• If you have diabetes, it’s important to work with your health care team to advocate for yourself and share your treatment goals.
• As you age, diabetes may exacerbate your risk for other issues, such as vision and hearing loss, but you can take preventative steps.
• Understanding how to stay on top of your blood glucose and A1c levels will help you better manage your condition.

Managing diabetes can sometimes feel all-consuming, but it’s important to work with your health care team to ensure you’re keeping the condition under control. “It’s a job, and if you do it well, you save your own life,” one DiabetesTeam member said. “No more rewarding career that I can think of.”

If you don’t stay in control of your diabetes, you can risk damage to your vital organs. By managing your blood sugar levels appropriately, you can cut your risk of nerve disease, eye disease, and kidney disease by 40 percent.

“I'm having good blood sugar readings,” one DiabetesTeam member wrote. “I’m watching my food intake, exercising, and of course, taking my insulin. This diabetes game will not beat me, it can't — I won't let it. It's like anything else, we have to use willpower and be positive. That’s the only way if we want to remain in the game. We can do it!”

Here are some things to keep in mind to ensure your diabetes stays under control.

Communicate With Your Health Care Team

The most important — and impactful — part of managing your diabetes is having a strong channel of communication with your health care providers. If you ask questions and bring up concerns in a timely manner, your doctor can provide you with information or resources you may not have considered before.

Your primary care physician is your first point of contact. Some health care providers who make up your health care team might include:

• An endocrinologist who specializes in conditions of the endocrine system, including diabetes
• An ophthalmologist who makes sure your eyes remain healthy
• A podiatrist who can ensure your feet stay healthy
• A dietitian who can offer advice on what to eat
• A certified diabetes care and education specialist who can help you work with your family and your environment to manage your diabetes most effectively
• A fitness specialist who can help you safely work exercise into your daily routine

You know your body better than anyone else. If you feel concerned or uncomfortable about your health for any reason, you should absolutely communicate this to a health care provider. If you tend to feel overwhelmed during your appointments, you may benefit from writing down your questions in advance.

Shared Decision-Making Can Improve Outcomes

Forging a strong relationship with your providers can allow you to engage in shared decision-making. During this process, you and your physician work together to create the health care strategy that will best allow you to reach your diabetes management goals. Because your preferences are prioritized during this process, you’re more likely to follow through with the treatment plan.

Shared decision-making can not only allow you to better manage your diabetes, but it may also help you improve your outcomes. One study of people with type 2 diabetes found that shared decision-making led to improvements in A1c levels, weight, and diabetes empowerment scores.

Type 2 Diabetes and Other Conditions

Type 2 diabetes is typically diagnosed by measuring your fasting blood sugar or by measuring your average blood sugar levels over the previous two or three months — a test known as an A1c or a glycated hemoglobin test. Since people with type 2 diabetes have different treatment needs from those with type 1 diabetes, your doctor may also perform additional tests to distinguish between the two conditions.

Many people with type 2 diabetes also have comorbidities, or co-occurring health conditions — such as high blood pressure, obesity, or high cholesterol — which may require medication. Your doctor will consider your specific circumstances, such as your age and sex, as well as diet and other relevant lifestyle factors, when creating your treatment plan. Be sure to tell your doctor about any other conditions you may have or medication you may be taking.

One DiabetesTeam member said they were able to reduce high cholesterol and blood pressure levels by adhering to a ketogenic (low-carbohydrate) diet. “I eat my 100 net carbs per day and my numbers have improved so much that my doctor told her medical student that some diabetics require statins, but because my labs have changed for the better, she will hold off on prescribing them for me, as there is no need for them,” they wrote. “For the first time in my life, I feel healthy on paper. I know I cannot reverse damage from the past, but I’m hoping to prevent further issues in the future.”

Although the ketogenic diet can be helpful for some people with diabetes, it’s not appropriate for everyone. Always talk to your doctor before making any dietary changes.

Some people have to take medications beyond those they take for diabetes so they can more effectively treat their other conditions. If you’re on other medications, you may risk a drug interaction or a lessened therapeutic effect of your diabetes medicine.

It’s important to talk to your entire health care team and let them know what medications you’re taking and which other specialists you’re seeing. These providers will work together to ensure you’re getting the best care possible for all of your conditions and you won’t face any negative medication interactions.

Managing Your Blood Sugar Levels

The best way to ensure your diabetes is under control is to understand how to manage your blood sugar. There are several ways to test your blood sugar to ensure you’re keeping it at the target range you and your health care team have set.

Checking Your A1c

The A1c test is an important management tool for controlling your diabetes because it helps you determine your average blood sugar levels over the past few months. If your A1c levels are too high, you may be at risk of complications related to your diabetes.

The frequency with which you’re tested will depend on your specific case. For example, people with prediabetes may only need to get tested once a year, while people taking insulin may be tested up to four times per year. Your testing schedule might change if your doctor adjusts your treatment plan, such as switching your medications.

Many physicians advise people with type 2 diabetes to keep their A1c levels below 7 percent. If your A1c levels rise above this threshold, your physician will work with you on ways to reduce them. Your physician may also suggest a higher A1c threshold, depending on your unique circumstances, including your risk of having a hypoglycemic (low blood sugar) reaction.

Testing Your Blood Sugar

Ask your physician how often you should check your blood glucose levels. For those with type 1 diabetes, this can range from four to 10 times per day. For people with type 2 diabetes, your blood sugar monitoring schedule will depend on your treatment plan.

For some people, this will mean checking your glucose levels a different scheduled times, including:

• Before you eat
• About two hours after you eat
• Before you go to bed
• Before changing medications

Your doctor will tell you when and how often you should check your blood sugar.

Controlling Diabetes as You Age

Your diabetes needs and treatment goals may change as you get older. Aside from getting regular A1c tests and performing blood sugar testing at home, there are a number of other considerations for managing your diabetes. Your health care team should screen you for potential complications or comorbid conditions, such as kidney disease or insulin resistance.

Caring for your diabetes in the long term can help you avoid:

• Tooth issues and gum disease
• Vision issues
• Nerve damage (which may cause pain or tingling sensations)
• Heart attacks
• Eye problems
• Strokes

Additionally, bringing your blood glucose levels closer to normal can give you more energy, make you feel less tired, reduce feelings of thirst, and lead to fewer bladder and skin infections.

There are a few concerns you should be especially aware of if you notice diabetes complications — or other comorbidities — impacting you as time goes on. For example, people with diabetes have double the chance of experiencing hearing loss than those in the general population.

Another important consideration as you get older is improving your balance to avoid dangerous falls. Hypoglycemia and vision problems can put you at a higher risk for falls, but getting regular exercise (such as walking) can help you maintain your physical ability. You can also benefit from eating a healthy diet. If your physician approves, you can work with a dietitian or nutritionist to put you on the right path.

Continue to ask your diabetes specialist if you should add any other doctors to your team. For instance, even if you don’t have any vision issues now, that may change in the future. You want to catch any developing conditions early, so you can treat them swiftly and avoid future complications.

The Importance of Self-Advocacy

The most important thing to remember as you go through your diabetes treatment is that you are the center of your health care team. No one else knows your body or your experience better than you do, so advocating for yourself during medical appointments is the best way to get your questions and concerns addressed.

Additionally, the stress of having diabetes may impact your mental health. If you’re experiencing symptoms of anxiety or depression, you may benefit from speaking with a counselor or therapist.

Ultimately, the energy and time you put into managing your diabetes now will help you avoid issues down the road. “I’m doing great with controlling my diabetes,” one DiabetesTeam member wrote. “It used to control me, but not anymore!”

Talk With Others Who Understand

DiabetesTeam is the social network for people with diabetes and their loved ones. On DiabetesTeam, more than 118,000 members come together to ask questions, give advice, and share their stories with others who understand life with diabetes.

Do you have specific methods to stay in control of your diabetes? Share your experience in the comments below, or start a conversation by posting on your Activities page.