Living with Diabetes

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 really mean?
  Day to day diabetes care means working with your team on the ABCs: A1C, blood pressure, and cholesterol. It also includes daily choices about food, movement, medicines, and checkups so you feel better now and lower your risk of heart, eye, kidney, nerve, and foot problems over time.
• What are the ABCs of diabetes and why are they important?
  A is A1C, your average blood glucose over about three months. B is blood pressure. C is cholesterol. Keeping all three in a healthy range lowers the chance of heart disease, stroke, kidney disease, vision loss, and nerve damage.
• What A1C and blood glucose goals are typical for adults?
  For many adults who are not pregnant, an A1C goal below 7 percent is common, though your exact target may differ. Typical day to day glucose targets often include premeal levels around 80 to 130 mg/dL and less than 180 mg/dL about one to two hours after starting a meal. Your clinician will set personalized goals.
• What blood pressure and cholesterol targets should I ask about?
  If you have diabetes and high blood pressure, many adults benefit from a goal below 130 over 80 mm Hg when it can be done safely. Because diabetes raises heart risk, many adults are advised to take a statin along with lifestyle changes. Ask which blood pressure goal and which cholesterol plan fit your age, history, and risks.
• What does healthy eating with diabetes look like in real life?
  A simple plate method works well. Fill half your plate with nonstarchy vegetables, one quarter with lean protein such as fish, chicken, eggs, beans, or tofu, and one quarter with carbohydrate foods like whole grains, beans, fruit, or starchy vegetables. Spread carbohydrates through the day, choose water or unsweetened drinks, and time meals safely if you take insulin or medicines that can cause lows.
• How much physical activity should I aim for?
  Many adults with diabetes are encouraged to get at least 150 minutes each week of moderate activity such as brisk walking, swimming, or cycling, plus resistance training two to three days per week. If you sit for long periods, try to stand or move briefly at least every 30 minutes. Ask your clinician what is safe for you and whether to check glucose around activity.
• How do medicines and technology fit into my plan?
  Take diabetes medicines and insulin exactly as prescribed and tell your team if side effects or cost are a problem. Some people benefit from continuous glucose monitors, smart insulin pens, or pumps to improve time in range and reduce lows. Your team can help you decide which tools match your needs and coverage.
• What can I do to prevent heart and stroke complications?
  Keep your ABCs in range, avoid tobacco, stay up to date on vaccines, and follow heart healthy habits for food, movement, stress, and sleep. Ask about statin therapy, whether aspirin is appropriate for you, and how often to check cholesterol and kidney function.
• How often should I have my eyes and kidneys checked?
  Most people with type 2 diabetes need a dilated eye exam at diagnosis. People with type 1 diabetes usually need one within five years of diagnosis. Follow up is typically every one to two years if no retinopathy is present and more often if changes are found. Kidney checks usually include a yearly urine albumin to creatinine ratio and an estimated glomerular filtration rate blood test.
• How do I protect my feet and nerves?
  Check your feet every day for cuts, blisters, redness, swelling, or warmth. Moisturize the tops and bottoms, trim nails straight across, and wear well fitting shoes and clean dry socks. Ask for a basic foot check at every visit and a full foot exam at least once a year. Call your clinician sooner if you notice numbness, burning pain, color changes, or sores that do not heal.
• Which vaccines are important if I have diabetes?
  Adults with diabetes should receive routine age based vaccines, including yearly influenza, updated COVID vaccines, pneumococcal vaccines as indicated, hepatitis B, Tdap, and shingles at age 50 or older. Ask your clinician to review the adult vaccine schedule and tailor it to you.
• What is a sick day plan and why do I need one?
  Illness can raise blood glucose and increase the risk of diabetic ketoacidosis for people who are insulin deficient. A sick day plan explains how often to check glucose, when to check for ketones, how to adjust medicines, what to drink and eat, and when to call the clinic or go to urgent care. Create this plan with your clinician before you get sick.
• When should I seek urgent care or call emergency services?
  Seek emergency help for severe chest pain, trouble breathing, confusion, seizures, signs of stroke, 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.
• How can an advocate or support service help me manage diabetes?
  An advocate can help schedule appointments, coordinate eye, kidney, and foot checks, enroll you in diabetes education covered by Medicare or your health plan, organize lab results, review medicines and costs, and arrange transportation to visits. Understood Care can build a simple diabetes folder with your key numbers, set reminders, and share updates with your clinicians so nothing falls through the cracks.

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

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.