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People who are eligible for such research studies are people who have a positive antibody test for type one diabetes and are willing to be in such studies. The treatment being tested is medication that suppresses the immune system. Willing participants would be randomized to receive immune suppressive treatment or placebo treatment.

Placebo looks like the medication, but does not do the same thing in the body. Initial research studies have been successful in decreasing the risk of development of type one diabetes in people that have received the immune system suppressing treatment and therefore, larger studies are now being undertaken.

Try to be informed about research going on and treatments that may be approved for type one diabetes. You can get this information through already available publications. Make sure that at least annually you see a physician who is an expert on your disorder. Never hesitate to ask your medical team any questions or concerns you have.

Being informed makes all the difference. Thanks for your time and we wish well. Type 1 diabetes symptoms often start suddenly and are often the reason for checking blood sugar levels. Because symptoms of other types of diabetes and prediabetes come on more gradually or may not be easy to see, the American Diabetes Association ADA has developed screening guidelines.

The ADA recommends that the following people be screened for diabetes:. A1C test. This blood test, which doesn't require not eating for a period of time fasting , shows your average blood sugar level for the past 2 to 3 months.

It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. It's also called a glycated hemoglobin test.

The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6. An A1C between 5. Below 5. Glucose tolerance test.

For this test, you fast overnight. Then, the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested regularly for the next two hours. If your provider thinks you may have type 1 diabetes, they may test your urine to look for the presence of ketones.

Ketones are a byproduct produced when muscle and fat are used for energy. Your provider will also probably run a test to see if you have the destructive immune system cells associated with type 1 diabetes called autoantibodies. Your provider will likely see if you're at high risk for gestational diabetes early in your pregnancy.

If you're at high risk, your provider may test for diabetes at your first prenatal visit. If you're at average risk, you'll probably be screened sometime during your second trimester. Our caring team of Mayo Clinic experts can help you with your diabetes-related health concerns Start Here.

Depending on what type of diabetes you have, blood sugar monitoring, insulin and oral drugs may be part of your treatment. Eating a healthy diet, staying at a healthy weight and getting regular physical activity also are important parts of managing diabetes.

An important part of managing diabetes — as well as your overall health — is keeping a healthy weight through a healthy diet and exercise plan:. Healthy eating. Your diabetes diet is simply a healthy-eating plan that will help you control your blood sugar.

You'll need to focus your diet on more fruits, vegetables, lean proteins and whole grains. These are foods that are high in nutrition and fiber and low in fat and calories. You'll also cut down on saturated fats, refined carbohydrates and sweets. In fact, it's the best eating plan for the entire family.

Sugary foods are OK once in a while. They must be counted as part of your meal plan. Understanding what and how much to eat can be a challenge. A registered dietitian can help you create a meal plan that fits your health goals, food preferences and lifestyle.

This will likely include carbohydrate counting, especially if you have type 1 diabetes or use insulin as part of your treatment. Physical activity. Everyone needs regular aerobic activity.

This includes people who have diabetes. Physical activity lowers your blood sugar level by moving sugar into your cells, where it's used for energy. Physical activity also makes your body more sensitive to insulin.

That means your body needs less insulin to transport sugar to your cells. Get your provider's OK to exercise.

Then choose activities you enjoy, such as walking, swimming or biking. What's most important is making physical activity part of your daily routine. Aim for at least 30 minutes or more of moderate physical activity most days of the week, or at least minutes of moderate physical activity a week.

Bouts of activity can be a few minutes during the day. If you haven't been active for a while, start slowly and build up slowly. Also avoid sitting for too long. Try to get up and move if you've been sitting for more than 30 minutes.

Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump, frequent blood sugar checks, and carbohydrate counting. For some people with type 1 diabetes, pancreas transplant or islet cell transplant may be an option.

Treatment of type 2 diabetes mostly involves lifestyle changes, monitoring of your blood sugar, along with oral diabetes drugs, insulin or both. Depending on your treatment plan, you may check and record your blood sugar as many as four times a day or more often if you're taking insulin.

Careful blood sugar testing is the only way to make sure that your blood sugar level remains within your target range. People with type 2 diabetes who aren't taking insulin generally check their blood sugar much less often.

People who receive insulin therapy also may choose to monitor their blood sugar levels with a continuous glucose monitor. Although this technology hasn't yet completely replaced the glucose meter , it can lower the number of fingersticks necessary to check blood sugar and provide important information about trends in blood sugar levels.

Even with careful management, blood sugar levels can sometimes change unpredictably. With help from your diabetes treatment team, you'll learn how your blood sugar level changes in response to food, physical activity, medications, illness, alcohol and stress.

For women, you'll learn how your blood sugar level changes in response to changes in hormone levels. Besides daily blood sugar monitoring, your provider will likely recommend regular A1C testing to measure your average blood sugar level for the past 2 to 3 months.

Compared with repeated daily blood sugar tests, A1C testing shows better how well your diabetes treatment plan is working overall. A higher A1C level may signal the need for a change in your oral drugs, insulin regimen or meal plan.

