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. In some people who have type 1 diabetes, a pancreas transplant may be an option.

Islet transplants are being studied as well. With a successful pancreas transplant, you would no longer need insulin therapy. But transplants aren't always successful. And these procedures pose serious risks.

You need a lifetime of immune-suppressing drugs to prevent organ rejection. These drugs can have serious side effects. Because of this, transplants are usually reserved for people whose diabetes can't be controlled or those who also need a kidney transplant.

Some people with type 2 diabetes who are obese and have a body mass index higher than 35 may be helped by some types of bariatric surgery. People who've had gastric bypass have seen major improvements in their blood sugar levels. But this procedure's long-term risks and benefits for type 2 diabetes aren't yet known.

Controlling your blood sugar level is essential to keeping your baby healthy. It can also keep you from having complications during delivery. In addition to having a healthy diet and exercising regularly, your treatment plan for gestational diabetes may include monitoring your blood sugar.

In some cases, you may also use insulin or oral drugs. Your provider will monitor your blood sugar level during labor. If your blood sugar rises, your baby may release high levels of insulin.

This can lead to low blood sugar right after birth. Treatment for prediabetes usually involves healthy lifestyle choices. These habits can help bring your blood sugar level back to normal.

Or it could keep it from rising toward the levels seen in type 2 diabetes. Keeping a healthy weight through exercise and healthy eating can help.

Drugs — such as metformin, statins and high blood pressure medications — may be an option for some people with prediabetes and other conditions such as heart disease. Many factors can affect your blood sugar. Problems may sometimes come up that need care right away.

High blood sugar hyperglycemia in diabetes can occur for many reasons, including eating too much, being sick or not taking enough glucose-lowering medication. Check your blood sugar level as directed by your provider.

And watch for symptoms of high blood sugar, including:. Diabetic ketoacidosis is a serious complication of diabetes. If your cells are starved for energy, your body may begin to break down fat. This makes toxic acids known as ketones, which can build up in the blood.

Watch for the following symptoms:. You can check your urine for excess ketones with a ketones test kit that you can get without a prescription. If you have excess ketones in your urine, talk with your provider right away or seek emergency care.

This condition is more common in people with type 1 diabetes. This condition is seen in people with type 2 diabetes. It often happens after an illness. Call your provider or seek medical care right away if you have symptoms of this condition.

If your blood sugar level drops below your target range, it's known as low blood sugar diabetic hypoglycemia. If you're taking drugs that lower your blood sugar, including insulin, your blood sugar level can drop for many reasons.

These include skipping a meal and getting more physical activity than normal. Low blood sugar also occurs if you take too much insulin or too much of a glucose-lowering medication that causes the pancreas to hold insulin.

Low blood sugar is best treated with carbohydrates that your body can absorb quickly, such as fruit juice or glucose tablets. There is a problem with information submitted for this request.

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Diabetes is a serious disease. Following your diabetes treatment plan takes total commitment. Careful management of diabetes can lower your risk of serious or life-threatening complications. Make physical activity part of your daily routine.

Regular physical activity can help prevent prediabetes and type 2 diabetes. It can also help those who already have diabetes to maintain better blood sugar control. A minimum of 30 minutes of moderate physical activity — such as brisk walking — most days of the week is recommended.

Aim for at least minutes of moderate aerobic physical activity a week. Getting regular aerobic exercise along with getting at least two days a week of strength training exercises can help control blood sugar more effectively than does either type of exercise alone.

Aerobic exercises can include walking, biking or dancing. Resistance training can include weight training and body weight exercises. Also try to spend less time sitting still. Try to get up and move around for a few minutes at least every 30 minutes or so when you're awake.

Keep your vaccinations up to date. High blood sugar can weaken your immune system. Error Include a valid email address. To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you.

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Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Many alternative therapies have been touted as possible ways to treat or prevent type 2 diabetes.

But there's no definitive evidence that any alternative treatments are effective. Therapies that have been said to be helpful in type 2 diabetes and are also likely to be safe, include:. Talk to your health care provider if you're considering dietary supplements or other alternative therapies to treat or prevent prediabetes.

