Your Rights and Care Standards: A Guide for People with Type 2 Diabetes Free

Working with your health care team, you can take steps to create a treatment plan that will prevent or delay diabetes complications.

You can start by checking your risk for type 2 diabetes. The ADA’s Type 2 Diabetes Risk Test is a common tool for this. Others will have a blood test right away. Talk to your doctor about your risk and if you need to be tested for diabetes.

The tests used to check if you have diabetes are the:

• A1C test: Shows your average blood glucose (blood sugar) over the past two to three months

• Fasting blood glucose test: Checks your blood glucose after you haven’t eaten for at least eight hours

• Oral glucose tolerance test (OGTT): Measures how your blood glucose changes after drinking a sugary drink

• Random blood glucose test: Measures your blood glucose at any time, without fasting

Your doctor may repeat the test to confirm the results if they show that you have diabetes or prediabetes. Finding out that you have diabetes as early as possible helps you start to manage it right away.

Learn more about how to find out if you have diabetes and the signs and symptoms of diabetes.

Medications are an important part of your treatment plan and help you reach your health goals. Knowing how well they’re working helps your health care team adjust your treatment plan when you’re not reaching your health targets. Regular checkups and lab tests ensure your medications will help you and your team stay on the right track.

Your health care team will consider several factors when choosing the best medication(s) for you:

• Your A1C and tracked blood glucose (blood sugar) levels

• Other health conditions you may have, like heart disease, kidney disease, or obesity

• Your risk of low blood glucose (hypoglycemia)

• Side effects of medications

• Your weight and weight loss goals (if you have them)

• Cost, insurance coverage, and what’s accessible to you

• Your lifestyle and preferences, such as whether you prefer to take pills or injections

You’re part of making the decision about what medication(s) will be included in your treatment plan. Your health care team will explain your options and help you know the pros and cons so that you feel confident and comfortable with your care plan.

Each medication works in a different way and you'll discuss which one is right for you. Here are some of the types of medications you may talk about:

• Metformin: A commonly used medication for type 2 diabetes.

• GLP-1 receptor agonists: Supports weight loss and may help reduce your risk of heart and kidney complications. They are either taken by injection once a week or as a pill once a day.

• SGLT2 inhibitors: These medications may also protect the heart and kidneys, especially in people with existing conditions.

• Insulin: A hormone the body uses to process blood glucose for energy. It may be needed if other medications aren’t enough to keep your blood glucose in your target range.

• Other medications: These include dual GLP-1/GIP receptor agonists, DPP-4 inhibitors, sulfonylureas, TZDs, and others. Each has specific benefits, and your doctor will help decide if any are right for you.

Your medications should be reviewed at every diabetes visit—and you’ll likely discuss options when:

• Your A1C or blood glucose levels change

• You develop a new health condition, like heart, kidney, or liver problems

• You’re experiencing side effects

• Your blood glucose levels are regularly high or low

• You’re pregnant or planning to become pregnant

• Your insurance changes or your medication costs too much

• You’re not reaching your weight or blood pressure goals

• You’re starting or stopping a device, like a continuous glucose monitor (CGM) or insulin pump

Your doctor may adjust your medications based on your lab results, daily routines, preferences, and overall health goals. Talking about your medications is a key part of making sure your treatment plan is working.

Learn more about oral and injectable medications for type 2 diabetes and insulin basics.

People with diabetes are at higher risk for infections, so staying up to date with vaccines is important for your health.

Learn more about protecting yourself with vaccines if you have diabetes and vaccinations that may be right for you.

Start with the ADA’s Ways to Help Manage Diabetes Care Costs to explore tips and resources that can lower your out-of-pocket expenses.

Check with manufacturers. Many companies that make diabetes medications and devices offer patient assistance programs, discount cards, or coupons, as well as savings on insulin, continuous glucose monitors, or other supplies.

Keeping your blood glucose (blood sugar) in your target range helps prevent both short- and long-term health problems. Highs and lows can happen with changes in your living situation, food, activity, or medications, so regular monitoring and support from your health care team will help you stay healthy.

Many tools can make managing diabetes easier—like continuous glucose monitors (CGMs), glucose meters, and health apps. Ask your health care team which options might work best for you and how to use them.

You can check your blood glucose at home using a glucose meter or a CGM. Your health care team can help you choose the right device and show you how to use it.

Yes—there are several ways to get help with the cost of devices like blood glucose meters, CGMs, insulin pumps and smart pens:

• Manufacturers often offer savings programs or free trial offers. Ask your doctor or pharmacist if the brand you use has a coupon or patient assistance program.

• Copay help is available through nonprofits like the PAN Foundation and the Co-Pay Relief Program.

• Community health centers and Medicare/Medicaid counselors may offer extra support based on your income or insurance.

Learn more about devices and technology.

Your targets will be based on your age, health conditions, risk of low blood glucose, and treatment plan. The general goals for most adults with diabetes are below along with space to fill in your targets:

Your health care team may adjust these goals based on your age, health conditions, or risk of low blood glucose.

Low and high blood glucose are common short-term issues in type 2 diabetes. They can happen due to your medications, what you eat, or changes in your physical activity.

Low blood glucose is when your blood glucose is too low—usually below 70 mg/dL.

A few of the common causes of low blood glucose are:

• Taking too much insulin or other diabetes medications

• Too little food or meals are delayed

• More physical activity than usual (this can last several hours after being active)

Common symptoms:

• Shakiness

• Sweating

• Hunger

• Dizziness

• Confusion

• Feeling weak

To treat low blood glucose (under 70 mg/dL) use the Rule of 15:

1. Eat or drink 15 grams of fast-acting carbohydrates like:

   • Glucose tablets or gel

   • ½ cup (4 ounces) of juice or regular soda

   • 1 tablespoon of sugar or honey

2. Recheck your blood glucose after 15 minutes.

3. If your blood glucose is still low, repeat.

Once your blood glucose is above 70 mg/dL or trending up on your continuous glucose monitor (CGM), eat a protein and carbohydrate snack (example: cheese and crackers) if your next meal is more than an hour away.

If you’re at risk for low blood glucose, always carry a quick source of carbs—like glucose tablets or gels—in case your blood glucose drops too low. Talk to your health care team about how to prevent and treat low blood glucose. Also ask if you’re at risk for severe hypoglycemia and need a prescription for glucagon.

To help prevent low blood glucose:

• Take medications as prescribed—don’t take more than prescribed.

• Follow your eating plan for meals and snacks.

• Check your blood glucose regularly, especially when changing your routine.

• Adjust food or medication when you’re physically active (talk to your health care team about how).

• Carry a fast-acting carbohydrate with you at all times.

Learn more about low blood glucose.

Hyperglycemia is when your blood glucose is higher than your target range. It can be caused by not taking enough medication, too much food, not enough physical activity, and stress or illness. Symptoms include increased thirst, frequent urination, feeling sleepy, and blurred vision.

If you think your blood glucose is high, start by checking it to be sure. Drink water to stay hydrated and make sure to take your medications as prescribed (don’t skip a dose). It’s important to regularly talk with your health care team about your blood glucose goals and what steps to take if your numbers stay high. They may suggest changes to your treatment plan to help you reach your blood glucose targets.

If your levels stay high or you start feeling symptoms like nausea, vomiting, or confusion, contact your doctor right away—these could be signs of diabetic ketoacidosis (DKA), a serious complication of diabetes that occurs when your body produces a high amount of ketones due to a lack of insulin.

Learn more about hyperglycemia.

When you have type 2 diabetes, you are at higher risk of heart, kidney, eye, and nerve problems. Talk to your health care team about how to prevent and manage your risk for diabetes-related health problems and what signs to look for if they develop.

Your health care team plays a key role in helping you stay healthy with diabetes. They can:

• Help you decide your blood glucose, blood pressure, and cholesterol targets

• Tell you when to have your eyes, kidneys, feet, and heart health checked

• Adjust and support your treatment plan, including medications, an eating plan, and physical activity to help prevent, delay, or address health problems

• Support your mental wellbeing

• Help you catch and manage problems early before they become serious

• Help you stop smoking, vaping, or using e-cigarettes

Regular checkups and shared decision making will help you stay on track and prevent complications.

These are some of your most important targets, called the “ABCs” of diabetes:

• A1C (average blood glucose levels over the past two to three months)

• B (blood pressure)

• C (cholesterol)

• S (not smoking)

Talk with your health care team about your overall health—not just your blood glucose levels. Ask about treatments for health problems like high blood pressure, cholesterol problems, heart disease, kidney disease, and nerve problems. Managing these together with your diabetes can help you feel your best and prevent or delay health problems down the road.

Key:

LDL = Low density lipoprotein

HDL = High density lipoprotein

TG = Triglycerides

FIB-4 = Fibrosis-4 index

Learn more about:

• Eye health

• Oral health

• Neuropathy (nerve damage)

• Foot health

• Kidney health

• Heart health

Learn more about diabetes treatment and care as well as diabetes self-management education and support (DSMES).