Your target A1C goal may vary depending on your age and various other factors, such as other medical conditions you may have or your ability to feel when your blood sugar is low. Ask your provider what your A1C target is.

People with type 1 diabetes must use insulin to manage blood sugar to survive. Many people with type 2 diabetes or gestational diabetes also need insulin therapy.

Many types of insulin are available, including short-acting regular insulin , rapid-acting insulin, long-acting insulin and intermediate options. Depending on your needs, your provider may prescribe a mixture of insulin types to use during the day and night.

Insulin can't be taken orally to lower blood sugar because stomach enzymes interfere with insulin's action. Insulin is often injected using a fine needle and syringe or an insulin pen — a device that looks like a large ink pen. An insulin pump also may be an option.

The pump is a device about the size of a small cellphone worn on the outside of your body. A tube connects the reservoir of insulin to a tube catheter that's inserted under the skin of your abdomen. A continuous glucose monitor, on the left, is a device that measures your blood sugar every few minutes using a sensor inserted under the skin.

An insulin pump, attached to the pocket, is a device that's worn outside of the body with a tube that connects the reservoir of insulin to a catheter inserted under the skin of the abdomen.

Insulin pumps are programmed to deliver specific amounts of insulin automatically and when you eat. A continuous glucose monitor, on the left, is a device that measures blood sugar every few minutes using a sensor inserted under the skin. Insulin pumps are programmed to deliver specific amounts of insulin continuously and with food.

A tubeless pump that works wirelessly is also now available. You program an insulin pump to dispense specific amounts of insulin. It can be adjusted to give out more or less insulin depending on meals, activity level and blood sugar level.

A closed loop system is a device implanted in the body that links a continuous glucose monitor to an insulin pump. The monitor checks blood sugar levels regularly. The device automatically delivers the right amount of insulin when the monitor shows that it's needed. The Food and Drug Administration has approved several hybrid closed loop systems for type 1 diabetes.

They are called "hybrid" because these systems require some input from the user. For example, you may have to tell the device how many carbohydrates are eaten, or confirm blood sugar levels from time to time. A closed loop system that doesn't need any user input isn't available yet.

But more of these systems currently are in clinical trials. Sometimes your provider may prescribe other oral or injected drugs as well.

Some diabetes drugs help your pancreas to release more insulin. Others prevent the production and release of glucose from your liver, which means you need less insulin to move sugar into your cells. Still others block the action of stomach or intestinal enzymes that break down carbohydrates, slowing their absorption, or make your tissues more sensitive to insulin.

Metformin Glumetza, Fortamet, others is generally the first drug prescribed for type 2 diabetes. Another class of medication called SGLT2 inhibitors may be used. They work by preventing the kidneys from reabsorbing filtered sugar into the blood.

Instead, the sugar is eliminated in the urine. Vildagliptin is available in some countries but not in the United States.

These medicines lower blood sugar levels by increasing insulin release from the pancreas in response to a meal. They can be given alone in people who cannot tolerate the first-line medicine metformin or other medicines, or they can be given together with other oral medicines if blood sugar levels are still higher than the goal.

These medicines do not cause hypoglycemia or changes in body weight. There have been rare reports of joint pain, pancreatitis, and severe skin reactions. SGLT2 inhibitors — The sodium-glucose co-transporter 2 SGLT2 inhibitors, canagliflozin brand name: Invokana , empagliflozin brand name: Jardiance , dapagliflozin brand name: Farxiga , and ertugliflozin brand name: Steglatro , lower blood sugar by increasing the excretion of sugar in the urine.

They are variably effective, but on average, they are similar in potency to the DPP-4 inhibitors see 'DPP-4 inhibitors' above.

SGLT2 inhibitors may be a good choice for people with heart failure or chronic kidney disease because they have been shown to have some cardiovascular, renal, and mortality benefits. SGLT2 inhibitors do not cause low blood sugar.

They promote modest weight loss and blood pressure reduction. Side effects include genital yeast infections in men and women, urinary tract infections, and dehydration. Some medicines in this class have been associated with an increased risk of bone fracture or amputation. An uncommon but deadly infection of the tissue in the perineum the area between the genitals and the anus has also been reported in men and women.

SGLT2 inhibitors can increase the risk of diabetic ketoacidosis DKA ; this is a serious problem that can happen when acids called "ketones" build up in the blood.

DKA can happen even when blood sugar is only mildly elevated. GLP-1 receptor agonists — The glucagon-like peptide-1 GLP-1 receptor agonists are medications given by injection that increase insulin release in response to a meal and slow digestion.

They include exenatide, dosed twice daily brand name: Byetta ; exenatide extended release, dosed weekly brand name: Bydureon ; liraglutide, dosed daily brand name: Victoza ; dulaglutide, dosed weekly brand name: Trulicity ; lixisenatide, dosed daily brand name: Adlyxin ; and semaglutide, dosed weekly as an injection brand name: Ozempic or daily as a tablet brand name: Rybelsus.

These medications are useful for people whose blood sugar is not controlled on the highest dose of one or two oral medicines.

