Med J Aust. Porcellati F, Rossetti P, Busciantella NR, et al. Comparison of pharmacokinetics and dynamics of the long-acting insulin analogs glargine and detemir at steady state in type 1 diabetes: a double-blind, randomized, crossover study [published correction appears in Diabetes Care.

Freeland B, Penprase BB, Anthony M. Nursing practice patterns: timing of insulin administration and glucose monitoring in the hospital. Diabetes Educ. Umpierrez GE, Reyes D, Smiley D, et al.

Hospital discharge algorithm based on admission HbA1c for the management of patients with type 2 diabetes. Griffith ML, Boord JB, Eden SK, Matheny ME.

Clinical inertia of discharge planning among patients with poorly controlled diabetes mellitus. Lilley SH, Levine GI. Management of hospitalized patients with type 2 diabetes mellitus. Sawin G, Shaughnessy AF. Glucose control in hospitalized patients. This content is owned by the AAFP.

A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.

search close. PREV Nov 15, NEXT. C 12 The metformin dosage should be decreased in hospitalized patients with an estimated glomerular filtration rate of 30 to 45 mL per minute per 1.

C 15 — 17 To prevent wide glucose fluctuations, either a basal insulin approach or a basal-bolus correctional approach, using long-acting insulin plus adjusted premeal short-acting insulin, should be used. C 24 Sliding scale insulin regimens have no benefit over continuation of routine home diabetes regimens and are not recommended.

Harms of Uncontrolled Blood Glucose. Glycemic Targets. Barriers to Achieving Glycemic Control. Oral Diabetes Medications. Insulin Therapy for Hospitalized Patients.

Hospital Discharge Planning. Prescriptions for new or changed medication should be filled and reviewed with the patient and family at or before discharge. Ensure follow-up Communicate medication changes, pending tests, and follow-up needs to the primary care physician. Transmit discharge summary to the primary care physician as soon as possible after discharge.

Schedule an outpatient follow-up visit before discharge. Provide patient education Ensure that the patient can identify the physician who will provide outpatient diabetes care. Check the patient's level of understanding related to the diabetes diagnosis, self-monitoring of glucose levels, and blood glucose goals.

Reinforce information on nutritional habits, insulin administration, and other topics. Prescribe medication regimen Ensure that the patient has prescriptions for any new medications and does not have redundant prescriptions for existing home medications. Review the role and regimen for oral diabetes medications, insulin regimens, and any other medication changes with patient.

CHARLES KODNER, MD, is an associate professor in the Department of Family and Geriatric Medicine at the University of Louisville Ky. School of Medicine. kodner louisville. Continue Reading. More in AFP. More in Pubmed. Copyright © by the American Academy of Family Physicians. Copyright © American Academy of Family Physicians.

All Rights Reserved. Routine home diabetes mellitus medications should be continued during hospitalization unless there are specific contraindications. The metformin dosage should be decreased in hospitalized patients with an estimated glomerular filtration rate of 30 to 45 mL per minute per 1.

To prevent wide glucose fluctuations, either a basal insulin approach or a basal-bolus correctional approach, using long-acting insulin plus adjusted premeal short-acting insulin, should be used.

Sliding scale insulin regimens have no benefit over continuation of routine home diabetes regimens and are not recommended. After excluding minor urinary tract infections, a study of 97 patients found that those with a single blood glucose measurement of more than mg per dL Observational studies show an association between hyperglycemia and worsened outcomes in patients with acute stroke.

In a study of patients with acute myocardial infarction, the one-year mortality rate was In a study of patients undergoing lumbar spine surgery, the mean length of hospitalization was six days in those with uncontrolled diabetes, four days in those with controlled diabetes, and 3.

Poor outcomes associated with hyperglycemia may lead to deferral of procedures until blood glucose levels are controlled, even when intravenous insulin can be used perioperatively. Medication changes: different medication regimens, potential drug-drug interactions, varying dosages.

Use of medications associated with increased insulin resistance, primarily glucocorticoids, with rapidly changing dosages. Impaired medication timing because of hospital logistics or lack of physician communication. Varying degrees of knowledge regarding evidence-based management of hyper- and hypoglycemia.

Lack of discharge planning to change or implement the diabetes treatment plan after hospitalization. Impaired renal function, which may affect drug metabolism and risk of hypoglycemia.

Regular insulin every six hours or rapid-acting analogue insulin every four hours. Rapid-acting analogue insulin with each meal and at bedtime reduced dose at bedtime.