Caring for your mind is as important as taking care of your body. Challenges with day-to- day tasks, work, money, housing, or food can add to the burden. If you’re overwhelmed, reach out to your health care team for help.

Learn more about understanding mental health and diabetes.

Living with diabetes can feel overwhelming—but you’re not alone. The ADA recommends that everyone with diabetes have access to emotional and mental health support.

You can ask your health care team to connect you with:

• A diabetes care and education specialist

• A mental health provider who understands diabetes

• Support groups—online or in person—to share what it’s like to live with diabetes and encourage you

Learn more about finding a behavioral health partner.

Your health care team can help connect you to local diabetes self-management education and support (DSMES) programs, support groups, or wellness classes that focus on nutrition and physical activity. Some communities also offer help through health workers who can assist with scheduling appointments, understanding medications, or even finding healthy food options if cost is a concern. Reaching out and staying connected can give you the support you need to manage diabetes with more confidence and less stress.

Learn more about how to get help for your needs.

An eating plan will help you manage your blood glucose, have a better relationship with food, and nourish your body to help it function at its best. Informed food choices are essential to preventing and living well with diabetes. Making purposeful decisions on the types of foods and how you build your plate can help contribute to your health goals.

There’s no one “perfect” way to eat with diabetes, but your health care team can help you find a meal plan that works for you. A registered dietitian nutritionist (RDN) or diabetes care and education specialist can work with you to build a plan that fits your lifestyle, culture, and goals—and helps keep your glucose in your target range.

A simple place to start as you plan your meals is by using the Diabetes Plate. Aim to fill half your nine-inch plate with non-starchy vegetables, ¼ with lean protein, ¼ with quality carbohydrates (i.e., whole grains, starchy vegetables, beans, fruit, milk, or yogurt). Include water or low- or no-calorie beverage on the side.

There are seven healthy eating patterns that have been shown to effectively prevent or manage type 2 diabetes. The seven eating pattern options include: the Mediterranean Style, Dietary Approaches to Stop Hypertension (DASH), Low Carbohydrate, Very Low Carbohydrate, Vegetarian or Vegan, Low Fat, or Very Low Fat.

Learn more about how to eat healthy and healthy eating patterns.

You don’t have to cut out carbs completely, but your RDN can help you find the right amount and types of carbs for your needs. Choosing high-quality carbs—like fruits, starchy vegetables, yogurt, milk, whole grains, and legumes—and watching portion sizes can help you manage your glucose levels.

Your RDN can guide you in creating a balanced eating plan that supports your health goals.

Learn more about nutrition and the ADA’s Diabetes Food Hub®.

For people living with diabetes, non-nutritive sweeteners do not appear to have a significant effect on blood glucose (blood sugar) and can help reduce calorie, sugar, and carb intake when used in moderation and in the short term.

Learn more about sugar substitutes.

People may fast for many reasons such as religious observations, lab tests, surgery, or weight loss. Fasting may be safe, but your doctor or health care team should first review your treatment plan to adjust medications and reduce your risk of hyperglycemia, hypoglycemia, or dehydration while fasting.

If you have concerns about what types of physical activity are right for you, talk with your health care team. They can help you create a safe and enjoyable plan based on your goals, interests, and abilities.

Look into local programs at community centers, parks, senior centers, or wellness facilities—many offer free or low-cost fitness options.

Being active along with reaching a healthy weight, eating well, managing stress, taking your medications, and getting support all work together to help you manage type 2 diabetes and stay healthy.

Learn more about lifestyle change programs and exercise and nutrition.

Physical activity helps you manage your blood glucose (blood sugar) by improving how well your body uses insulin. It also supports weight loss goals and helps with your energy, mood, heart health, and stress.

Even small amounts of movement—like walking or light housework—can make a big difference. Talk with your health care team about the best ways to get moving safely and stay active.

Most adults with diabetes should aim for at least 150 minutes of moderate-intensity physical activity per week, such as brisk walking. That’s about 30 minutes a day, five days a week. Also, try to move more and sit less throughout the day, limiting your time seated or inactive to 30 minutes if you can.

Include both strength activities (light weights or resistance bands) and stretching (flexibility) sessions twice a week.

If you’re concerned about what activities are safe for you, talk to your health care team.

Learn more about getting started safely, types of physical activity, and aerobic, resistance, balance, and flexibility exercises.

Navigating type 2 diabetes can feel challenging and overwhelming. By focusing on what inspires you—family, joy, connection, self-worth, tradition, vitality, and personal goals—you discover your own motivation in managing your diabetes. This passion fuels your commitment to seeking ongoing medical support, staying active, and eating healthfully, helping you live well.