context: There are four things you need to do every day to lower high blood sugar: Eat healthy food. Get regular exercise. Take your diabetes medicine. Test your blood sugar. If you have diabetes, you should try to keep your blood sugar level as close as possible to that of someone who doesn't have diabetes. This may not be possible or right for everyone. Check with your doctor about what the right range of blood sugar is for you. You will get plenty of help in learning how to do this from your health care team, which is made up of your doctor, nurses, and dietitian. Bring a family member or friend with you when you see your doctor. Ask lots of questions. Before you leave, be sure you understand everything you need to know about taking care of your diabetes. The foods on your diabetes eating plan are the same ones that are good for everyone. Try to stick to things that are low in fat, salt, and sugar and high in fiber, like beans, fruits, vegetables, and grains. Eating right will help you: Reach and stay at a weight that is good for you Keep your blood sugar in a good range Prevent heart and blood vessel disease Ask your doctor for the name of a dietitian who can work with you on an eating plan for you and your family. Your dietitian can help you plan meals with foods that you and your family like and that are good for you. If You Use Insulin Give yourself an insulin shot. Eat about the same amount of food each day at about the same time. Don't skip meals, especially if you've already given yourself an insulin shot. Your blood sugar may go too low. If You Don't Use Insulin Follow your meal plan. Don't skip meals, especially if you take diabetes pills. Your blood sugar may go too low. Skipping a meal can make you eat too much at the next meal. It may be better to eat several small meals each day instead of one or two big ones. Being active each day is good for everyone. Good ways to do it include: Walking Swimming Dancing Biking Playing sports Cleaning your house or working in your garden count, too. Getting active is especially good for people with diabetes because: It helps keep your weight down. Your insulin may lower your blood sugar more easily. It helps your heart and lungs work better. Exercise gives you more energy. Before you start, talk with your doctor. If you have high blood pressure or eye problems, some exercises, like weightlifting, may not be safe. Your doctor or nurse will help you find safe exercises. Try to exercise at least three times a week for about 30 to 45 minutes each time. If you haven't been active in a while, ease in. Start with 5 to 10 minutes, then work up from there. If you haven't eaten for more than an hour or if your blood sugar level is less than 100-120, have something like an apple or a glass of milk before you exercise. When you're being active, carry a snack with you in case your blood sugar drops. Make sure to carry an identification tag or card that says you have diabetes. If You Use Insulin Exercise after eating, not before. Test your blood sugar before, during, and after. Don't exercise when it's higher than 240. Avoid exercise right before you sleep. It could cause low blood sugar during the night. If You Don't Use Insulin See your doctor before starting an exercise program. Test your blood sugar before and after exercising if you take diabetes pills. You want it no lower than 70 or no higher than 240. Insulin and diabetes pills and shots are the kinds of medicines used to lower blood sugar. These can include: Dulaglutide ( Trulicity) Exenatide ( Byetta) Exenatide Extended Release ( Bydureon) Liraglutide ( Victoza) Pramlintide ( Symlin) Semaglutide ( Ozempic) If You Need Insulin This is you if your body has stopped making insulin or if it doesn't make enough. Everyone with insulin-dependent diabetes (or type 1 diabetes) needs insulin, and many people with type 2 diabetes also need it. Insulin can't be taken as a pill. You will have to give yourself shots every day. Some people give themselves one a day. Some people give themselves two or more a day. Never skip a shot, even if you are sick. Insulin is injected with a needle. Your doctor will tell you what kind of insulin to use, how much, and when to give yourself a shot. Talk to your doctor before changing the type or amount of insulin you use or when you give your shots. Your doctor or the diabetes educator will show you how to draw up insulin in the needle. They'll also show you the best places on your body to give yourself a shot. Ask someone to help you with your shots if your hands are shaky or you can't see well. Good places on your body for a shot are: The outside part of your upper arms Around your waist and hips The outside part of your upper legs Avoid areas with scars and stretch marks. Ask your doctor or nurse to check your skin where you give your shots. At first, you may be a little afraid to give yourself a shot. But most people find that the shots hurt less than they expected. The needles