Metformin should not be crushed; glucagon-like peptide 1 receptor agonists should be avoided. Cross-check medications to ensure that no routine medications were stopped and that new prescriptions are safe for the patient to take.

Communicate medication changes, pending tests, and follow-up needs to the primary care physician. Ensure that the patient can identify the physician who will provide outpatient diabetes care. Ensure that the patient has prescriptions for any new medications and does not have redundant prescriptions for existing home medications.

These medicines help you manage your ABCs. Ask your doctor if you need to take aspirin to prevent a heart attack or stroke. Tell your health care professional if you cannot afford your medicines or if you have any side effects from your medicines.

Learn more about insulin and other diabetes medicines. For many people with diabetes, checking their blood glucose level each day is an important way to manage their diabetes. Monitoring your blood glucose level is most important if you take insulin. The results of blood glucose monitoring can help you make decisions about food, physical activity, and medicines.

The most common way to check your blood glucose level at home is with a blood glucose meter. You get a drop of blood by pricking the side of your fingertip with a lancet.

Then you apply the blood to a test strip. The meter will show you how much glucose is in your blood at the moment. Ask your health care team how often you should check your blood glucose levels.

Make sure to keep a record of your blood glucose self-checks. You can print copies of this glucose self-check chart. Take these records with you when you visit your health care team.

Continuous glucose monitoring CGM is another way to check your glucose levels. Most CGM systems use a tiny sensor that you insert under your skin. If the CGM system shows that your glucose is too high or too low, you should check your glucose with a blood glucose meter before making any changes to your eating plan, physical activity, or medicines.

A CGM system is especially useful for people who use insulin and have problems with low blood glucose. Talk with your health care team about the best target range for you. Be sure to tell your health care professional if your glucose levels often go above or below your target range.

Sometimes blood glucose levels drop below where they should be, which is called hypoglycemia. Hypoglycemia can be life threatening and needs to be treated right away. Learn more about how to recognize and treat hypoglycemia. If you often have high blood glucose levels or symptoms of high blood glucose, talk with your health care team.

You may need a change in your diabetes meal plan, physical activity plan, or medicines. Most people with diabetes get health care from a primary care professional. Primary care professionals include internists, family physicians, and pediatricians. Sometimes physician assistants and nurses with extra training, called nurse practitioners, provide primary care.

You also will need to see other care professionals from time to time. A team of health care professionals can help you improve your diabetes self-care. Remember, you are the most important member of your health care team. When you see members of your health care team, ask questions.

Watch a video to help you get ready for your diabetes care visit. You should see your health care team at least twice a year, and more often if you are having problems or are having trouble reaching your blood glucose, blood pressure, or cholesterol goals.

At each visit, be sure you have a blood pressure check, foot check, and weight check; and review your self-care plan. Talk with your health care team about your medicines and whether you need to adjust them. Routine health care will help you find and treat any health problems early, or may be able to help prevent them.

Talk with your doctor about what vaccines you should get to keep from getting sick, such as a flu shot and pneumonia shot. Preventing illness is an important part of taking care of your diabetes. Feeling stressed, sad, or angry is common when you live with diabetes.

Stress can raise your blood glucose levels, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Make physical activity part of your daily routine. Regular physical activity can help prevent prediabetes and type 2 diabetes.

It can also help those who already have diabetes to maintain better blood sugar control. A minimum of 30 minutes of moderate physical activity — such as brisk walking — most days of the week is recommended. Aim for at least minutes of moderate aerobic physical activity a week. Getting regular aerobic exercise along with getting at least two days a week of strength training exercises can help control blood sugar more effectively than does either type of exercise alone.

Aerobic exercises can include walking, biking or dancing. Resistance training can include weight training and body weight exercises.

Also try to spend less time sitting still. Try to get up and move around for a few minutes at least every 30 minutes or so when you're awake. Keep your vaccinations up to date. High blood sugar can weaken your immune system. Get a flu shot every year. Your provider may recommend the pneumonia and COVID vaccines, as well.

The Centers for Disease Control and Prevention CDC also currently recommends hepatitis B vaccination if you haven't previously had it and you're an adult ages 19 to 59 with type 1 or type 2 diabetes.

The most recent CDC guidelines suggest vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes.

If you are age 60 or older, have been diagnosed with diabetes, and haven't previously received the vaccine, talk to your provider about whether it's right for you. If you drink alcohol, do so responsibly.

Alcohol can cause either high or low blood sugar. This depends on how much you drink and if you eat at the same time.

If you choose to drink, do so only in moderation — one drink a day for women and up to two drinks a day for men — and always with food. Remember to include the carbohydrates from any alcohol you drink in your daily carbohydrate count.

And check your blood sugar levels before going to bed. Many substances have been shown to improve the body's ability to process insulin in some studies. Other studies fail to find any benefit for blood sugar control or in lowering A1C levels.

Because of the conflicting findings, there aren't any alternative therapies that are currently recommended to help everyone to manage blood sugar. If you decide to try any type of alternative therapy, don't stop taking the drugs that your provider has prescribed.

Be sure to discuss the use of any of these therapies with your provider. Make sure that they won't cause bad reactions or interact with your current therapy. Also, no treatments — alternative or conventional — can cure diabetes. If you're using insulin therapy for diabetes, never stop using insulin unless directed to do so by your provider.

Living with diabetes can be difficult and frustrating. Sometimes, even when you've done everything right, your blood sugar levels may rise. But stick with your diabetes management plan and you'll likely see a positive difference in your A1C when you visit your provider.

Good diabetes management can take a great deal of time and feel overwhelming. Some people find that it helps to talk to someone.

Your provider can probably recommend a mental health professional for you to speak with. Or you may want to try a support group. Sharing your frustrations and triumphs with people who understand what you're going through can be very helpful.

And you may find that others have great tips to share about diabetes management. Your provider may know of a local support group.

You can also call the American Diabetes Association at DIABETES or the Juvenile Diabetes Research Foundation at CURE You're likely to start by seeing your health care provider if you're having diabetes symptoms. If your child is having diabetes symptoms, you might see your child's health care provider.

If blood sugar levels are very high, you'll likely be sent to the emergency room. If blood sugar levels aren't high enough to put you or your child immediately at risk, you may be referred to a provider trained in diagnosing and treating diabetes endocrinologist.

Soon after diagnosis, you'll also likely meet with a diabetes educator and a registered dietitian to get more information on managing your diabetes. Preparing a list of questions can help you make the most of your time with your provider. For diabetes, some questions to ask include:.

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Care at Mayo Clinic Our caring team of Mayo Clinic experts can help you with your diabetes-related health concerns Start Here. Enlarge image Close. Continuous glucose monitor and insulin pump A continuous glucose monitor, on the left, is a device that measures your blood sugar every few minutes using a sensor inserted under the skin.

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By Mayo Clinic Staff. Show references Ferri FF. Diabetes mellitus. In: Ferri's Clinical Advisor Elsevier; Accessed May 7, Classification and diagnosis of diabetes: Standards of medical care in diabetes — Diabetes Care.

Papadakis MA, et al. McGraw Hill; Accessed May 4, Diabetes risk factors. Centers for Disease Control and Prevention.

Accessed June 2, Cunningham FG, et al. In: Williams Obstetrics. McGraw-Hill Education; Diabetes and DKA ketoacidosis. American Diabetes Association.

Diabetes Canada Clinical Practice Guidelines Expert Committee. Complementary and alternative medicine for diabetes. Canadian Journal of Diabetes. Nimmagadda R. Allscripts EPSi. Mayo Clinic. June 16, Jameson JL, et al. Diabetes mellitus: Diagnosis, classification and pathophysiology.

In: Harrison's Principles of Internal Medicine. Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes — Facilitating behavior change and well-being to improve health outcomes: Standards of medical care in diabetes — Type 1 diabetes mellitus.

Mayo Clinic; Glycemic targets: Standards of Medical Care in diabetes — Comprehensive medical evaluation and assessment of comorbidities: Standards of Medical Care in Diabetes — Prevention or delay of type 2 diabetes and associated comorbidities: Standards of Medical Care in diabetes — Obesity and weight management for the prevention and treatment of type 2 diabetes: Standards of Medical Care in Diabetes — Diabetes technology.

Standards of Medical Care in Diabetes — See also News from Mayo Clinic Science Saturday: Mayo Clinic study indicates U. rural counties have higher diabetes-related deaths Nov. CDT Innovative breakthrough offers good news for people with diabetes Nov. CDT Mayo Clinic Q and A: How does diabetes affect the heart?

June 23, , p. CDT Mayo Clinic Q and A: Putting your best foot forward with diabetes May 09, , p. CDT Mayo Clinic Q and A: Diabetes and fasting during Ramadan April 07, , p.

