Understood Care
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.
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/.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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/
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.
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