Lifestyle & Management

There are a number of lifestyle changes to make to manage diabetes and minimize possible complications. Click below to read more about them.

Important Steps in Managing Your Diabetes

Healthy eating and exercise are very beneficial for people with diabetes. They can improve overall health, help manage blood glucose levels, and decrease risk for complications from diabetes.

Your healthcare providers can help design an individualized diet and exercise program that is right for you. They will help you increase your level of physical activity safely and gradually, so you can keep it up over time.  Your diet and exercise plan will also take into account any other illnesses or physical limitations you may have. Your healthcare provider may also have you work with a dietician to help you develop a healthy food plan that you will enjoy.

Choose Healthy, Low-Calorie Foods

To help manage your blood glucose levels, you need to control the number of calories and carbohydrates you eat each day. But, you don’t have to give up taste and satisfaction! Here’s how to eat well and healthfully when you have diabetes:

  • Eat smaller portions at each meal. If you eat out, share what you order with a friend or bring home part of your meal to eat the next day.
  • Eat cereals, breads, and pasta made with whole grains instead of white flour. Substitute brown rice for white rice and sweet potatoes for white potatoes.
  • Read labels on foods such as cereal, bread, and pasta. Choose those containing at least 3 grams or more of fiber per serving.
  • Eat a variety of brightly-colored, low calorie fruits and vegetables. Aim for 6 to 9 servings a day. Especially good choices include leafy greens (such as spinach, chard, kale, collards, mustard greens, and dark green or red lettuces), broccoli, broccoli rabe, red peppers, carrots, berries, cherries, apples, pears, and citrus fruits.
  • Drink water or unsweetened tea instead of fruit juices, soft drinks, or other beverages high in sugar.
  • Avoid eating processed and prepared foods. These foods are often loaded with fat, calories, and sodium, plus they can contain unhealthy ingredients such as trans-saturated fats and high fructose corn syrup.
  • At fast food restaurants, choose the salad option (with low-fat dressing). At family-style restaurants, choose broiled poultry, fish, or lean meat entrees with steamed vegetables. Skip cheesy, buttery, or creamy sauces. Choose oil and vinegar dressings on salads.
  • Limit the amount of alcohol you drink.
  • Less than 20-35% of your total daily calories should come from fat. The healthiest fats are found in foods such as whole grains, avocados, walnuts, almonds, sunflower seeds, peanut butter, and fatty fish (such as salmon, sardines, mackerel, herring, and trout).
  • Choose olive and canola oil for cooking and salads.
  • Choose foods high in protein, including eggs, low-fat dairy products, lean meats, poultry, fish, beans, and nuts.
  • Your diet should also be high in fiber.
  • Save desserts and other sweet treats for special occasions. Choose fruit canned in its own juice instead of sugar syrup.


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

People with pre-diabetes or diabetes should exercise 20 to 30 minutes at least three times a week. If you are able to, there is even greater benefit in exercising 20 to 30 minutes on most days.

Activities such as doing yard work or cleaning the house count as exercise, as long as they increase your heart rate and cause you to sweat lightly. Walking, swimming, and water aerobics are also great forms of exercise.

Exercise can be more fun if you do it with a friend or a group. Exercise classes are available at many local hospitals, community and senior centers, and adult education programs. An exercise teacher can help guide you on how to prevent injuries and modify activities for any physical limitations you may have. You may check with your insurance plan if you are eligible for a Silver Sneakers program. This program provides people 65 and over with free access to local fitness centers.

Diabetes Education and Self-Management

If you have diabetes, Medicare pays for a visit with a diabetes educator once every year. Ask your healthcare provider to give you a referral. The educator will teach you how to manage your blood glucose and will work with you to develop a self-management program.

It is important that you know everything you can about how to manage your diabetes. Therefore, you should feel comfortable asking the diabetes educator as many questions as you need to, as often as you need to. Make sure you fully understand the answers to all your questions, and ask the educator to explain anything you do not understand. Common topics to discuss include meal size and the correct amount and type of carbohydrates in typical meals.  The glycemic index might be a helpful tool to rank foods according to how they affect blood glucose.

If you need help, your family or other caregivers should also receive training and become involved in your diabetes self-management. Caregivers may need to take over the self-management program if a person with diabetes becomes significantly disabled.

Recognizing Symptoms

Despite your best efforts, you could experience problems. If you have any of these symptoms, call your healthcare provider at the first sign of trouble.
Very High Blood Glucose

This is an uncommon but serious complication of diabetes that occurs most often in older adults. A spike in glucose can be caused by a sudden illness, particularly an infection, or certain medications. Watch out for these symptoms:

  • Physical weakness
  • Lack of energy
  • Agitation
  • Confusion
Low Blood Glucose  

Low blood glucose usually occurs when you take too much of your diabetes medication, or if you skip a meal. Illness and infections can also cause low blood glucose. Watch for these symptoms:

  • Nervousness
  • Shaking
  • Sweating
  • Confusion
What to Do
It can be easy to confuse symptoms of low and high blood sugar. Therefore, you should measure your blood glucose level at the first sign of any unusual symptoms, and then call your healthcare provider right away. If you are unable to measure your glucose, call your provider promptly.

