Your Guide to Diabetes:

Type 1 and Type 2

National Diabetes Information 

Clearinghouse

Your Guide to Diabetes:

Type 1 and Type 2

Contents

Learn about Diabetes ............................................................ 1

What is diabetes? .............................................................. 2

What is prediabetes?......................................................... 3

What are the signs and symptoms 

of diabetes?........................................................................ 4

What kind of diabetes do you have? ............................... 5

Why do you need to take care of 

your diabetes?.................................................................... 7

Who is part of your health care team?............................ 8

Take Care of Your Diabetes Each Day ............................ 10

Follow Your Healthy Eating Plan ................................. 10

Be Physically Active........................................................ 12

Take Your Medicines as Prescribed.............................. 16

Monitor Your Diabetes....................................................... 21

Keep Daily Records........................................................ 25

Learn about High and Low Blood 

Glucose Levels ................................................................ 26

Prevent Diabetes Problems................................................. 33
Take Care of Your Diabetes during Special 

Times or Events.................................................................... 36

When You’re Sick........................................................... 36

When You’re at School or Work................................... 39

When You’re Away from Home.................................... 41

When You’re Flying on a Plane..................................... 42

When an Emergency or a Natural Disaster 

Happens........................................................................... 45

If You’re a Woman and Planning 

a Pregnancy...................................................................... 46

Your Diabetes Care Records.............................................. 48

Points to Remember............................................................ 56

Hope through Research ...................................................... 61

Pronunciation Guide............................................................ 63

For More Information ......................................................... 65

Acknowledgments................................................................ 66
1

Learn about Diabetes

You can learn how to take care of your diabetes and 

prevent some of the serious problems diabetes can cause. 

The more you know, the better you can manage your 

diabetes.

Share this booklet with your family and friends so they will 

understand more about diabetes. Also make sure to ask 

your health care team any questions you might have. 

You can learn how to take care of your diabetes.
2

What is diabetes?

Diabetes is when your blood glucose*, also called blood 

sugar, is too high. Blood glucose is the main type of sugar 

found in your blood and your main source of energy. 

Glucose comes from the food you eat and is also made in 

your liver and muscles. Your blood carries glucose to all of 

your body’s cells to use for energy. 

Your pancreas—an organ, located between your stomach 

and spine, that helps with digestion—releases a hormone it 

makes, called insulin, into your blood. Insulin helps your 

blood carry glucose to all your body’s cells. Sometimes your 

body doesn’t make enough insulin or the insulin doesn’t 

work the way it should. Glucose then stays in your blood 

and doesn’t reach your cells. Your blood glucose levels get 

too high and can cause diabetes or prediabetes.

Over time, having too much glucose in your blood can 

cause health problems.

*See the Pronunciation Guide for tips on how to say the 

words in bold type.
3

What is prediabetes?

Prediabetes is when the amount of glucose in your blood 

is above normal yet not high enough to be called diabetes. 

With prediabetes, your chances of getting type 2 diabetes, 

heart disease, and stroke are higher. With some weight loss 

and moderate physical activity, you can delay or prevent 

type 2 diabetes. You can even return to normal glucose 

levels, possibly without taking any medicines.

Prediabetes Caution: Take steps to prevent type 2 diabetes now.

Diabetes

Normal
4

What are the signs and symptoms of diabetes?

The signs and symptoms of diabetes are

● being very thirsty

● urinating often

● feeling very hungry

● feeling very tired

● losing weight without trying

● sores that heal slowly

● dry, itchy skin

● feelings of pins and needles in your feet

● losing feeling in your feet

● blurry eyesight

Some people with diabetes don’t have any of these signs or 

symptoms. The only way to know if you have diabetes is to 

have your doctor do a blood test.
5

What kind of diabetes do you have? 

The three main types of diabetes are type 1, type 2, and 

gestational diabetes. People can develop diabetes at any 

age. Both women and men can develop diabetes. 

Type 1 Diabetes

Type 1 diabetes, which used to be called juvenile diabetes, 

develops most often in young people; however, type 1 

diabetes can also develop in adults. In type 1 diabetes, your 

body no longer makes insulin or enough insulin because 

the body’s immune system, which normally protects you 

from infection by getting rid of bacteria, viruses, and other 

harmful substances, has attacked and destroyed the cells 

that make insulin. 

Treatment for type 1 diabetes includes 

● taking shots, also called injections, of insulin. 

● sometimes taking medicines by mouth.

● making healthy food choices.

● being physically active.

● controlling your blood pressure levels. Blood pressure 

is the force of blood flow inside your blood vessels. 

● controlling your cholesterol levels. Cholesterol is a 

type of fat in your body’s cells, in your blood, and in 

many foods. 
6

Type 2 Diabetes

Type 2 diabetes, which used to be called adult-onset 

diabetes, can affect people at any age, even children. 

However, type 2 diabetes develops most often in middleaged and older people. People who are overweight and 

inactive are also more likely to develop type 2 diabetes.

Type 2 diabetes usually begins with insulin resistance—a 

condition that occurs when fat, muscle, and liver cells do 

not use insulin to carry glucose into the body’s cells to use 

for energy. As a result, the body needs more insulin to help 

glucose enter cells. At first, the pancreas keeps up with 

the added demand by making more insulin. Over time, the 

pancreas doesn’t make enough insulin when blood sugar 

levels increase, such as after meals. If your pancreas can 

no longer make enough insulin, you will need to treat your 

type 2 diabetes. 

Treatment for type 2 diabetes includes 

● using diabetes medicines

● making healthy food choices

● being physically active

● controlling your blood pressure levels 

● controlling your cholesterol levels
7

Gestational Diabetes 

Gestational diabetes can develop when a woman is 

pregnant. Pregnant women make hormones that can lead 

to insulin resistance. All women have insulin resistance late 

in their pregnancy. If the pancreas doesn’t make enough 

insulin during pregnancy, a woman develops gestational 

diabetes.

Overweight or obese women have a higher chance of 

gestational diabetes. Also, gaining too much weight during 

pregnancy may increase your likelihood of developing 

gestational diabetes. 

Gestational diabetes most often goes away after the baby is 

born. However, a woman who has had gestational diabetes 

is more likely to develop type 2 diabetes later in life. Babies 

born to mothers who had gestational diabetes are also more 

likely to develop obesity and type 2 diabetes.

Read more about diabetes and pregnancy in 

What I need to know about Gestational Diabetes at 

www.diabetes.niddk.nih.gov. 

Why do you need to take care of your diabetes? 