They may be especially helpful for overweight people who are gaining weight or struggling to lose weight on other diabetes medicines. Liraglutide, dulaglutide, or semaglutide injections are recommended for people who have, or are at high risk for, cardiovascular disease, as they have been shown to have cardiovascular benefits in these groups.

GLP-1 receptor agonists do not usually cause low blood sugar when used without other medications that cause low blood sugar. They promote loss of appetite and a sense of feeling full after eating a smaller amount of food, which helps with weight loss, but can also cause bothersome side effects, including nausea, vomiting, and diarrhea.

Gastrointestinal side effects usually improve with time. Pancreatitis inflammation of the pancreas has been reported rarely in people taking GLP-1 receptor agonists, but it is not known if the medications caused the pancreatitis. They have also been associated with gall bladder disease.

You should stop taking these medications if you develop severe abdominal pain. Exenatide and lixisenatide should not be used in people with abnormal kidney function, and liraglutide and dulaglutide should be used with caution in this situation.

These drugs are generally expensive. Meglitinides — Meglitinides include repaglinide brand name: Prandin and nateglinide brand name: Starlix. They work to lower blood sugar levels, similar to the sulfonylureas, but they act more quickly than sulfonylureas and should be taken right before a meal; they might also be recommended in people who are allergic to sulfonylureas.

They are taken in pill form. Meglitinides are not generally used as a first-line treatment, because they are more expensive than sulfonylureas. Repaglinide can be used in patients with kidney failure. Thiazolidinediones — This class of medicines includes pioglitazone brand name: Actos and rosiglitazone brand name: Avandia , which work to lower blood sugar levels by increasing the body's sensitivity to insulin.

They are taken in pill form and usually in combination with other medicines such as metformin, a sulfonylurea, or insulin. The risk of heart failure is small but serious. An early sign of heart failure is swelling of the feet and ankles.

People who take thiazolidinediones should monitor for swelling. Alpha-glucosidase inhibitors — These medicines, which include acarbose brand name: Precose and miglitol brand name: Glyset , work by interfering with the absorption of carbohydrates in the intestine.

This helps to lower blood sugar levels but not as well as metformin or the sulfonylureas. They can be combined with other medicines if the first medicine does not lower blood sugar levels enough. The main side effects of alpha-glucosidase inhibitors are gas flatulence , diarrhea, and abdominal pain; starting with a low dose may minimize these side effects.

The medicine is usually taken three times per day with the first bite of each meal. Insulin — In the past, insulin treatment was reserved for patients with type 2 diabetes whose blood sugar was not controlled with oral medicines and lifestyle changes ie, diet and exercise.

However, there is increasing evidence that insulin treatment at earlier stages may improve overall diabetes management over time. Side effects include low blood sugar, if you take more insulin than your body needs, and weight gain. Adjusting the dose of insulin to the body's needs can minimize the risk of these side effects.

It may be necessary to readjust your dose frequently. In some situations, insulin injections shots can be used as a first-line treatment for type 2 diabetes. In other cases, insulin can be added to or substituted for oral medicines. If you take insulin, you will need to get comfortable giving yourself the injections or have a family member or housemate learn how to do it for you.

More detailed information about insulin treatment is available separately. Living with type 2 diabetes can be stressful. It is a lot of responsibility to have to monitor your blood sugar if you need to do this , watch your diet, exercise regularly, keep all your appointments, and take your medications every day.

It can also be scary to think about the potential complications of diabetes. It can help to involve your family and friends and make sure you have a solid support system in place to provide encouragement, reminders, and help as you need it.

It is not uncommon for stress to lead to burnout or even depression, and this can make taking care of yourself more difficult. Having an open and honest discussion with your doctor, nurse, or other health care provider can help you to understand your diagnosis, treatment plan, and what to do if you are overwhelmed.

Some people also benefit from talking with a counselor or social worker to help them cope with their responsibilities and worries.

Your health care provider is the best source of information for questions and concerns related to your medical problem. This article will be updated as needed on our website www.

Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition.

These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Patient education: Treatment for type 2 diabetes The Basics Patient education: Type 2 diabetes The Basics Patient education: Using insulin The Basics Patient education: Low blood sugar in people with diabetes The Basics Patient education: Nonalcoholic fatty liver disease The Basics Patient education: Exercise and movement The Basics Patient education: Carb counting for adults with diabetes The Basics Patient education: Lowering your risk of prediabetes and type 2 diabetes The Basics Patient education: Diabetic ketoacidosis The Basics Patient education: Hyperosmolar hyperglycemic state The Basics.

Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Patient education: Type 2 diabetes: Overview Beyond the Basics Patient education: Type 2 diabetes: Insulin treatment Beyond the Basics Patient education: Type 2 diabetes and diet Beyond the Basics Patient education: Glucose monitoring in diabetes Beyond the Basics Patient education: Hypoglycemia low blood glucose in people with diabetes Beyond the Basics Patient education: Exercise and medical care for people with type 2 diabetes Beyond the Basics Patient education: Preventing complications from diabetes Beyond the Basics.

Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings.