe foot infections or ulcers also need prompt care.

Practical next steps

Create a simple diabetes folder or phone note that lists your medicines and doses, recent A1C, blood pressure, cholesterol results, vaccination dates, and contact information for your clinicians and eye and foot specialists. Bring it to every visit. Set calendar reminders for refills and annual eye, kidney, and foot checks. Ask about local or virtual education programs covered by Medicare or your health plan.

Understood Care can set up the folder with you, track labs, schedule reminders, enroll you in Medicare covered diabetes education, and share updates with your clinicians. For help, call us at (646) 904-4027 or book at https://app.understoodcare.com/

FAQ

• What does day to day diabetes management mean
  Day to day management means combining food choices, activity, medicines, and regular checkups into a plan that fits your life. Most plans focus on three main areas sometimes called the ABCs of diabetes. A is A1C which shows your average blood glucose over about three months. B is blood pressure. C is cholesterol. Keeping these in a healthy range lowers the risk of heart disease, stroke, kidney disease, vision loss, and nerve damage. Diabetes self management education and support is recommended at diagnosis and again when goals are not met, when life changes or complications occur, and during care transitions.

• What A1C and blood glucose targets are common
  For many adults who are not pregnant, an A1C goal of less than seven percent is common, although your individual target may be higher or lower depending on your health and risks. Typical day to day targets for many adults include premeal glucose around eighty to one hundred thirty milligrams per deciliter and less than one hundred eighty milligrams per deciliter about one to two hours after starting a meal. Your care team may suggest continuous glucose monitoring if you use insulin or if frequent checks are useful for treatment decisions.

• What blood pressure goals are usually recommended in diabetes
  For adults with diabetes and high blood pressure, many benefit from a blood pressure below one hundred thirty over eighty millimeters of mercury when that goal can be reached safely. The exact target should be chosen with your clinician based on your overall health, other conditions, and risk of side effects such as dizziness or falls.

• How does cholesterol fit into diabetes care
  Diabetes raises the risk of heart disease and stroke. Many adults with diabetes are advised to take a statin medicine in addition to lifestyle changes. Your plan should consider your age, family history, past heart or stroke events, and other risk factors. Ask which statin intensity is right for you and whether you might need additional medicines for triglycerides or other cholesterol problems.

• What does healthy eating look like for someone with diabetes
  A simple approach is to think about a balanced plate. Aim for half of your plate to be nonstarchy vegetables such as greens, broccoli, peppers, or green beans, one quarter lean protein such as chicken, fish, eggs, beans, or tofu, and one quarter carbohydrate foods such as whole grains, beans, fruit, or starchy vegetables. Choose water or unsweetened drinks more often. Spreading carbohydrate foods across the day and pairing them with protein and fiber can help steady glucose. If you use insulin or medicines that can cause low blood sugar, ask how to time meals and snacks safely. A registered dietitian nutritionist or diabetes educator can help tailor your plan to your culture, budget, and preferences.

• How much physical activity is recommended
  Many adults with diabetes are encouraged to aim for about one hundred fifty minutes each week of moderate aerobic activity such as brisk walking, swimming, or cycling, plus resistance training on two or three days each week to maintain strength. If you sit for long periods, try to stand or move briefly at least every thirty minutes. Start slowly if you are new to activity and increase as you feel safe. Ask your clinician whether you should check glucose before and after activity, especially if you use insulin or medicines that can cause low blood sugar.

• How should I think about diabetes medicines and technology
  Take your medicines as prescribed and tell your care team if you have side effects or cannot afford them so the plan can be adjusted. Some people benefit from tools such as continuous glucose monitoring, smart insulin pens, or insulin pumps, which can improve time in range and reduce lows. Your team can help you decide what is covered by your insurance and what fits your needs and comfort level.

• How can I reduce my risk of heart disease and stroke
  Keeping your A1C, blood pressure, and cholesterol at agreed upon targets is central. Avoiding smoking or vaping, staying active, and getting enough sleep matter too. Ask whether you should be on a statin, whether aspirin is appropriate for you, and how often to check cholesterol and kidney function. Managing stress and mental health can also help both heart risk and glucose control.

• What should I do to protect my eyes
  Schedule regular comprehensive dilated eye exams with an ophthalmologist or optometrist who cares for people with diabetes. People with type 2 diabetes usually need an eye exam at diagnosis. People with type 1 diabetes usually need a first exam within about five years of diagnosis. If no retinopathy is found and your diabetes and blood pressure are well managed, follow up may be every one to two years as your eye specialist advises. If retinopathy is present, you will need at least yearly exams and sometimes more frequent visits.

• How do I protect my kidneys
  Ask your clinician about yearly urine albumin to creatinine ratio testing and blood tests for estimated glomerular filtration rate. These can detect kidney problems early when treatment can slow or prevent progression. Keeping blood pressure and glucose at target and using kidney protecting medicines when appropriate are key parts of kidney care.

• Why are feet and nerves such a focus in diabetes
  High glucose over time can damage nerves and blood vessels which raises the risk of numbness, pain, and slow healing wounds. Check your feet every day for cuts, blisters, redness, swelling, or warm spots. Moisturize the tops and bottoms of your feet but not between the toes. Trim nails straight across. Wear well fitting shoes and clean, dry socks. Ask for a basic foot check at every visit and a full comprehensive exam at least once a year. Call sooner if you notice numbness, burning pain, a sore that does not heal, or a change in color or temperature.

• Which vaccines are important for people with diabetes
  Vaccines help prevent serious infections that can disrupt glucose and lead to complications. Adults with diabetes should receive the routine vaccines recommended for their age and health, which usually include annual influenza vaccine, updated COVID vaccines, pneumococcal vaccines depending on age and risk, hepatitis B vaccine, Tdap at recommended intervals, and shingles vaccine starting at about age fifty. Your clinician can review the adult schedule and tailor it to you.

• Who should be on my diabetes care team
  Your core team often includes your primary care clinician, and sometimes an endocrinologist, along with diabetes educators, dietitians, pharmacists, eye clinicians, and foot specialists. Diabetes self management education and support is helpful at diagnosis and when your plan changes or complications appear. Many people also benefit from help with transportation, scheduling, and insurance and billing questions. Family, friends, peer groups, and community health workers can make the daily work of diabetes care more manageable.

• What is a sick day plan and why do I need one
  Illness can raise glucose and increase the risk of diabetic ketoacidosis for people who are insulin deficient. Before you get sick, work with your clinician to create a written sick day plan. It should explain how often to check glucose, when to check for ketones, how to adjust insulin or other medicines, what fluids and foods to aim for, and when to call the clinic or go to urgent care. Call promptly if you have persistent vomiting or diarrhea, high fever, signs of dehydration, large ketones, very high glucose that does not come down, or warning signs of severe low blood sugar.

• When should I seek urgent or emergency care
  Seek emergency care if you have severe chest pain, trouble breathing, confusion, seizures, signs of stroke such as sudden difficulty speaking or weakness on one side, or signs of diabetic ketoacidosis such as rapid breathing, fruity smelling breath, severe abdominal pain, or large ketones. Severe foot infections or ulcers also need prompt medical attention.

• What practical steps can I take to stay organized
  Create a simple diabetes folder or a note on your phone that lists your medicines and doses, your most recent A1C, blood pressure, and cholesterol results, vaccination dates, and contact information for your main clinicians and your eye and foot specialists. Bring this to every visit. Set calendar reminders for refills, annual eye, kidney, and foot checks, and vaccines. Ask about local or virtual education programs that may be covered by Medicare or your health plan.

• How can Understood Care support my diabetes management
  Understood Care can help you set up and maintain your diabetes folder, track labs, schedule reminders, and enroll in diabetes education programs that are covered by Medicare. Advocates can also help with appointments, care coordination, transportation planning, and reviewing medical bills. For support, you can call Understood Care at 646 904 4027 or book at the app link provided in the article.