Over time, diabetes can lead to serious problems with your 

blood vessels, heart, nerves, kidneys, mouth, eyes, and feet. 

These problems can lead to an amputation, which is surgery 

to remove a damaged toe, foot, or leg, for example. 
8

The most serious problem caused by diabetes is heart 

disease. When you have diabetes, you are more than twice 

as likely as people without diabetes to have heart disease or 

a stroke. With diabetes, you may not have the usual signs 

or symptoms of a heart attack. The best way to take care of 

your health is to work with your health care team to keep 

your blood glucose, blood pressure, and cholesterol levels 

in your target range. Targets are numbers you aim for. 

Who is part of your health care team?

Most people with diabetes get care from primary care 

providers, such as internists, family physicians, or 

pediatricians. A team of health care providers can also 

improve your diabetes care. 

In addition to a primary care provider, your health care 

team may include

● an endocrinologist for more specialized diabetes care 

● a dietitian, a nurse, or a certified diabetes educator—

experts who can provide information about managing 

diabetes 

● a counselor or mental health professional 

● a pharmacist

● a dentist

● an ophthalmologist or an optometrist for eye care 

● a podiatrist for foot care 
9

If diabetes makes you feel sad or angry, or if you have other 

problems that worry you, you should talk with a counselor 

or mental health professional. Your doctor or certified 

diabetes educator can help you find a counselor.

Talk with your doctor about what vaccines and 

immunizations, or shots, you should get to keep from 

getting sick. Preventing illness is an important part of 

taking care of your diabetes. 

When you see members of your health care team, ask lots 

of questions. Prepare a list of questions before your visit. 

Be sure you understand everything you need to know about 

taking care of your diabetes. 

When you see members of your health care team, ask 

lots of questions. Prepare a list of questions before 

your visit. 
10

Take Care of Your Diabetes Each Day 

Do four things each day to help your blood glucose levels 

stay in your target range: 

● Follow your healthy eating plan. 

● Be physically active. 

● Take your medicines as prescribed. 

● Monitor your diabetes. 

These things may seem like a lot to do at first. Just make 

small changes until these steps become a normal part of 

your day.

Follow Your Healthy Eating Plan 

Ask your doctor to give you the name of someone trained 

to help you create a healthy eating plan, such as a dietitian. 

This plan, often called medical nutrition therapy, will 

include regular monitoring by your dietitian and education 

about how to adjust your eating habits as the need occurs. 

Medical nutrition therapy is usually covered by insurance or 

Medicare as long as your doctor refers you. Your dietitian 

can help you plan meals that include foods that you and 

your family like and that are good for you. 
11

Your healthy eating plan will include 

● breads, cereals, rice, and whole grains

● fruits and vegetables

● meat and meat substitutes

● dairy products

● healthy fats 

Your plan will also help you learn how to eat the right 

amount, or portions, of food. Making good food choices 

will

● help you reach and stay at a healthy weight 

● keep your blood glucose, blood pressure, and 

cholesterol levels under control 

● prevent heart and blood vessel disease

If you take insulin, look at the white boxes like this one for 

“Action Steps.” 

Action Steps

If You Take Insulin

•	 Follow your healthy eating plan.

•	 Don’t skip meals, especially if you’ve already taken your insulin, 

because your blood glucose levels may drop too low. 

•	Learn more about how to handle low blood glucose, also called 

hypoglycemia, in the section “Learn about High and Low Blood 

Glucose Levels.”
12

If you don’t take insulin, look at the blue boxes like this one 

for “Action Steps.” 

Action Steps

If You Don’t Take Insulin

•	 Follow your healthy eating plan.

•	 Don’t skip meals, especially if you take diabetes medicines, 

because your blood glucose levels may drop too low. 

•	 Read more about how to handle low blood glucose, also called 

hypoglycemia, in the section “Learn about High and Low Blood 

Glucose Levels.”

•	Eat several small meals during the day instead of big meals.

Read more about healthy eating plans in What I need to know 

about Eating and Diabetes at www.diabetes.niddk.nih.gov.

Be Physically Active 

Physical activity helps you stay healthy. Physical activity is 

especially good if you have diabetes because it 

● helps you reach or stay at a healthy weight 

● helps insulin work better to lower your blood glucose 

levels 

● is good for your heart and lungs 

● gives you more energy
13

Even small amounts of physical activity help manage 

diabetes, such as when you are physically active at work 

or home. People with diabetes should aim for 30 to 

60 minutes of activity most days of the week. Children and 

adolescents with type 2 diabetes who are 10 to 17 years old 

should aim for 60 minutes of activity every day. Not all 

physical activity has to take place at the same time. 

Increase daily activity by decreasing time spent watching 

TV or at the computer. Children and adolescents should 

limit screen time not related to school to less than 2 hours a 

day. Limiting screen time can help you meet your physical 

activity goal.

People with diabetes should

● always talk with a doctor before starting a new physical 

activity program.

● do aerobic activities, such as brisk walking, which use 

the body’s large muscles to make the heart beat faster. 

The large muscles are those of the upper and lower 

arms and legs and those that control head, shoulder, 

and hip movements. 

● do activities to strengthen muscles and bone, such as 

sit-ups or lifting weights. Aim for two times a week. 

● stretch to increase flexibility, lower stress, and help 

prevent muscle soreness after physical activity. 
14

Many activities can help your child and your family stay 

active and have fun. Consider activities that they might 

enjoy and can stick with, such as 

● playing basketball 

● dancing to music with friends 

● taking a walk or a bike ride

Physical activity helps you 

stay healthy.
15

Action Steps

If You Take Insulin

•	 See your doctor before becoming physically active.

•	 Check your blood glucose levels before, during, and after 

physical activity. Don’t start a physical activity program when 

your blood glucose levels are high or if you have ketones in 

your blood or urine. Read more about ketones in the section 

“Monitor Your Diabetes.”

•	 Don’t be physically active right before you go to bed because it 

could cause low blood glucose while you sleep.

Action Steps

If You Don’t Take Insulin

•	 See your doctor before becoming physically active.

•	 Ask your doctor about whether you need to eat before you are 

physically active.

When you are being physically active, carry glucose tablets 

or a carbohydrate-rich snack or drink with you, such as fruit 

or juice, in case your blood glucose levels go too low. 

Read more about increasing your physical activity in What 

I need to know about Physical Activity and Diabetes at 

www.diabetes.niddk.nih.gov.
16

Take Your Medicines as Prescribed

If you have type 2 diabetes and are unable to reach your 

target blood glucose levels with a healthy eating plan and 

physical activity, diabetes medicines may help. Your doctor 

may prescribe you diabetes medicines that work best for 

you and your lifestyle. 

