Treatment Overview

Controlling your blood sugar is essential to feeling healthy and avoiding long-term complications of diabetes. Some people are able to control their blood sugar with diet and exercise alone. Others may need to use insulin or other medications in addition to lifestyle changes. In either case, monitoring your blood sugar is a key part of your treatment program. A healthy diet and exercise should be placed as a priority for diabetes treatment. Second, you might also try some of the diabetes treatment using alternative medicine. Third, follow your doctor's prescriptions. And last, pancreas or islet cell transplantation may be an option for people whose kidneys are failing or who aren't responding to other treatments.

Monitoring blood sugar If you've just received a diagnosis of diabetes, monitoring your blood sugar may seem like an overwhelming task. But once you learn to measure your blood sugar and understand how important it is, you'll feel more comfortable with the procedure and more in control of your disease. Testing is crucial because it tells you whether you're keeping your glucose levels in the range you and your doctor have agreed on. The best range for you depends on your age and the type of diabetes you have. For younger adults who don't have complications of diabetes, a typical target range might be 80 to 120 mg/dL before meals, and below 180 mg/dL after eating. Older adults who have complications from their disease may have a fasting target goal of 100 to 140 mg/dL and below 200 mg/dL after meals. That's because blood sugar that falls too low in older adults can be more dangerous than in younger people. How often you test your blood sugar depends on the type of diabetes you have. If you take insulin, test your blood sugar at least twice a day, and preferably three or four times a day. But if you have type 2 diabetes and don't use insulin, you may need to test your blood sugar levels only once a day or as little as twice a week. Keep in mind that the amount of sugar in your blood is constantly changing. Self-monitoring helps you learn what makes your blood sugar levels rise and fall, so you can make adjustments in your treatment. Factors that affect your blood sugar include:

• Food. Food raises your blood sugar level ? it's highest one to two hours after a meal. What and how much you eat, and the time of day, also affect your blood sugar level.
• Exercise and physical activity. In general, the more active you are, the lower your blood sugar. Physical activity causes sugar to be transported to your cells, where it's used for energy, thereby lowering the levels in your blood. Aerobic exercises such as brisk walking, jogging or biking are especially good. But gardening, housework and even just being on your feet all day also can lower your blood sugar.
• Medications. Insulin and oral diabetes medications deliberately work to lower your blood sugar. But medications you take for other conditions may affect glucose levels. Corticosteroids, in particular, may raise blood sugar levels. Medications such as thiazides, used to control high blood pressure, and niacin, used for high cholesterol, also may increase blood sugar. If you need to take certain high blood pressure medications, your doctor will likely make changes in your diabetes treatment.
• Illness. The physical stress of a cold or other illness causes your body to produce hormones that raise your blood sugar level. The additional sugar helps promote healing. But if you have diabetes, this can be a problem. In addition, a fever increases your metabolism and how quickly sugar is utilized, which can alter the amount of insulin you need. For these reasons, be sure to monitor your glucose levels frequently when you're sick.
• Alcohol. Even a small amount of alcohol ? about 2 ounces ? can cause your sugar levels to fall too low. But sometimes alcohol can cause sugar levels to rise. If you choose to drink, do so only in moderation. And monitor your blood sugar before and after consuming alcohol to see how it affects you. Also, keep in mind that alcohol counts as carbohydrate calories in your diet.
• Fluctuations in hormone levels. The female hormone estrogen typically makes cells more responsive to insulin, and progesterone makes cells more resistant. Although these two hormones fluctuate throughout the menstrual cycle, the majority of women don't notice a corresponding change in blood sugar levels. Those who do are more likely to experience changes in blood sugar during the third week of their menstrual cycle, when estrogen and progesterone levels are highest.