References

• American Diabetes Association. Checking your blood sugar and target ranges. https://diabetes.org/living-with-diabetes/treatment-care/checking-your-blood-sugar American Diabetes Association
• American Diabetes Association. Cardiovascular disease and risk management. Standards of Care in Diabetes 2025. https://diabetesjournals.org/care/article/48/Supplement_1/S207/157549/10-Cardiovascular-Disease-and-Risk-Management Diabetes Journals
• American Diabetes Association. Retinopathy, neuropathy, and foot care. Standards of Care in Diabetes 2025. PDF. https://diabetesjournals.org/care/article-pdf/48/Supplement_1/S252/791472/dc25s012.pdf Diabetes Journals
• American Diabetes Association. Summary of revisions. Standards of Care in Diabetes 2025. https://diabetesjournals.org/care/article/48/Supplement_1/S6/157564/Summary-of-Revisions-Standards-of-Care-in-Diabetes Diabetes Journals+1
• American Diabetes Association. Protect your eyes. https://diabetes.org/health-wellness/eye-health/protect-your-eyes American Diabetes Association
• Centers for Disease Control and Prevention. Recommended adult immunization schedule United States 2025. PDF. https://www.cdc.gov/vaccines/hcp/imz-schedules/downloads/adult/adult-combined-schedule.pdf CDC
• Centers for Disease Control and Prevention. Adult immunization schedule notes 2025. https://www.cdc.gov/vaccines/hcp/imz-schedules/adult-notes.html CDC
• Centers for Disease Control and Prevention. Managing sick days. https://www.cdc.gov/diabetes/living-with/managing-sick-days.html CDC
• Centers for Disease Control and Prevention. Diabetes and smoking. https://www.cdc.gov/diabetes/risk-factors/diabetes-and-smoking.html CDC
• National Institute of Diabetes and Digestive and Kidney Diseases. Managing diabetes. https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes NIDDK
• National Institute of Diabetes and Digestive and Kidney Diseases. Healthy living with diabetes. https://www.niddk.nih.gov/health-information/diabetes/overview/healthy-living-with-diabetes NIDDK
• National Institute of Diabetes and Digestive and Kidney Diseases. Diabetic kidney disease. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-kidney-disease NIDDK
• National Institute of Diabetes and Digestive and Kidney Diseases. Quick reference on urine albumin to creatinine ratio and eGFR. https://www.niddk.nih.gov/health-information/professionals/advanced-search/quick-reference-uacr-gfr NIDDK
• National Institute of Diabetes and Digestive and Kidney Diseases. Foot problems and daily foot care. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems NIDDK
• Centers for Disease Control and Prevention. Diabetes and your feet. https://www.cdc.gov/diabetes/diabetes-complications/diabetes-and-your-feet.html CDC
• American Diabetes Association. Diabetes and high blood pressure. https://diabetes.org/about-diabetes/complications/high-blood-pressure American Diabetes Association
• American Diabetes Association. Diabetes sick day guidance. https://diabetes.org/getting-sick-with-diabetes/sick-days American Diabetes Association
• Centers for Disease Control and Prevention. Prevent diabetes complications overview. https://www.cdc.gov/diabetes/prevention-type-2/stop-diabetes-complications.html CDC
• American Diabetes Association and partners. Diabetes self management education and support key times. https://www.cdc.gov/diabetes-toolkit/php/patient-referral-process/referral-process.html CDC

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Related Understood Care pages

• Care coordination support https://understoodcare.com/care-types/care-coordination understoodcare.com
• Help with appointments and transportation https://understoodcare.com/care-types/appointments understoodcare.com
• Application and paperwork help for financial assistance programs https://understoodcare.com/care-types/application-help understoodcare.com
• Help reviewing and negotiating medical bills https://understoodcare.com/care-types/analyze-bills understoodcare.com
• Home care navigation and cost guidance https://understoodcare.com/care-types/home-care understoodcare.com

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This content is for education only and does not replace professional medical advice. If you have new weakness, severe pain, fever with confusion, chest pain, or trouble breathing, call emergency services.