If you have type 1 diabetes, you need insulin shots if your 

body has stopped making insulin or if it doesn’t make 

enough. Some people with type 2 diabetes or gestational 

diabetes also need to take insulin shots. 

If you have type 2 diabetes and are unable 

to reach your target blood glucose levels 

with a healthy eating plan and physical 

activity, diabetes medicines may help. 
17

Diabetes Medicines 

Most people with type 2 diabetes use medicines other than 

insulin shots. People with type 2 diabetes use medicine to 

help their blood glucose levels stay in their target range. If 

your body makes insulin and the insulin doesn’t lower your 

blood glucose levels enough, you may need to take one or 

more medicines. 

Diabetes medicines come in pill and shot form. Some 

people take diabetes medicines once a day and other 

medicines more often. Ask your health care team when you 

should take your diabetes medicines. Sometimes, people 

who take diabetes medicines may also need insulin shots for 

a while. 

Be sure to tell your doctor if your medicines make you feel 

sick or if you have any other problems. If you get sick or 

have surgery, your diabetes medicines may no longer work 

to lower your blood glucose levels. Always check with your 

doctor before you stop taking your diabetes medicines. 
18

Insulin Shots

Only a doctor can prescribe insulin. Your doctor can tell 

you how much insulin you should take and which of the 

following ways to take insulin is best for you: 

● Insulin shot. You’ll use a needle attached to a 

syringe—a hollow tube with a plunger—that you fill 

with a dose of insulin. Some people use an insulin 

pen, a penlike device with a needle and a cartridge of 

insulin. Never share insulin needles or insulin pens, 

even with family.

● Insulin pump. An insulin pump is a small device filled 

with insulin that you wear on your belt or keep in your 

pocket. The pump connects to a small, plastic tube 

and a small needle. You or your doctor inserts the 

needle under your skin. The needle can stay in for 

several days. 

● Insulin jet injector. This device sends a fine spray of 

insulin through your skin with high-pressure air instead 

of a needle. 
19

● Insulin injection port. You or your doctor inserts a 

small tube just beneath your skin, where it remains in 

place for several days. You can inject insulin into the 

end of the tube instead of through your skin. 

Read more about ways to take insulin in Alternative Devices

for Taking Insulin at www.diabetes.niddk.nih.gov.

Only a doctor can prescribe insulin. Your 

doctor can tell you how much insulin you 

should take.
20

Other Medicines

Your doctor may prescribe other medicines to help with 

problems related to diabetes, such as

● aspirin for heart health

● cholesterol-lowering medicines

● medicines for high blood pressure

Remembering to take your medicines at the correct times 

each day can be challenging. Many people find that 

keeping a weekly pill box with separate boxes for each day, 

and even separate boxes for morning and evening, can 

help. Also ask your health care team to update your list of 

medicines at each visit so you always have an accurate list of 

what medicines to take and when.

Read more about diabetes and medicines in 

What I need to know about Diabetes Medicines at 

www.diabetes.niddk.nih.gov. 
21

Monitor Your Diabetes

Check Your Blood Glucose Levels 

Checking and recording your blood glucose levels can help 

you monitor and better manage your diabetes. If your blood 

has too much or too little glucose, you may need a change in 

your healthy eating plan, physical activity plan, or medicines. 

A member of your health care team will show you how 

to check your blood glucose levels using a blood glucose 

meter. Your health care team can teach you how to

● prick your finger to get a drop of blood for testing

● use your meter to find out your blood glucose level 

from your drop of blood

Read more in Continuous Glucose Monitoring at 

www.diabetes.niddk.nih.gov.

Your health insurance or Medicare may pay for the blood 

glucose meter and test strips you need.

Checking and recording your blood glucose 

levels can help you better manage your diabetes. 
22

Ask your doctor how often you should check your blood 

glucose levels. You may need to check before and after 

eating, before and after physical activity, before bed, and 

sometimes in the middle of the night. Make sure to keep a 

record of your blood glucose self-checks. 

Target Range for Blood Glucose Levels 

Most people with diabetes should try to keep their blood 

glucose levels as close as possible to the level of someone 

who doesn’t have diabetes. This normal target range is 

about 70 to 130. The closer to normal your blood glucose 

levels are, the lower your chance of developing serious 

health problems. 

Ask your doctor what your target levels are and when you 

should check your blood glucose levels with a meter. Make 

copies of the chart in the section “Your Diabetes Care 

Records” to take with you when you visit your doctor. 

Reaching your target range all of the time can be hard. 

Remember, the closer you get to your target range, the 

better you will feel. 

The A1C Test

Another test for blood glucose, the A1C—also called the 

hemoglobin A1C test, HbA1C, or glycohemoglobin test—is 

a blood test that reflects the average level of glucose in your 

blood during the past 2 to 3 months. 
23

You should have the A1C test at least twice a year. If your 

result is not on target, your doctor may have you take the 

test more often to see if your A1C improves.

For the test, your doctor will draw a sample of your blood 

during an office visit or send you to a lab to have your blood 

drawn. Your A1C test result is given as a percentage. Your 

A1C result plus the record of your blood glucose numbers 

show whether your blood glucose levels are under control. 

● If your A1C result is too high, you may need to change 

your diabetes treatment plan. Your health care team 

can help you decide what part of your plan to change. 

● If your A1C result is on target, then your diabetes 

treatment plan is working. The lower your A1C result, 

the lower your chance of having diabetes problems.

Talk with your doctor about what your A1C target should 

be. Your personal target may be above or below the target 

shown in the chart. 

A1C Targets

Target for most people with diabetes Below 7 percent

Time to change my diabetes care plan 8 percent or above
24

A1C targets can also depend on 

● how long you have had diabetes

● whether or not you have other health problems

Read more about A1C targets at www.ndep.nih.gov.

Tests for Ketones 

You may need to check your blood or urine for ketones if 

you’re sick or if your blood glucose levels are above 240. 

Your body makes ketones when you burn fat instead of 

glucose for energy. If you have too many ketones, you are 

more likely to have a serious condition called ketoacidosis. 

If not treated, ketoacidosis can cause death. 

Signs of ketoacidosis are 

● vomiting

● weakness

● fast breathing

● sweet-smelling breath

Ketoacidosis is more likely in people with type 1 diabetes. 