If your blood glucose is low, you should be able to raise it quickly by having some sugar. You can eat a piece of candy, have a spoonful of honey, or drink a half glass of fruit juice (such as orange juice). For people with diabetes, it is a good idea to keep hard candies available, just in case. However, this sugar boost only lasts a little while. Therefore, it’s important to eat a meal as soon as possible.

If your blood glucose is frequently or severely low, your healthcare provider will need to check your diabetes treatment plan and change it if necessary. You may just need a better plan for controlling your blood glucose levels. You may also need to visit your healthcare provider more frequently for check-ups, or see a diabetes care specialist.

Understanding Your Medications

You need to know all of the medications you are taking, not just your diabetes medications. Ask your healthcare provider(s) to tell you about each medication prescribed for you and ask to have the indication for each prescription printed on the bottle, including:

  • Why you are taking it
  • How and when to take it
  • Common side effects

Managing Stress

Extreme or chronic stress can raise blood glucose levels. Though you can’t avoid stress, you can learn to manage your reaction to it.

These tips can help:

  • Don’t put unnecessary demands on yourself. Try to avoid being a perfectionist or workaholic.
  • Schedule time for things you enjoy, such as socializing with friends or family, gardening, singing or playing an instrument, or doing crafts or other creative activities.
  • Keep a positive attitude and focus on the things in your life that are going well.
  • Talk to your spouse or partner, a close friend, a family member, or a counselor or clergy member about the things you find stressful.
  • Exercise. It is an excellent way to relieve stress.
  • Learn and use simple relaxation techniques, such as listening to calming music or sounds, deep breathing, muscle relaxation, or meditation.

Dealing with Complications of Diabetes

Over time, high levels of glucose in your bloodstream can damage your nerves and the small blood vessels in your heart, kidneys, and eyes. This puts you at higher risk for visual impairment, blindness, heart, and kidney problems.

Serious health conditions that are often caused by diabetes include:

  • Heart disease, such as heart attacks
  • Blood vessel problems, such as narrowing of the arteries
  • Nerve problems (usually burning, tingling, or numbness of the feet or hands)
  • Foot problems (sores or ulcers)
  • Eye problems (including impaired vision or blindness)
  • Kidney failure
  • Erectile dysfunction

Heart Disease

Cardiovascular disease is a major cause of illness and death for people with diabetes. Because heart problems are so common with diabetes, your healthcare provider will check for other conditions that can also cause heart trouble, such as smoking, high blood pressure, being overweight, high cholesterol, and a family history of heart problems. If you have high cholesterol, your healthcare provider may prescribe medications that lower your cholesterol, such as statin drugs. These drugs are more helpful for patients with diabetes than for those without diabetes.

 Preventing and managing risk factors for heart disease in older adults with diabetes is especially important. These steps include:

  • Losing weight if necessary.
  • Increasing physical activity.
  • Quitting smoking. The benefits of quitting are much higher in patients with diabetes. Quitting smoking is even more beneficial than controlling blood pressure or cholesterol level to reduce the risk of death.

Foot Care

Diabetes can cause problems with blood vessels and peripheral circulation. This means that people with diabetes are at very high risk for serious foot complications. Unfortunately, these foot problems can even lead to amputation. Therefore, taking excellent care of your feet is a very important part of diabetes management.

Your healthcare provider should examine your feet at least once a year, and you should examine your feet every day. Tell your healthcare provider right away about any changes to your feet or any signs of damage, including sores, ulcers or discolored toes. Due to the potential for nerve damage, you may not feel a sore on the bottom of your foot or recognize that a callus may actually be an abscess. Therefore, performing a visual examination of your feet daily with the aid of a small handheld mirror can help catch these complications early.

You must also take good care of your toenails to prevent foot infections. Ask your healthcare provider to refer you to a foot doctor (podiatrist), especially if it’s hard for you to care for your toenails yourself. 

Eye Care

The blood vessel and circulation problems associated with diabetes can also affect your eyes. Have a thorough eye examination by an eye doctor (ophthalmologist), every year or as often as recommended. Yearly checkups with your eye doctor can identify complications of diabetes early when there are often more treatment options available.

Other Steps to Prevent Complications

To help monitor whether you may be developing diabetes complications, work with your healthcare provider to:

  • Review all the medications you are taking that might increase your blood glucose, such as certain water pills (diuretics) or certain steroid medications for asthma or arthritis.
  • Have a urine test every year. Having a protein called albumin in your urine can be an early sign of kidney damage.
  • See your dentist twice a year to keep your teeth and gums healthy.
  • Get a flu shot every year. Talk to your healthcare provider about getting a vaccine for pneumonia (two different types of pneumococcal vaccine are recommended now).
  • Protect your skin from the sun with hats and clothing, and keep your skin clean and moisturized. Take care of cuts and bruises to prevent infections.

Last Updated August 2020