CDT Nonprofit co-founded by Mayo Clinic announces plan to manufacture affordable insulin March 03, , p. CDT Show more news from Mayo Clinic.

Alcohol can lead to low blood sugar shortly after you drink it and for hours afterward. The liver usually releases stored sugar to offset falling blood sugar levels.

But if your liver is processing alcohol, it may not give your blood sugar the needed boost. Get your healthcare professional's OK to drink alcohol. With diabetes, drinking too much alcohol sometimes can lead to health conditions such as nerve damage.

But if your diabetes is under control and your healthcare professional agrees, an occasional alcoholic drink is fine. Women should have no more than one drink a day. Men should have no more than two drinks a day. One drink equals a ounce beer, 5 ounces of wine or 1.

Don't drink alcohol on an empty stomach. If you take insulin or other diabetes medicines, eat before you drink alcohol. This helps prevent low blood sugar. Or drink alcohol with a meal. Choose your drinks carefully. Light beer and dry wines have fewer calories and carbohydrates than do other alcoholic drinks.

If you prefer mixed drinks, sugar-free mixers won't raise your blood sugar. Some examples of sugar-free mixers are diet soda, diet tonic, club soda and seltzer. Add up calories from alcohol. If you count calories, include the calories from any alcohol you drink in your daily count.

Ask your healthcare professional or a registered dietitian how to make calories and carbohydrates from alcoholic drinks part of your diet plan.

Check your blood sugar level before bed. Alcohol can lower blood sugar levels long after you've had your last drink. So check your blood sugar level before you go to sleep. The snack can counter a drop in your blood sugar. Changes in hormone levels the week before and during periods can lead to swings in blood sugar levels.

Look for patterns. Keep careful track of your blood sugar readings from month to month. You may be able to predict blood sugar changes related to your menstrual cycle.

Your healthcare professional may recommend changes in your meal plan, activity level or diabetes medicines. These changes can make up for blood sugar swings.

Check blood sugar more often. If you're likely nearing menopause or if you're in menopause, talk with your healthcare professional. Ask whether you need to check your blood sugar more often. Also, be aware that menopause and low blood sugar have some symptoms in common, such as sweating and mood changes.

So whenever you can, check your blood sugar before you treat your symptoms. That way you can confirm whether your blood sugar is low.

Most types of birth control are safe to use when you have diabetes. But combination birth control pills may raise blood sugar levels in some people. It's very important to take charge of stress when you have diabetes. The hormones your body makes in response to prolonged stress may cause your blood sugar to rise.

It also may be harder to closely follow your usual routine to manage diabetes if you're under a lot of extra pressure. Take control. Once you know how stress affects your blood sugar level, make healthy changes. Learn relaxation techniques, rank tasks in order of importance and set limits.

Whenever you can, stay away from things that cause stress for you. Exercise often to help relieve stress and lower your blood sugar. Get help. Learn new ways to manage stress. You may find that working with a psychologist or clinical social worker can help.

These professionals can help you notice stressors, solve stressful problems and learn coping skills. The more you know about factors that have an effect on your blood sugar level, the better you can prepare to manage diabetes.

If you have trouble keeping your blood sugar in your target range, ask your diabetes healthcare team for help. There is a problem with information submitted for this request. Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health.

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Products and services. Diabetes management: How lifestyle, daily routine affect blood sugar Diabetes management takes awareness. By Mayo Clinic Staff. Thank you for subscribing!

Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. Show references Facilitating behavior change and well-being to improve health outcomes. Standards of Medical Care in Diabetes — Diabetes Care.

Nutrition overview. American Diabetes Association. Accessed Dec. Diabetes and mental health. Centers for Disease Control and Prevention. Insulin, medicines, and other diabetes treatments.

National Institute of Diabetes and Digestive and Kidney Diseases. Insulin storage and syringe safety. Diabetes diet, eating, and physical activity. Type 2 diabetes mellitus adult. Mayo Clinic; Wexler DJ. Initial management of hyperglycemia in adults with type 2 diabetes mellitus.

Diabetes and women. Planning for sick days. Diabetes: Managing sick days. Castro MR expert opinion. Mayo Clinic. Hypoglycemia low blood glucose. Blood glucose and exercise. Riddell MC. Exercise guidance in adults with diabetes mellitus.

Colberg SR, et al. Palermi S, et al. The complex relationship between physical activity and diabetes: An overview. Journal of Basic and Clinical Physiology and Pharmacology. Take charge of your diabetes: Your medicines. Sick day management for adults with type 1 diabetes.