are small and sharp and do not go deep into your skin. Always use your own needles, and never share them with anyone else. Your doctor or diabetes educator will tell you how to throw away used needles safely. Keep extra insulin in your refrigerator in case you break the bottle you're using. Don't keep insulin in the freezer or in hot places like your glove compartment. Also, keep it away from bright light. Too much heat, cold, or bright light can damage insulin. If your body makes insulin but it doesn't lower your blood sugar, you may have to take diabetes pills or some other injectable. These only work in people who have some insulin of their own. Some are taken once a day, and others are taken more often. Ask your doctor when you should take yours. Diabetes medications are safe and easy to take. Be sure to tell your doctor if yours make you feel bad or if you have any other problems. Remember, you'll still have to follow an eating plan and exercise to help lower your blood sugar. Sometimes, people who take diabetes pills may need insulin shots for a while. This may happen if you get very sick, need to go to a hospital, or become pregnant. You may also need them if the diabetes pills no longer lower your blood sugar. You may be able to stop taking diabetes pills if you lose weight. Losing even a little bit can help lower your blood sugar. If You Don't Use Insulin or Take Diabetes Pills Everyone with diabetes needs to follow their doctor's advice about eating and getting enough exercise. You need to know how well you are taking care of your diabetes. You need to know if you are lowering your blood sugar. The best way to find out is to test your blood. If it has too much or too little sugar in it, your doctor may need to change your eating, exercise, or medicine plan. Some people test their blood once a day. Others do it three or four times a day. Your doctor may want you to test before eating, before bed, and sometimes in the middle of the night. Ask your doctor how often and when you should test your blood sugar. How to Test Your Blood Sugar You need a small needle called a lancet. You also need special blood testing strips that come in a bottle. Your doctor or diabetes educator will show you how to test your blood. Here are the basic steps to follow: Depending on your monitoring device, prick your finger or another area of your body with the lancet to get a drop of blood. Place the blood on the end of the strip. Put the strip into the meter. The meter will display a number for your blood sugar, like 128. Pricking your finger with a lancet may hurt a little. It's like sticking your finger with a pin. Use the lancet only once, and be careful when you throw away used ones. Ask your doctor or nurse how to get rid of them safely. You can buy lancets, strips, and meters at a drugstore. Ask your doctor or diabetes educator for advice on what kind to buy. Take your blood testing items with you when you see your doctor or nurse so that you can learn how to use them the right way. Urine Tests: You may need to test your urine or blood for ketones when you are sick or if your blood sugar is over 240 before eating a meal. Your body makes ketones when there is not enough insulin in your blood. They can make you very sick. You can buy strips for testing urine ketones at a drugstore. Also, some blood glucose meters can detect ketones with specialized strips. Your doctor or diabetes educator will show you how to use testing monitors correctly. Call your doctor right away if you find ketones when you test. You may have something called ketoacidosis. If not treated, it can cause death. Signs of ketoacidosis are: Vomiting Weakness Fast breathing A sweet smell on the breath Ketoacidosis is more likely to happen in people with insulin-dependent diabetes. The Hemoglobin A1c Test: This shows what your average blood sugar was for the past 3 months. It shows how much sugar is sticking to your red blood cells. The doctor does this test to see what level your blood sugar is most of the time. To do the test, the doctor or nurse takes a sample of your blood. The blood is tested in a laboratory. The laboratory sends the results to your doctor. See your doctor for a hemoglobin A1c test every 3 months. Keep Daily Records Write down the results of your blood tests every day in a record book or notebook. You may also want to include what you eat, how you feel, and how much you've exercised. By keeping daily records of your blood and urine tests, you can tell how well you are taking care of your diabetes. Show your book to your doctor. She can use your records to see if you need to make changes in your insulin shots or diabetes pills or in your eating plan. Ask your doctor or nurse if you don't know what your test results mean. Things to write down every day in your notebook are: If you had very low blood sugar If you ate more or less food than you usually do If you felt sick or very tired What kind of exercise you did and for how long