Some supplements or alternative therapies might be harmful if combined with certain prescription medications. Your health care provider can help you weigh the pros and cons of specific alternative therapies.

You're likely to start by seeing your primary care provider. He or she may refer you to a specialist in diabetes treatment endocrinologist , a dietitian or a certified diabetes educator. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

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Diagnosis The American Diabetes Association ADA recommends that diabetes screening for most adults begin at age More Information A1C test Glucose tolerance test.

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By Mayo Clinic Staff. Show references American Diabetes Association. Standards of medical care in diabetes — Diabetes Care. Centers for Disease Control and Prevention.

Accessed Oct. The surprising truth about prediabetes. Diabetes: 12 warning signs that appear on your skin. American Academy of Dermatology Association.

Insulin resistance and prediabetes. National Institute of Diabetes and Digestive and Kidney Diseases. Type 2 diabetes. Diabetes tests and diagnosis. Rett K, et al. You may not be able to eat or drink as much as usual, which can affect blood sugar levels. High ketones can be an early sign of diabetic ketoacidosis, which is a medical emergency and needs to be treated immediately.

Ketones are a kind of fuel produced when fat is broken down for energy. When too many ketones are produced too fast, they can build up in your body and cause diabetic ketoacidosis, or DKA.

DKA is very serious and can cause a coma or even death. Common symptoms of DKA include:. If you think you may have DKA, test your urine for ketones. Follow the test kit directions, checking the color of the test strip against the color chart in the kit to see your ketone level.

If your ketones are high, call your health care provider right away. DKA requires treatment in a hospital. Talk to your doctor about how to keep your blood sugar levels within your target range.

Your doctor may suggest the following:. Carbs in food make your blood sugar levels go higher after you eat them than when you eat proteins or fats. You can still eat carbs if you have diabetes. The amount you can have and stay in your target blood sugar range depends on your age, weight, activity level, and other factors.

Counting carbs in foods and drinks is an important tool for managing blood sugar levels. Make sure to talk to your health care team about the best carb goals for you. The A1C test is a simple blood test that measures your average blood sugar levels over the past 2 or 3 months.

A1C testing is part of the ABCs of diabetes—important steps you can take to prevent or delay health complications down the road:. Work with your doctor to establish a personal A1C goal for you.

Eating a healthy diet with plenty of fruit and vegetables, maintaining a healthy weight , and getting regular physical activity can all help.

Other tips include:. Medicare , Medicaid, and most private insurance plans pay for the A1C test and fasting blood sugar test as well as some diabetes supplies.

By keeping your insulin levels at a steadier state, the body can counter the natural surge in glucose in the morning. You don't need a hardcore workout to achieve this. Instead, aim for low-intensity exercises like:. If morning levels are still high, doing moderate-intensity exercise before breakfast can help bring down your blood sugar levels fast while improving glucose control throughout the day.

Some alternative practitioners endorse the use of apple cider vinegar to counter the effects of morning blood sugar spikes.

Apple cider vinegar does not "treat" diabetes but may provide short-term blood sugar control. According to a study published in the Journal of Evidence-Based Integrative Medicine , taking 2 tablespoons 1, milligrams of apple cider vinegar can significantly lower fasting blood sugar levels 30 minutes after consumption.

After 60 minutes, no benefit is seen. Side effects include stomach upset and sore throat. Over time, the risks may outweigh the benefits as the long-term use of apple cider vinegar can lead to tooth enamel loss, throat burns, and bone mineral loss.

Drug interactions are also common. Diet plays a major role in managing diabetes and maintaining healthy blood sugar levels. This is particularly true when it comes to eating carbohydrates. While carbs are a critical part of any diet, they need to be consumed in moderation if you have diabetes.

So, if you eat carbs late at night, the level of glucose in your blood will rise as insulin levels start to decrease. If you are hungry before bedtime, opt for a high-fiber or high-protein, low-fat snack that can satisfy your hunger without significantly affecting your blood sugar.

Limiting your evening carb intake is one way to avoid morning spikes. But you also need to be mindful of how many carbs you eat at dinner, counting carbs so that you don't exceed the recommended per-meal intake. The American Diabetes Association recommends between 45 and 60 grams g of carbs per meal and between 15 and 20 g of carbs per snack.