Your doctor or diabetes educator will show you how to test 

for ketones. 
25

Keep Daily Records 

Make copies of the daily diabetes record at the end of this 

booklet. Then, write down the results of your blood glucose 

checks each day. You may also want to record what you 

ate, how you felt, and whether you were physically active. 

Bring your blood glucose records to all visits with your 

health care team. They can use your records to see whether 

you need changes in your diabetes medicines or in your 

healthy eating plan. 

Action Steps

If You Take Insulin

Keep a daily record of

•	 your blood glucose levels

•	 the times of day you take insulin

•	 the amount and type of insulin you take

•	 what types of physical activity you do and for how long

•	 when and what you eat

•	 whether you have ketones in your blood or urine

•	 when you are sick

Action Steps

If You Don’t Take Insulin

Keep a daily record of

•	 your blood glucose levels

•	 the times of day you take your medicines

•	 what types of physical activity you do and for how long
26

Learn about High and Low Blood Glucose Levels 

Sometimes, no matter how hard you try to keep your blood 

glucose levels in your target range, they will be too high or 

too low. Blood glucose that’s too high or too low can make 

you feel sick. If you try to control your high or low blood 

glucose and can’t, you may become even sicker and need 

help. Talk with your doctor to learn how to handle these 

emergencies. 

Learn about High Blood Glucose Levels

If your blood glucose levels stay above 180 for more than 

1 to 2 hours, they may be too high. See the chart on 

page 54. High blood glucose, also called hyperglycemia,

means you don’t have enough insulin in your body. High 

blood glucose can happen if you 

● miss taking your diabetes medicines

● eat too much

● don’t get enough physical activity

● have an infection

● get sick

● are stressed 

● take medicines that can cause high blood glucose 
27

Be sure to tell your doctor about other medicines you take. 

When you’re sick, be sure to check your blood glucose 

levels and keep taking your diabetes medicines. Read more 

about how to take care of yourself when you’re sick in the 

section “Take Care of Your Diabetes during Special Times 

or Events.” 

Signs that your blood glucose levels may be too high are the 

following:

● feeling thirsty 

● feeling weak or tired 

● headaches

● urinating often

● having trouble paying attention

● blurry vision

● yeast infections

Very high blood glucose may also make you feel sick to 

your stomach. 

If your blood glucose levels are high much of the time, or if 

you have symptoms of high blood glucose, call your doctor. 

You may need a change in your healthy eating plan, 

physical activity plan, or medicines.
28

Learn about Low Blood Glucose Levels

If your blood glucose levels drop below 70, you have low 

blood glucose, also called hypoglycemia. Low blood 

glucose can come on fast and can be caused by 

● taking too much diabetes medicine

● missing or delaying a meal

● being more physically active than usual

● drinking alcoholic beverages 

Sometimes, medicines you take for other health problems 

can cause your blood glucose levels to drop. 

Signs your blood glucose levels may be too low are the 

following:

● hunger

● dizziness or shakiness

● confusion

● being pale

● sweating more

● weakness

● anxiety or moodiness

● headaches

● a fast heartbeat
29

If your blood glucose levels drop lower, you could have 

severe hypoglycemia, where you pass out or have a seizure. 

A seizure occurs when cells in the brain release a rush 

of energy that can cause changes in behavior or muscle 

contractions. Some seizures are life threatening. 

If you have any of these symptoms, check your blood 

glucose levels. If your blood glucose levels are less than 70, 

have one of the following right away: 

● three or four glucose tablets 

● one serving of glucose gel—the amount equal to 

15 grams of carbohydrates 

● 1/2 cup, or 4 ounces, of fruit juice 

● 1/2 cup, or 4 ounces, of a regular—nondiet—soft drink 

● 1 cup, or 8 ounces, of milk 

● five or six pieces of hard candy 

● 1 tablespoon of sugar, syrup, or honey 
30

Have one of these foods or 

drinks when your blood glucose 

levels are low.

After 15 minutes, check your blood glucose levels again. 

Repeat these steps until your blood glucose levels are 70 or 

above. If it will be at least 1 hour before your next meal, 

eat a snack.

If you take diabetes medicines that can cause low blood 

glucose, always carry food for emergencies. You should 

also wear a medical identification bracelet or necklace that 

says you have diabetes. 
31

If you take insulin, keep a prescription glucagon kit at 

home and at other places where you often go. A glucagon 

kit has a vial of glucagon, a syringe, and a needle to inject 

the glucagon. Given as a shot, the glucagon quickly raises 

blood glucose. If you have severe hypoglycemia, you’ll 

need someone to help bring your blood glucose levels back 

to normal by giving you a glucagon shot. Show your family, 

friends, and coworkers how to give you a glucagon shot 

when you have severe hypoglycemia. Someone should call 

911 for help if a glucagon kit is not available.

Action Steps

If You Take Insulin

•	Tell your doctor if you have low blood glucose, especially at the 

same time of the day or night, several times in a row.

•	Tell your doctor if you’ve passed out from low blood glucose.

•	 Ask your doctor about glucagon. Glucagon is a medicine that 

raises blood glucose.

•	 Show your family, friends, and coworkers how to give you a 

glucagon shot when you have severe hypoglycemia. 

•	When you have severe hypoglycemia, someone should call 911 

for help if a glucagon shot is not available.
32

Action Steps

If You Don’t Take Insulin

•	Tell your doctor if you have low blood glucose, especially at the 

same time of the day or night, several times in a row.

•	Tell your doctor about other medicines you are taking.

•	 Ask your doctor whether your diabetes medicines might cause 

low blood glucose.

Read more about low blood glucose in Hypoglycemia at 

www.diabetes.niddk.nih.gov. 

Tell your doctor if you have low blood 

glucose, especially at the same time of day 

or night, several times in a row.
33

Prevent Diabetes Problems

Taking care of your diabetes every day will help your blood 

glucose, blood pressure, and cholesterol levels stay in 

your target ranges. Caring for your diabetes can also help 

prevent other health problems over the years. You can do 

a lot to prevent diabetes problems:

● Follow your healthy eating plan every day.

● Be physically active every day. 
34

● Take your medicines every day. 

● Check your blood glucose levels every day. 
35

Types of Diabetes Problems

Diabetes problems can damage parts of the body such as the

● heart

● blood vessels

● eyes

● kidneys

● nerves

Heart and blood vessel disease can lead to heart attacks 

and strokes. Nerve damage can lead to a loss of feeling in 

the feet, which may lead to an amputation. You will want 

to take steps to prevent these diabetes problems.

Read more about preventing diabetes problems in the 

following booklets at www.diabetes.niddk.nih.gov. These 

booklets are also available in Spanish and large-print 

versions:

● Prevent diabetes problems: Keep your diabetes under 

control 

● Prevent diabetes problems: Keep your eyes healthy 

● Prevent diabetes problems: Keep your feet healthy

● Prevent diabetes problems: Keep your heart and blood 

vessels healthy

● Prevent diabetes problems: Keep your kidneys healthy

● Prevent diabetes problems: Keep your mouth healthy

● Prevent diabetes problems: Keep your nervous system 

healthy
36

Take Care of Your Diabetes during Special 

Times or Events

Diabetes is part of your life. You can learn how to take 

care of yourself and your diabetes when you’re sick, when 

you’re at school or work, when you’re away from home, 

when an emergency or a natural disaster happens, or when 

you’re thinking about having a baby or are pregnant. 

When You’re Sick 

Having a cold, the flu, or an infection can raise your blood 

glucose levels. Being sick puts stress on your body. Your 

body releases hormones to deal with the stress and to fight 

the sickness. Higher hormone levels can also cause high 

blood glucose levels. You should have a plan for managing 

your diabetes when you’re sick. The first step is to talk with 

your health care team and write down

● how often to check your blood glucose levels 

● whether you should check for ketones in your blood or 

urine 

● whether you should change your usual dose of your 

diabetes medicines 

● what to eat and drink 

● when to call your doctor 
37

Action Steps

If You Take Insulin

•	Take your insulin, even if you are sick and have been throwing 

up. 

•	 Ask your health care team about how to adjust your insulin dose 

based on your blood glucose test results.

Action Steps

If You Don’t Take Insulin

•	Take your diabetes medicines, even if you are sick and have been 

throwing up. 

People who are sick sometimes feel as though they can’t 

eat as much or can’t keep food down, which can cause low 

blood glucose levels. Consuming carbohydrate-rich drinks 

or snacks can help prevent low blood glucose.

If you are sick, your health care team may recommend the 

following:

● Check your blood glucose levels at least four times a 

day and write down the results in your record book. 

Keep your results handy so you can report the results 

to your health care team. 

● Keep taking your diabetes medicines, even if you 

can’t eat. 
38

● Drink at least 1 cup, or 8 ounces, of water or other 

calorie-free, caffeine-free liquid every hour while 

you’re awake. 

● If you can’t eat your usual food, try eating or drinking 

any of the following to prevent low blood glucose 

levels: 

•	 juice 

•	 saltine crackers 

•	 dry toast 

•	 soup 

•	 broth or bouillon 

•	 ice pops or sherbet 

•	 gelatin that isn’t sugar-free

•	 milk 

•	 yogurt 

•	 soda that isn’t sugar-free
39

Your doctor may ask that you call right away if

● your blood glucose levels are above 240 even though 

you’ve taken your diabetes medicines 

● your urine or blood ketone levels are above normal 

● you vomit more than once 

● you have diarrhea for more than 6 hours 

● you have trouble breathing 

● you have a high fever 

● you can’t think clearly or you feel more drowsy than 

usual 

You should call your doctor if you have questions about 

taking care of yourself.

When You’re at School or Work 

Take care of your diabetes when you’re at school or at 

work: 

● Follow your healthy eating plan. 

● Take your medicines and check your blood glucose 

levels as usual. 

● Tell your teachers, friends, or close coworkers that you 

have diabetes and teach them about the signs of low 

blood glucose. You may need their help if your blood 

glucose levels drop too low. 
40

● Keep snacks nearby and carry some with you at all 

times to treat low blood glucose. 

● If you have trained diabetes staff at your school or 

work, tell them that you have diabetes. 

● Wear or carry an identification tag or card that says 

you have diabetes.

Tell your teachers, friends, or close 

coworkers about the signs of low 

blood glucose. You may need their 

help if your blood glucose levels drop 

too low. 
41

When You’re Away from Home 

These tips can help you when you’re away from home:

● Get all your vaccines and immunizations, or shots, 

before you travel. Find out what shot you need for 

where you’re going, and make sure you get the right 

shots on time.

● Follow your healthy eating plan as much as possible 

when you eat out. Always carry a snack with you in 

case you have to wait for a waiter to serve you. 

● Limit alcoholic beverages. Ask your health care team 

how many alcoholic beverages you can safely drink. 

Eat something when you drink to prevent low blood 

glucose. 

● If you’re taking a long trip by car, check your blood 

glucose levels before driving. Stop and check your 

blood glucose levels every 2 hours. 

● Always carry your diabetes medicines and supplies in 

the car where you can reach them in case your blood 

glucose levels drop too low. 

● In case you can’t leave for home on time, bring twice 

the amount of diabetes supplies and medicines you 

normally need.

● Take comfortable, well-fitting shoes on vacation. 

You’ll probably be walking more than usual. Keep 

your medical insurance card, emergency phone 

numbers, and a first aid kit handy.
42

● Wear or carry an identification tag or card that says 

you have diabetes.

● If you’re going to be away for a long time, ask your 

doctor for a written prescription for your diabetes 

medicines and the name of a doctor in the place you’re 

going to visit.

● Don’t count on buying extra supplies when you’re 

traveling, especially if you’re going to another country. 

Different countries use different kinds of diabetes 

medicines.

When You’re Flying on a Plane

These tips can help you when you’re flying on a plane:

● Ask your health care team in advance how to adjust 

your medicines, especially your insulin, if you’re 

traveling across time zones. 

● Take a letter from your doctor stating you have 

diabetes. The letter should include a list of all the 

medical supplies and medicines you need on the plane. 

In the letter, the doctor should also include a list of any 

devices that shouldn’t go through an x-ray machine.

● Carry your diabetes medicines and your blood testing 

supplies with you on the plane. Never put these items 

in your checked baggage. 
43

● Bring food for meals and snacks on the plane. 

● If you use an insulin pump, ask airport security to 

check the device by hand. X-ray machines can damage 

insulin pumps, whether the pump is on your body or in 

your luggage. 

● When on a plane, get up from your seat and walk 

around when possible.

Read more about planning for travel and travel safety 

if you have diabetes in Have Diabetes. Will Travel. at 

www.ndep.nih.gov.

Bring food for meals and snacks on 

the plane.
44

Action Steps

If You Take Insulin

When you travel,

•	 take a special insulated bag to carry your insulin to keep it 

from freezing or getting too hot

•	 bring extra supplies for taking insulin and testing your blood 

glucose levels in case of loss or breakage

•	 ask your doctor for a letter saying you have diabetes and need 

to carry supplies for taking insulin and testing blood glucose

Action Steps

If You Don’t Take Insulin

When you travel,

•	 ask your health care team in advance how to adjust your 

medicines if you’re traveling across time zones 

•	 carry your diabetes medicines and your blood testing supplies 

with you on the plane 

•	 ask your doctor for a letter saying you have diabetes and need 

to carry supplies for testing blood glucose
45

When an Emergency or a Natural Disaster Happens

Everyone with diabetes should be prepared for emergencies 

and natural disasters, such as power outages or hurricanes. 

Always have a disaster kit ready. Include everything you 

need to take care of your diabetes, such as

● a blood glucose meter, lancets, and testing strips 

● your diabetes medicines 

● insulin, syringes, and an insulated bag to keep insulin 

cool, if you take insulin 

● a glucagon kit if you take insulin or if recommended by 

your doctor

● glucose tablets and other food or drinks to treat low 

blood glucose 

● antibiotic cream or ointment 

● a copy of your medical information, including a list of 

your conditions, medicines, and recent lab test results 

● a list of your prescription names with dosage 

information and prescription numbers from your 

pharmacy

● phone numbers for the American Red Cross and other 

disaster relief groups 
46

You also might want to include some food that doesn’t 

spoil, such as canned or dried food, along with bottled 

water. Read more about preparing for an emergency at the 

Centers for Disease Control and Prevention Emergency 

Preparedness and You website at www.emergency.cdc.gov/

preparedness.

If You’re a Woman and Planning a Pregnancy 

Keeping your blood glucose levels near normal before and 

during pregnancy helps protect both you and your baby. 

Even before you become pregnant, your blood glucose 

levels should be close to the normal range. 

Your health care team can work with you to get your blood 

glucose levels under control before you try to get pregnant. 

If you’re already pregnant and you have diabetes, see your 

doctor right away. You can take steps to bring your blood 

glucose levels close to normal. 

Your insulin needs may change when you’re pregnant. 

Your doctor may want you to take more insulin and check 

your blood glucose levels more often. 

If you plan to have a baby,

● work with your health care team to get your blood 

glucose levels as close to the normal range as possible 

● see a doctor who has experience taking care of 

pregnant women with diabetes 
47

● don’t smoke, drink alcoholic beverages, or use harmful 

drugs 

● follow your healthy eating plan 

Be sure to have your eyes, heart and blood vessels, blood 

pressure, and kidneys checked. Your doctor should also 

check for nerve damage. Pregnancy can make some health 

problems worse.

Read more about diabetes and pregnancy in What I need 

to know about Preparing for Pregnancy if I Have Diabetes at 

www.diabetes.niddk.nih.gov.

Your health care team can work with you to get your blood 

glucose levels under control before you try to get pregnant. 

If you’re already pregnant, see your doctor right away. 
Your Diabetes Care Records

Make copies of the charts in this section. These charts list 

important things you should discuss with your doctor at 

each visit. 

Things to Discuss with Your Health Care Team 

at Each Visit

Date: _______________

Whom you visited: __________________________________

Your 

information Things to remember

Check off what you 

covered, or write the 

result of your visit. 

Your blood 

glucose levels

•	Share your blood 

glucose records. Your 

doctor will ask how 

you are checking your 

blood glucose levels 

to make sure you are 

doing it right. 

•	Mention if you often 

have low or high blood 

glucose.

❏ Shared blood glucose 

records? 

❏ Checked meter? 

❏ Practiced blood 

glucose reading? 

❏ Shared high or low 

blood glucose? 

Your weight •	Talk about how much 

you should weigh.

•	Talk about ways to 

reach your target 

weight that will work 

for you.

❏ My weight now is 

________.

❏ My target weight is 

________.

❏ Steps to take:

48
49

Your 

information Things to remember

Check off what you 

covered, or write the 

result of your visit. 

Your blood 

pressure

•	Ask about ways to 

reach your target.

•	The target for most 

people with diabetes 

is below 140/80 unless 

your doctor helps you 

set a different target.

❏ My blood pressure 

now is ________.

❏ My target blood 

pressure is _______.

❏ Steps to take:

Your 

medicines

•	Talk about any 

problems you have had 

with your medicines. 

•	Ask if you should take 

a low-dose aspirin 

every day to lower 

your chance of getting 

heart disease.

❏ Shared medicine 

problems?

❏ Take aspirin? 

Yes ____

No ____

❏ Steps to take:

Your feet •	Ask to have your feet 

checked for problems.

•	Talk about any 

problems you are 

having with your feet, 

such as numbness, 

tingling, or sores that 

heal slowly.

❏ Checked feet? 

❏ Shared problems?

❏ Steps to help with 

my feet:

Your physical 

activity plan

•	Talk about how often 

you are physically 

active, the type of 

physical activity you 

do, and any problems 

you have when being 

physically active.

❏ Shared activities?

❏ Steps to take:
50

Your 

information Things to remember

Check off what you 

covered, or write the 

result of your visit. 

Your healthy 

eating plan

•	Talk about what you 

eat, how much you eat, 

and when you eat.

❏ Shared eating habits?

❏ Steps to take:

Your feelings •	If you feel stressed, 

ask about ways to 

cope. 

•	Talk about whether 

you are feeling sad.

❏ Shared stress and 

problems?

❏ Steps to take:

Your smoking •	If you smoke, ask for 

help with quitting.

❏ Shared smoking 

habits?

❏ Steps to take:
51

This chart lists important tests, exams, and vaccines to get 

at least once or twice a year. 

Tests, Exams, and Vaccines to Get at Least Once or 

Twice a Year

Test Instructions Results or Dates

A1C test •	Have this blood test 

at least twice a year. 

Your result will tell 

you what your average 

blood glucose level 

was for the past 

2 to 3 months.

Date: ______________

A1C: _______________

Next test: ___________

Blood lipid 

(fats) lab 

tests

•	Get a blood test to 

check your

– total cholesterol—aim 

for below 200

– LDL, or bad, 

cholesterol—aim for 

below 100 

– HDL, or good, 

cholesterol—men: 

aim for above 40; 

women: aim for 

above 50

– triglycerides—aim for 

below 150

Date: ______________

Total cholesterol: 

_______________

LDL: ______________

HDL: ______________

Triglycerides: ________

Next test: ___________

Kidney 

function tests

•	Once a year, get a 

urine test to check for 

protein. 

