Aging & Health A to Z

Diabetes

Care & Treatment

Happily, you can take steps to treat and manage diabetes and prevent its complications. 

Glycemic control (control of blood sugar) is important in preventing or delaying problems from diabetes. 

Even a small weight loss of 10 to 15 pounds can bring a big improvement in your blood glucose level. 

Exercise is also helpful for losing weight and controlling your blood glucose.  Even small increases in physical activity can help.  

Non-insulin Medications

If diet and exercise alone don’t control your type 2 diabetes, your healthcare professional will prescribe a medication to help lower your blood sugar. Many options are available. Most of them are are oral medications (pills) but some are shots.

Each medication has advantages and possible side effects. Depending on the drug, side effects may include stomach upset, liver damage, heart failure, or other problems.

Your healthcare professional will talk with you and your family or other caregivers about which medication is right for you. Your pharmacist is also a good source of information about any medications you are taking.

Insulin

If diet, exercise, and non-insulin medications don’t control your blood glucose level, your healthcare professional may suggest insulin treatment. Insulin may also be the first choice of treatment if your blood glucose levels are very high.

Caution: With most medications used to treat diabetes, there is a risk of lowering your blood sugar level too much. This is a serious concern for frail older adults, who may not experience early warning symptoms of low blood sugar. Because of this, it’s essential to check your blood glucose level several times a day—on an empty stomach, after eating, and at bedtime—to be sure that the level does not drop suddenly.

Monitoring your Glucose Levels

Glucose Meter
Once you’ve been diagnosed with diabetes, your healthcare professional will teach you or your caregivers how to use a glucose meter. This simple device lets you check your blood glucose level as often as your healthcare professional recommends. If you take insulin, you’ll also learn how to change your dose, depending on your blood glucose level. 

If you take insulin, check your blood glucose level at least once a day, even if your blood glucose is stable. Check it more often if you are change medications, your diet, or if you become ill.

Keep a record of your blood glucose results, noting the time of day, when you last ate, and when you took your blood glucose medication. Bring this record with you to each visit with your healthcare provider. (Some glucose meters will do this for you). Ask your healthcare professional to make sure you’re managing your blood glucose correctly with diet, exercise, and medication. 

Hemoglobin A1c Test
Another way your blood glucose levels may be monitored for control of blood sugar is with the hemoglobin A1c test, which lets you know how good your sugar control has been over the past 3 months. Everyone with diabetes needs at least two of these tests each year.

No matter what your age or general health is, everyone with diabetes needs to work with their healthcare provider to decide what level of A1C will be best for their long-term health. Your treatment & management will depend on how long you have had diabetes, what other conditions you have and your life expectancy. You should talk to your healthcare professional about what target is right for you. 

Generally:

• If you are a middle-aged adult and otherwise healthy and active, your healthcare provider will want you to aim for an A1C of 7% or less. 
• If you are older and have a lot of medical problems, it is likely that an A1C between 7 and 8% would be very safe for you. It takes 10 to19 years before the benefits of an A1C less than 7% is seen, and so generally moderate control is generally better for older adults

Updated: February 2013
Posted: March 2012