Healthy fats are an essential part of a balanced diet. However, fat slows down digestion. By doing so, high-fat dinners can delay the normal post-meal rise in glucose until the following morning. Fatty foods also contribute to obesity , a leading risk factor for diabetes as well as a leading risk factor for poor blood sugar control.

Rather than eating "bad" saturated fats derived from animals that are hard to digest, opt for "good" monosaturated and polyunsaturated fats that are derived from plants and are easier to digest.

This is one measure that can help naturally lower blood sugar in people with diabetes. Nighttime low blood sugar hypoglycemia can cause a rebound in blood sugar levels in the morning. This is referred to as the Somogyi effect.

In people without diabetes, glucose and insulin levels tend to stay flat and constant throughout the night, with a slight increase in insulin just before dawn. In people with diabetes, insulin levels typically decrease at night. So, if blood sugar levels are low, the body will sense this and release excess cortisone and glucagon in the early morning hours to compensate.

Without enough insulin to "put the brakes" on glucose production, hyperglycemia will occur. Unlike the dawn phenomenon that can affect people with otherwise well-controlled diabetes, the Somogyi effect often occurs in people whose diabetes is poorly controlled.

To avoid nighttime hypoglycemia:. If you have diabetes, getting too little sleep can reduce your ability to control your blood sugar by disrupting your normal sleep-wake cycle. When you are sleep-deprived, hormones aren't released during the early morning hours as they should and blood sugar levels tend to rise precipitously.

At the same time, for reasons that are not entirely understood, cells don't respond as well to insulin as well as they are meant to a condition known as insulin resistance. This almost invariably leads to high blood sugar. High blood sugar and high insulin are characteristic of insulin resistance. By contrast, getting a solid seven hours of sleep per night is associated with a decrease in insulin resistance.

There are several key ways to improve your sleep:. The best way to control your diabetes at nighttime or daytime is to work with your healthcare provider and follow the prescribed treatment plan. Manage Weight: Stay at a healthy weight to help prevent, delay or manage diabetes.

No Nicotine: Smoking, vaping, exposure to secondhand smoke or using tobacco can increase your risk of heart disease, stroke, many cancers and other chronic diseases. It may also make prediabetes and diabetes harder to manage.

How to Manage Blood Sugar Resources. Diabetes Tools and Resources. Life's Essential 8 Fact Sheets Life's Essential 8 - How to Eat Better Fact Sheet Life's Essential 8 - How to Be More Active Fact Sheet Life's Essential 8 - How to Quit Tobacco Fact Sheet Life's Essential 8 - How to Get Healthy Sleep Fact Sheet Life's Essential 8 - How to Manage Weight Fact Sheet Life's Essential 8 - How to Control Cholesterol Fact Sheet Life's Essential 8 - How to Manage Blood Sugar Fact Sheet Life's Essential 8 - How to Manage Blood Pressure Fact Sheet Life's Essential 8 Fact Sheet.

Occurrences of hypoglycemia low blood sugar and hyperglycemia high blood sugar did not differ between the diet groups and control groups. Today, 1 in 10 U. residents has diabetes, and that number is expected to rise to 1 in 3 by if current trends continue, the researchers explain.

Finding more options for controlling weight and blood sugar levels for these patients, therefore, is crucial. This is notable as diabetes is particularly prevalent among those groups, so having studies that document the success of time-restricted eating for them is particularly useful, the researchers said.

The study was small and should be followed up by larger ones, said Varady, who is also a member of the University of Illinois Cancer Center.

While it acts as a proof of concept to show that time-restricted eating is safe for those with Type 2 diabetes, Varady said people with diabetes should consult their doctors before starting this sort of diet.

The other current and former UIC authors on the paper are Vasiliki Pavlou, Sofia Cienfuegos , Shuhao Lin, Mark Ezpeleta, Kathleen Ready, Sarah Corapi, Jackie Wu, Jason Lopez, Kelsey Gabel , Lisa Tussing-Humphreys , Vanessa Oddo , Julienne Sanchez and Dr.