Association of Diabetes Care and Education Specialists. Alcohol and diabetes. Diabetes and nerve damage. Roe AH, et al. Combined estrogen-progestin contraception: Side effects and health concerns.

Products and Services The Mayo Clinic Diet Online A Book: The Essential Diabetes Book. See also Medication-free hypertension control A1C test Alcohol: Does it affect blood pressure?

Hypoglycemia can be life threatening and needs to be treated right away. Learn more about how to recognize and treat hypoglycemia.

If you often have high blood glucose levels or symptoms of high blood glucose, talk with your health care team.

You may need a change in your diabetes meal plan, physical activity plan, or medicines. Most people with diabetes get health care from a primary care professional. Primary care professionals include internists, family physicians, and pediatricians. Sometimes physician assistants and nurses with extra training, called nurse practitioners, provide primary care.

You also will need to see other care professionals from time to time. A team of health care professionals can help you improve your diabetes self-care.

Remember, you are the most important member of your health care team. When you see members of your health care team, ask questions. Watch a video to help you get ready for your diabetes care visit.

You should see your health care team at least twice a year, and more often if you are having problems or are having trouble reaching your blood glucose, blood pressure, or cholesterol goals. At each visit, be sure you have a blood pressure check, foot check, and weight check; and review your self-care plan.

Talk with your health care team about your medicines and whether you need to adjust them. Routine health care will help you find and treat any health problems early, or may be able to help prevent them.

Talk with your doctor about what vaccines you should get to keep from getting sick, such as a flu shot and pneumonia shot. Preventing illness is an important part of taking care of your diabetes. Feeling stressed, sad, or angry is common when you live with diabetes.

Stress can raise your blood glucose levels, but you can learn ways to lower your stress. Try deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to your favorite music. Consider taking part in a diabetes education program or support group that teaches you techniques for managing stress.

Learn more about healthy ways to cope with stress. Depression is common among people with a chronic, or long-term, illness. Depression can get in the way of your efforts to manage your diabetes. Ask for help if you feel down.

A mental health counselor, support group, clergy member, friend, or family member who will listen to your feelings may help you feel better. Try to get 7 to 8 hours of sleep each night. Getting enough sleep can help improve your mood and energy level.

You can take steps to improve your sleep habits. If you often feel sleepy during the day, you may have obstructive sleep apnea , a condition in which your breathing briefly stops many times during the night. Sleep apnea is common in people who have diabetes.

Talk with your health care team if you think you have a sleep problem. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases NIDDK , part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public.

Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts. Home Health Information Diabetes Diabetes Overview Managing Diabetes. English English Español.

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Typically, dark chocolate has a reasonably low glycemic index of 42 and a glycemic load of 9. As with all dietary matters, moderation is key,so keep an eye on portion size and read nutrition labels.

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High levels Low levels What is glucose? High blood glucose levels. Low blood glucose levels. What is glucose? Maintaining balanced blood glucose levels.

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Fasting blood sugar glucose : Normal levels and testing.

Then, the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested regularly for the next two hours. If your provider thinks you may have type 1 diabetes, they may test your urine to look for the presence of ketones. Ketones are a byproduct produced when muscle and fat are used for energy.

Your provider will also probably run a test to see if you have the destructive immune system cells associated with type 1 diabetes called autoantibodies. Your provider will likely see if you're at high risk for gestational diabetes early in your pregnancy. If you're at high risk, your provider may test for diabetes at your first prenatal visit.

If you're at average risk, you'll probably be screened sometime during your second trimester. Our caring team of Mayo Clinic experts can help you with your diabetes-related health concerns Start Here.

Depending on what type of diabetes you have, blood sugar monitoring, insulin and oral drugs may be part of your treatment. Eating a healthy diet, staying at a healthy weight and getting regular physical activity also are important parts of managing diabetes.

An important part of managing diabetes — as well as your overall health — is keeping a healthy weight through a healthy diet and exercise plan:. Healthy eating. Your diabetes diet is simply a healthy-eating plan that will help you control your blood sugar. You'll need to focus your diet on more fruits, vegetables, lean proteins and whole grains.

These are foods that are high in nutrition and fiber and low in fat and calories. You'll also cut down on saturated fats, refined carbohydrates and sweets.

In fact, it's the best eating plan for the entire family. Sugary foods are OK once in a while. They must be counted as part of your meal plan. Understanding what and how much to eat can be a challenge. A registered dietitian can help you create a meal plan that fits your health goals, food preferences and lifestyle.

This will likely include carbohydrate counting, especially if you have type 1 diabetes or use insulin as part of your treatment. Physical activity. Everyone needs regular aerobic activity.

This includes people who have diabetes. Physical activity lowers your blood sugar level by moving sugar into your cells, where it's used for energy. Physical activity also makes your body more sensitive to insulin.

That means your body needs less insulin to transport sugar to your cells. Get your provider's OK to exercise. Then choose activities you enjoy, such as walking, swimming or biking.

What's most important is making physical activity part of your daily routine. Aim for at least 30 minutes or more of moderate physical activity most days of the week, or at least minutes of moderate physical activity a week. Bouts of activity can be a few minutes during the day.

If you haven't been active for a while, start slowly and build up slowly. Also avoid sitting for too long. Try to get up and move if you've been sitting for more than 30 minutes.

Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump, frequent blood sugar checks, and carbohydrate counting.

For some people with type 1 diabetes, pancreas transplant or islet cell transplant may be an option. Treatment of type 2 diabetes mostly involves lifestyle changes, monitoring of your blood sugar, along with oral diabetes drugs, insulin or both.

Depending on your treatment plan, you may check and record your blood sugar as many as four times a day or more often if you're taking insulin.

Careful blood sugar testing is the only way to make sure that your blood sugar level remains within your target range. People with type 2 diabetes who aren't taking insulin generally check their blood sugar much less often.

People who receive insulin therapy also may choose to monitor their blood sugar levels with a continuous glucose monitor. Although this technology hasn't yet completely replaced the glucose meter , it can lower the number of fingersticks necessary to check blood sugar and provide important information about trends in blood sugar levels.

Even with careful management, blood sugar levels can sometimes change unpredictably. With help from your diabetes treatment team, you'll learn how your blood sugar level changes in response to food, physical activity, medications, illness, alcohol and stress. For women, you'll learn how your blood sugar level changes in response to changes in hormone levels.

Besides daily blood sugar monitoring, your provider will likely recommend regular A1C testing to measure your average blood sugar level for the past 2 to 3 months. Compared with repeated daily blood sugar tests, A1C testing shows better how well your diabetes treatment plan is working overall. A higher A1C level may signal the need for a change in your oral drugs, insulin regimen or meal plan.

Your target A1C goal may vary depending on your age and various other factors, such as other medical conditions you may have or your ability to feel when your blood sugar is low.

Ask your provider what your A1C target is. People with type 1 diabetes must use insulin to manage blood sugar to survive. Many people with type 2 diabetes or gestational diabetes also need insulin therapy. Many types of insulin are available, including short-acting regular insulin , rapid-acting insulin, long-acting insulin and intermediate options.

Depending on your needs, your provider may prescribe a mixture of insulin types to use during the day and night. Insulin can't be taken orally to lower blood sugar because stomach enzymes interfere with insulin's action.

Insulin is often injected using a fine needle and syringe or an insulin pen — a device that looks like a large ink pen. An insulin pump also may be an option. The pump is a device about the size of a small cellphone worn on the outside of your body.

A tube connects the reservoir of insulin to a tube catheter that's inserted under the skin of your abdomen. A continuous glucose monitor, on the left, is a device that measures your blood sugar every few minutes using a sensor inserted under the skin.

An insulin pump, attached to the pocket, is a device that's worn outside of the body with a tube that connects the reservoir of insulin to a catheter inserted under the skin of the abdomen. Insulin pumps are programmed to deliver specific amounts of insulin automatically and when you eat.

A continuous glucose monitor, on the left, is a device that measures blood sugar every few minutes using a sensor inserted under the skin. Insulin pumps are programmed to deliver specific amounts of insulin continuously and with food. A tubeless pump that works wirelessly is also now available.

You program an insulin pump to dispense specific amounts of insulin. It can be adjusted to give out more or less insulin depending on meals, activity level and blood sugar level. A closed loop system is a device implanted in the body that links a continuous glucose monitor to an insulin pump.

The monitor checks blood sugar levels regularly. The device automatically delivers the right amount of insulin when the monitor shows that it's needed. The Food and Drug Administration has approved several hybrid closed loop systems for type 1 diabetes.

They are called "hybrid" because these systems require some input from the user. For example, you may have to tell the device how many carbohydrates are eaten, or confirm blood sugar levels from time to time.