•	At least once a year, 

get a blood test to 

check for creatinine.

Date: ______________

Urine protein: _______

Creatinine: __________

Next test: ___________
52

Test Instructions Results or Dates

Dilated eye 

exam

•	See an eye doctor 

once a year for a 

complete eye exam 

that includes using 

drops in your eyes to 

dilate your pupils. 

•	If you are pregnant, 

have a complete 

eye exam in your 

first 3 months of 

pregnancy. Have 

another complete 

eye exam 1 year after 

your baby is born.

Date: ______________

Result: _____________

Next test: ___________

Dental exam •	See your dentist twice 

a year for a cleaning 

and checkup.

Date: ______________

Result: _____________

Next test: ___________

Pneumonia 

vaccine 

(recommended 

by the Centers 

for Disease 

Control and 

Prevention 

[CDC])

•	Get the vaccine if you 

are younger than 64. 

•	If you’re older than 

64 and your shot was 

more than 5 years 

ago, get another 

vaccine.

Date received: 

____________________
53

Test Instructions Results or Dates

Flu vaccine 

(recommended 

by the CDC)

•	Get a flu shot each 

year.

Date received: 

__________________

Hepatitis B 

vaccine 

(recommended 

by the CDC)

•	Get this vaccine if 

you are age 19 to 59 

and have not had this 

vaccine.

•	Consider getting this 

vaccine if you are 60 

or older and have not 

had this vaccine. 

Date of 1st dose: 

__________________

Date of 2nd dose: 

__________________

Date of 3rd dose: 

__________________
54 55

Daily Diabetes Record Page Week Starting ________________________

Other 

blood 

glucose

Breakfast 

blood 

glucose

Medicine

Lunch 

blood 

glucose

Medicine

Dinner 

blood 

glucose

Medicine

Bedtime 

blood 

glucose

Medicine Notes: (Special events, 

sick days, exercise)

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

You can also find a food and activity tracker at www.ndep.nih.gov.
56

Points to Remember

● Diabetes is when your blood glucose, also called blood 

sugar, is too high. Blood glucose is the main type of 

sugar found in your blood and your main source of 

energy. 

● Prediabetes is when the amount of glucose in your 

blood is above normal yet not high enough to be called 

diabetes. 

● In type 1 diabetes, your body no longer makes insulin 

or enough insulin. 

● Type 2 diabetes develops when, over time, the pancreas 

doesn’t make enough insulin when blood sugar levels 

increase, such as after meals. 

● People who are overweight and inactive are more likely 

to develop type 2 diabetes.

● Gestational diabetes can develop when a woman is 

pregnant. Pregnant women make hormones that can 

lead to insulin resistance. 

● Gestational diabetes most often goes away after the 

baby is born. 
57

● The best way to take care of your health is to work 

with your health care team to keep your blood glucose, 

blood pressure, and cholesterol levels in your target 

range. Targets are numbers you aim for. 

● When you see members of your health care team, ask 

lots of questions. Prepare a list of questions before 

your visit. 

● Do four things each day to help your blood glucose 

levels stay in your target range: 

•	 Follow your healthy eating plan. 

•	 Be physically active. 

•	 Take your medicines as prescribed. 

•	 Monitor your diabetes. 

● Ask your doctor to give you the name of someone 

trained to help you create a healthy eating plan, such 

as a dietitian. 

● People with diabetes should aim for 30 to 60 minutes 

of activity most days of the week. Children and 

adolescents with type 2 diabetes who are 10 to 17 years 

old should aim for 60 minutes of activity every day. 

● See your doctor before becoming physically active. 
58

● Check your blood glucose levels before, during, and 

after physical activity. 

● Your doctor may prescribe you diabetes medicines that 

work best for you and your lifestyle. 

● If you have type 1 diabetes, you need insulin shots if 

your body has stopped making insulin or if it doesn’t 

make enough. Some people with type 2 diabetes or 

gestational diabetes also need to take insulin shots. 

● Ask your health care team when you should take your 

diabetes medicines. 

● Be sure to tell your doctor if your medicines make you 

feel sick or if you have any other problems. 

● Checking and recording your blood glucose levels can 

help you monitor and better manage your diabetes. 

Ask your doctor how often you should check your 

blood glucose levels.

● You may need to check your blood or urine for ketones 

if you’re sick or if your blood glucose levels are above 

240. 

● Bring your blood glucose records to all visits with your 

health care team. 
59

● If your blood glucose levels stay above 180 for more 

than 1 to 2 hours, they may be too high. High blood 

glucose, also called hyperglycemia, means you don’t 

have enough insulin in your body. 

● If your blood glucose levels drop below 70, you have 

low blood glucose, also called hypoglycemia.

● If you take diabetes medicines that can cause low 

blood glucose, always carry food for emergencies. You 

should also wear a medical identification bracelet or 

necklace that says you have diabetes.

● If you take insulin, keep a prescription glucagon kit at 

home and at other places where you often go. If you 

have severe hypoglycemia, you’ll need someone to 

help bring your blood glucose levels back to normal by 

giving you a glucagon shot. 

● You can do a lot to prevent diabetes problems:

•	 Follow your healthy eating plan every day.

•	 Be physically active every day. 

•	 Take your medicines every day. 

•	 Check your blood glucose levels every day. 

● You should have a plan for managing your diabetes 

when you’re sick. You should call your doctor if you 

have questions about taking care of yourself.
60

● Tell your teachers, friends, or close coworkers that you 

have diabetes and teach them about the signs of low 

blood glucose. You may need their help if your blood 

glucose levels drop too low. 

● Get all your vaccines and immunizations, or shots, 

before you travel. Find out what shot you need for 

where you’re going, and make sure you get the right 

shots on time.

● When traveling, carry your diabetes medicines and 

your blood testing supplies with you on the plane. 

Never put these items in your checked baggage. 

● Always have a disaster kit ready. Include everything 

you need to take care of your diabetes in the disaster 

kit.

● Keeping your blood glucose levels near normal before 

and during pregnancy helps protect both you and your 

baby. 

● If you’re already pregnant and you have diabetes, see 

your doctor right away. 
61

Hope through Research

The National Institute of Diabetes and Digestive and 

Kidney Diseases (NIDDK) conducts research in its own 

labs and supports a great deal of basic and clinical research 

in medical centers and hospitals throughout the United 

States. The NIDDK also gathers and analyzes statistics 

about diabetes. Other Institutes at the National Institutes 

of Health (NIH) conduct and support research on diabetesrelated eye diseases, heart and vascular complications, 

autoimmunity, pregnancy complications, and dental 

problems. 

The Molecular and Clinical Profile of Diabetes Mellitus 

and Its Complications study is funded under NIH clinical 

trial number NCT01105858. 

The Diabetes Prevention Program (DPP), a large clinical 

trial, studied people at increased chance of developing 

type 2 diabetes. Some of the DPP participants were 

assigned to an intensive lifestyle change group. After 

3 years, people in this group lost about 5 to 7 percent of 

their body weight by eating a diet low in fat and calories 

and getting more physical activity. This modest weight 

loss cut their chances of getting type 2 diabetes by 

58 percent compared with people in the placebo group, 

which received information only. People ages 60 and 

older reduced their chance by 70 percent. A follow-up 

study called the Diabetes Prevention Program Outcomes 

Study (DPPOS) found that 10 years after the DPP began, 
62

people in the lifestyle change group continued to have 

a reduced chance of developing type 2 diabetes. Read 

more about the DPPOS, funded under NIH clinical trial 

number NCT00038727, in Diabetes Prevention Program at 

www.diabetes.niddk.nih.gov.

Clinical trials are research studies involving people. 

Clinical trials look at safe and effective new ways to 

prevent, detect, or treat disease. Researchers also use 

clinical trials to look at other aspects of care, such as 

improving the quality of life for people with chronic 

illnesses. To learn more about clinical trials, why they 

matter, and how to participate, visit the NIH Clinical 

Research Trials and You website at www.nih.gov/health/

clinicaltrials. For information about current studies, visit 

www.ClinicalTrials.gov.

Read more about the NIDDK’s research on diabetes 

and related topics at www.diabetes.niddk.nih.gov/

diabetesresearch/dm_research.aspx. 
63

Pronunciation Guide 

A1C (AY-WUHN-SEE)

aerobic (air-OH-bik)

amputation (AM-pyoo-TAY-shuhn)

carbohydrate (KAR-boh-HY-drayt) 

cholesterol (koh-LESS-tur-ol) 

creatinine (kree-AT-ih-neen) 

endocrinologist (EN-doh-krih-NOL-uh-jist) 

gestational (jess-TAY-shuhn-uhl) 

glucagon (GLOO-kuh-gon) 

glucose (GLOO-kohss) 

glycohemoglobin (GLY-koh-HEE-moh-GLOH-bin) 

hemoglobin (HEE-moh-GLOH-bin) 

hyperglycemia (HY-pur-gly-SEE-mee-uh) 

hypoglycemia (HY-poh-gly-SEE-mee-uh) 

immune (ih-MYOON) 
64

injections (in-JEK-shuhnz) 

insulin (IN-suh-lin)

ketoacidosis (KEE-toh-ASS-ih-DOH-siss) 

ketones (KEE-tohnz) 

ophthalmologist (AHF-thal-MOL-uh-jist)

pancreas (PAN-kree-uhss) 

prediabetes (PREE-dy-uh-BEE-teez)

seizure (SEE-zhur)

syringe (suh-RINJ) 

triglycerides (try-GLISS-ur-eyedz)
65

For More Information

To find a dietitian near you, go to the Academy of 

Nutrition and Dietetics’ website at www.eatright.org and 

click on “Find a Registered Dietitian.”

To find a diabetes educator near you, call 

American Association of Diabetes Educators

200 West Madison Street, Suite 800

Chicago, IL 60606

Phone: 1–800–338–3633 

Internet: www.diabeteseducator.org

For additional information about diabetes, contact 

American Diabetes Association 

1701 North Beauregard Street 

Alexandria, VA 22311

Phone: 1–800–DIABETES (1–800–342–2383)

Email: askADA@diabetes.org 

Internet: www.diabetes.org 

JDRF 

26 Broadway, 14th Floor

New York, NY 10004 

Phone: 1–800–533–CURE (1–800–533–2873) 

Fax: 212–785–9595

Email: info@jdrf.org 

Internet: www.jdrf.org 
66

Acknowledgments

Publications produced by the Clearinghouse are carefully 

reviewed by both NIDDK scientists and outside experts. 

This publication was reviewed by Michael L. Parchman, 

M.D., M.P.H., F.A.A.F.P., MacColl Center for Health Care 

Innovation, Group Health Research Institute in Seattle, 

Washington. Marion J. Franz, M.S., R.D., L.D., C.D.E., 

Minneapolis, Minnesota, also contributed to sections of this 

publication.
67

National Diabetes Education Program

1 Diabetes Way

Bethesda, MD 20814–9692

Phone: 1–888–693–NDEP (1–888–693–6337)

TTY: 1–866–569–1162

Fax: 703–738–4929

Email: ndep@mail.nih.gov

Internet: www.ndep.nih.gov

 www.yourdiabetesinfo.org

The National Diabetes Education Program is a federally 

funded program sponsored by the U.S. Department of 

Health and Human Services’ National Institutes of Health 

and the Centers for Disease Control and Prevention and 

includes over 200 partners at the federal, state, and local 

levels, working together to reduce the morbidity and 

mortality associated with diabetes.

National Diabetes 

Information Clearinghouse

1 Information Way

Bethesda, MD 20892–3560

Phone: 1–800–860–8747

TTY: 1–866–569–1162

Fax: 703–738–4929

Email: ndic@info.niddk.nih.gov

Internet: www.diabetes.niddk.nih.gov

The National Diabetes Information Clearinghouse (NDIC) is a service 

of the National Institute of Diabetes and Digestive and Kidney Diseases 

(NIDDK). The NIDDK is part of the National Institutes of Health of the 

U.S. Department of Health and Human Services. Established in 1978, the 

Clearinghouse provides information about diabetes to people with diabetes 

and to their families, health care professionals, and the public. The NDIC 

answers inquiries, develops and distributes publications, and works closely 

with professional and patient organizations and Government agencies to 

coordinate resources about diabetes.

This publication is not copyrighted. The Clearinghouse encourages users

of this publication to duplicate and distribute as many copies as desired.

This publication is available at www.diabetes.niddk.nih.gov.

This publication may contain information about medications and, when 

taken as prescribed, the conditions they treat. When prepared, this 

publication included the most current information available. For updates 

or for questions about any medications, contact the U.S. Food and Drug 

Administration toll-free at 1–888–INFO–FDA (1–888–463–6332) or visit 

www.fda.gov. Consult your health care provider for more information.
NIH Publication No. 14–4016

December 2013

The NIDDK prints on recycled paper with bio-based ink.