Four (4) Steps to Manage your Diabetes for Life Four (4) Steps to Manage your Diabetes for Life
National Diabetes Education Program

These four steps help people with diabetes understand, monitor, and manage their diabetes to help them stay healthy. This publication is excellent for people newly diagnosed with diabetes or who just want to learn more about controlling the disease.

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This publication has been reviewed by NDEP for plain language principles. Learn more about our review process. Last reviewed: 06/01/2013

Step 1: Learn about diabetes.
Step 2: Know your diabetes ABCs
Step 3: Learn how to live with diabetes
Step 4: Get routine care to stay healthy
Things to remember
My Diabetes Care Record

Step 1: Learn about diabetes.

What is diabetes?
There are three main types of diabetes:

Type 1 diabetes – Your body does not make insulin. This is a problem because you need insulin to take the sugar (glucose) from the foods you eat and turn it into energy for your body. You need to take insulin every day to live. Type 2 diabetes – Your body does not make or use insulin well. You may need to take pills or insulin to help control your diabetes. Type 2 is the most common type of diabetes. Gestational (jest-TAY-shun-al) diabetes – Some women get this kind of diabetes when they are pregnant. Most of the time, it goes away after the baby is born. But even if it goes away, these women and their children have a greater chance of getting diabetes later in life.

You are the most important member of your health care team. You are the one who manages your diabetes day by day. Talk to your doctor about how you can best care for your diabetes to stay healthy. Some others who can help are:

dentist diabetes doctor diabetes educator dietitian eye doctor foot doctor friends and family mental health counselor nurse nurse practitioner pharmacist social worker

How to learn more about diabetes.

Take classes to learn more about living with diabetes. To find a class, check with your health care team, hospital, or area health clinic. You can also search online. Join a support group — in-person or online — to get peer support with managing your diabetes. Read about diabetes online. Go to

Take diabetes seriously.
You may have heard people say they have “a touch of diabetes” or that their “sugar is a little high.” These words suggest that diabetes is not a serious disease. That is not correct. Diabetes is serious, but you can learn to manage it. People with diabetes need to make healthy food choices, stay at a healthy weight, move more every day, and take their medicine even when they feel good. It’s a lot to do. It’s not easy, but it’s worth it!

Why take care of your diabetes?
Taking care of yourself and your diabetes can help you feel good today and in the future. When your blood sugar (glucose) is close to normal, you are likely to:

have more energy be less tired and thirsty need to pass urine less often heal better have fewer skin or bladder infections

You will also have less chance of having health problems caused by diabetes such as:

heart attack or stroke eye problems that can lead to trouble seeing or going blind pain, tingling, or numbness in your hands and feet, also called nerve damage kidney problems that can cause your kidneys to stop working teeth and gum problems

Step 2: Know your diabetes ABCs.

Talk to your health care team about how to manage your A1C, Blood pressure, and Cholesterol. This can help lower your chances of having a heart attack, stroke, or other diabetes problems. Here’s what the ABCs of diabetes stand for:

A for the A1C test (A-one-C).

What is it?
The A1C is a blood test that measures your average blood sugar level over the past three months. It is different from the blood sugar checks you do each day.

Why is it important?
You need to know your blood sugar levels over time. You don’t want those numbers to get too high. High levels of blood sugar can hurt your heart and blood vessels, kidneys, feet, and eyes.

What is the A1C goal?
The A1C goal for many people with diabetes is below 7. Ask what your goal should be.

B for Blood pressure.

What is it?
Blood pressure is the force of your blood against the wall of your blood vessels.

Why is it important?
If your blood pressure gets too high, it makes your heart work too hard. It can cause a heart attack, stroke, and kidney disease.

What is the blood pressure goal?
Your blood pressure goal should be below 140/80 unless your doctor helps you set a different goal.

C for Cholesterol (ko-LESS-tuh-ruhl).

What is it?
There are two kinds of cholesterol in your blood: LDL and HDL. LDL or “bad” cholesterol can build up and clog your blood vessels. It can cause a heart attack or stroke. HDL or “good” cholesterol helps remove the “bad” cholesterol from your blood vessels.

What are the LDL and HDL goals for people with diabetes?
Ask what your cholesterol numbers should be. If you are over 40 years of age, you may need to take a statin drug for heart health.

Step 3: Learn how to live with diabetes.

It is common to feel overwhelmed, sad, or angry when you are living with diabetes. You may know the steps you should take to stay healthy, but have trouble sticking with your plan over time. This section has tips on how to cope with your diabetes, eat well, and be active.

Cope with your diabetes.

Stress can raise your blood sugar. Learn ways to lower your stress. Try deep breathing, gardening, taking a walk, meditating, working on your hobby, or listening to your favorite music. Ask for help if you feel down. A mental health counselor, support group, member of the clergy, friend, or family member who will listen to your concerns may help you feel better.

Eat well.

Make a diabetes meal plan with help from your health care team. Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt. Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice, or pasta. Choose foods such as fruits, vegetables, whole grains, bread and cereals, and low-fat or skim milk and cheese. Drink water instead of juice and regular soda. When eating a meal, fill half of your plate with fruits and vegetables, one quarter with a lean protein, such as beans, or chicken or turkey without the skin, and one quarter with a whole grain, such as brown rice or whole wheat pasta.

Be active.

Set a goal to be more active most days of the week. Start slow by taking 10 minute walks, 3 times a day. Twice a week, work to increase your muscle strength. Use stretch bands, do yoga, heavy gardening (digging and planting with tools), or try push-ups. Stay at a healthy weight by using your meal plan and moving more.

Know what to do every day.

Take your medicines for diabetes and any other health problems even when you feel good. Ask your doctor if you need aspirin to prevent a heart attack or stroke. Tell your doctor if you cannot afford your medicines or if you have any side effects. Check your feet every day for cuts, blisters, red spots, and swelling. Call your health care team right away about any sores that do not go away. Brush your teeth and floss every day to keep your mouth, teeth, and gums healthy. Stop smoking. Ask for help to quit. Call 1-800-QUITNOW (1-800-784-8669). Keep track of your blood sugar. You may want to check it one or more times a day. Use the card at the back of this booklet to keep a record of your blood sugar numbers. Be sure to talk about it with your health care team. Check your blood pressure if your doctor advises and keep a record of it.

Talk to your health care team.

Ask your doctor if you have any questions about your diabetes. Report any changes in your health.

Step 4: Get routine care to stay healthy.

Things to Remember:

You are the most important member of your health care team. Follow the four steps in this booklet to help you learn how to manage your diabetes. Learn how to reach your diabetes ABC goals. Ask your health care team for information.

My Diabetes Care Record
Write down the date and results for each test or check-up you get. Take this card with you on your health care visits. Show it to your health care team. Talk about your goals and how you are doing.
My Diabetes Care Record card

Self Checks of Blood Sugar
Each time you check your blood sugar, write down the date, time, and results. Take this card with you on your health care visits. Show it to your health care team. Talk about your goals and how you are doing.
Self Checks of Blood Sugar card