A closed loop system that doesn't need any user input isn't available yet. But more of these systems currently are in clinical trials. Sometimes your provider may prescribe other oral or injected drugs as well. Some diabetes drugs help your pancreas to release more insulin. Others prevent the production and release of glucose from your liver, which means you need less insulin to move sugar into your cells.

Still others block the action of stomach or intestinal enzymes that break down carbohydrates, slowing their absorption, or make your tissues more sensitive to insulin. Metformin Glumetza, Fortamet, others is generally the first drug prescribed for type 2 diabetes. Another class of medication called SGLT2 inhibitors may be used.

They work by preventing the kidneys from reabsorbing filtered sugar into the blood. Instead, the sugar is eliminated in the urine.

In some people who have type 1 diabetes, a pancreas transplant may be an option. Islet transplants are being studied as well. With a successful pancreas transplant, you would no longer need insulin therapy.

But transplants aren't always successful. And these procedures pose serious risks. You need a lifetime of immune-suppressing drugs to prevent organ rejection.

These drugs can have serious side effects. Because of this, transplants are usually reserved for people whose diabetes can't be controlled or those who also need a kidney transplant.

Some people with type 2 diabetes who are obese and have a body mass index higher than 35 may be helped by some types of bariatric surgery. People who've had gastric bypass have seen major improvements in their blood sugar levels. But this procedure's long-term risks and benefits for type 2 diabetes aren't yet known.

Controlling your blood sugar level is essential to keeping your baby healthy. It can also keep you from having complications during delivery.

In addition to having a healthy diet and exercising regularly, your treatment plan for gestational diabetes may include monitoring your blood sugar.

In some cases, you may also use insulin or oral drugs. Your provider will monitor your blood sugar level during labor.

If your blood sugar rises, your baby may release high levels of insulin. This can lead to low blood sugar right after birth. Treatment for prediabetes usually involves healthy lifestyle choices.

These habits can help bring your blood sugar level back to normal. Or it could keep it from rising toward the levels seen in type 2 diabetes. Keeping a healthy weight through exercise and healthy eating can help. Drugs — such as metformin, statins and high blood pressure medications — may be an option for some people with prediabetes and other conditions such as heart disease.

Many factors can affect your blood sugar. Problems may sometimes come up that need care right away. High blood sugar hyperglycemia in diabetes can occur for many reasons, including eating too much, being sick or not taking enough glucose-lowering medication.

Check your blood sugar level as directed by your provider. And watch for symptoms of high blood sugar, including:.

Diabetic ketoacidosis is a serious complication of diabetes. If your cells are starved for energy, your body may begin to break down fat. This makes toxic acids known as ketones, which can build up in the blood. Watch for the following symptoms:.

You can check your urine for excess ketones with a ketones test kit that you can get without a prescription. If you have excess ketones in your urine, talk with your provider right away or seek emergency care. This condition is more common in people with type 1 diabetes.

This condition is seen in people with type 2 diabetes. It often happens after an illness. Call your provider or seek medical care right away if you have symptoms of this condition.

If your blood sugar level drops below your target range, it's known as low blood sugar diabetic hypoglycemia.

If you're taking drugs that lower your blood sugar, including insulin, your blood sugar level can drop for many reasons. These include skipping a meal and getting more physical activity than normal. Low blood sugar also occurs if you take too much insulin or too much of a glucose-lowering medication that causes the pancreas to hold insulin.

Low blood sugar is best treated with carbohydrates that your body can absorb quickly, such as fruit juice or glucose tablets. There is a problem with information submitted for this request.

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Diabetes is a serious disease. Following your diabetes treatment plan takes total commitment. Careful management of diabetes can lower your risk of serious or life-threatening complications. Make physical activity part of your daily routine. Regular physical activity can help prevent prediabetes and type 2 diabetes.

It can also help those who already have diabetes to maintain better blood sugar control. A minimum of 30 minutes of moderate physical activity — such as brisk walking — most days of the week is recommended. Aim for at least minutes of moderate aerobic physical activity a week.

Getting regular aerobic exercise along with getting at least two days a week of strength training exercises can help control blood sugar more effectively than does either type of exercise alone. Aerobic exercises can include walking, biking or dancing.

Resistance training can include weight training and body weight exercises. Also try to spend less time sitting still. Try to get up and move around for a few minutes at least every 30 minutes or so when you're awake.

Keep your vaccinations up to date. High blood sugar can weaken your immune system. Get a flu shot every year. Your provider may recommend the pneumonia and COVID vaccines, as well.

The Centers for Disease Control and Prevention CDC also currently recommends hepatitis B vaccination if you haven't previously had it and you're an adult ages 19 to 59 with type 1 or type 2 diabetes.

The most recent CDC guidelines suggest vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older, have been diagnosed with diabetes, and haven't previously received the vaccine, talk to your provider about whether it's right for you.

If you drink alcohol, do so responsibly. Alcohol can cause either high or low blood sugar. This depends on how much you drink and if you eat at the same time.

If you choose to drink, do so only in moderation — one drink a day for women and up to two drinks a day for men — and always with food.

Remember to include the carbohydrates from any alcohol you drink in your daily carbohydrate count. Symptoms of low blood glucose tend to come on quickly.

The symptoms can be different for everyone, but they may include:. Low blood glucose levels can be common in people with type 1 diabetes and people with type 2 diabetes who take certain diabetes medicines. If you think you may have low blood glucose, check your level, even if you don't have symptoms.

Low blood glucose can be dangerous and should be treated as soon as possible. Although it's rare, you can still get low blood glucose without having diabetes.

The causes can include conditions such as liver disease , kidney disease , and hormone deficiencies lack of certain hormones. Some medicines, such as certain heart medicines and antibiotics , can also cause it. See your provider to find out the cause of your low blood glucose and how to treat it.

The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

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What is blood glucose? What is diabetes? When and how should I check my blood glucose? What happens if my blood glucose level becomes too high? Symptoms that your blood glucose levels may be too high include: Feeling thirsty Feeling tired or weak headaches Urinating peeing often Blurred vision If you often have high blood glucose levels or symptoms of high blood glucose, talk with your health care team.

What happens if my blood glucose level becomes low for me? The symptoms can be different for everyone, but they may include: Shaking Sweating Nervousness or anxiety Irritability or confusion Dizziness Hunger Low blood glucose levels can be common in people with type 1 diabetes and people with type 2 diabetes who take certain diabetes medicines.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases. Start Here. Blood Sugar Testing: Why, When and How Mayo Foundation for Medical Education and Research Also in Spanish Continuous Glucose Monitoring National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Management: How Lifestyle, Daily Routine Affect Blood Sugar Mayo Foundation for Medical Education and Research Also in Spanish Monitoring Your Blood Sugar Level American Academy of Family Physicians Also in Spanish.

Diagnosis and Tests. A1C: MedlinePlus Health Topic National Library of Medicine Also in Spanish At-Home Medical Tests National Library of Medicine Also in Spanish Blood Glucose Test National Library of Medicine Also in Spanish Diabetes Tests and Diagnosis National Institute of Diabetes and Digestive and Kidney Diseases Also in Spanish Fasting for a Blood Test National Library of Medicine Also in Spanish.

Living With. A1C and eAG American Diabetes Association Blood Glucose Monitoring Devices Food and Drug Administration Manage Blood Sugar Centers for Disease Control and Prevention Also in Spanish Monitoring Association of Diabetes Care and Education Specialists - PDF Monitoring blood glucose - Series Medical Encyclopedia Also in Spanish Understanding A1C American Diabetes Association.

Related Issues. What Is the Difference between Hyperglycemia and Hypoglycemia? American Foundation for the Blind. Diabetes and Exercise: When to Monitor Your Blood Sugar Mayo Foundation for Medical Education and Research Also in Spanish How to Safely Use Glucose Meters and Test Strips for Diabetes Food and Drug Administration Also in Spanish.

Donohue syndrome: MedlinePlus Genetics National Library of Medicine Maturity-onset diabetes of the young: MedlinePlus Genetics National Library of Medicine Type A insulin resistance syndrome: MedlinePlus Genetics National Library of Medicine.

Test Your Knowledge. Managing Type 2 Diabetes Quiz Medical Encyclopedia Also in Spanish. Clinical Trials. gov: Blood Glucose National Institutes of Health.

Article: Association between alcohol consumption and latent fasting blood glucose trajectories among Article: Pseudohypoglycemia: A Pitfall in Everyday Practice. Article: A Small Highly Sensitive Glucose Sensor Based on a Glucose Oxidase-Modified Blood Glucose -- see more articles. Find an Expert.

American Diabetes Association Find a Diabetes Educator Association of Diabetes Care and Education Specialists National Institute of Diabetes and Digestive and Kidney Diseases NIDDK Information Clearinghouses and Health Information Center National Institute of Diabetes and Digestive and Kidney Diseases.