Diabetes
Summary
Watch Video: Introduction to Diabetes
Diabetes is a common medical condition in which the level of sugar (glucose) in the blood becomes too high. Glucose is the body’s main source of energy, but it must move from the bloodstream into the body’s cells to be used. This process depends on a hormone called insulin, which is produced by the pancreas. In Type 1 diabetes, the pancreas produces little or no insulin, so glucose cannot enter the cells. In Type 2 diabetes, which is much more common, the body still produces insulin, but the cells no longer respond to it normally. As a result, glucose builds up in the bloodstream instead of being used for energy.
Diabetes is a serious condition because high blood sugar can slowly damage many parts of the body over time. It increases the risk of heart disease, stroke, kidney disease, vision loss, and nerve damage. Diabetes can also have major effects on the feet. High blood sugar can damage the nerves, causing a loss of feeling known as peripheral neuropathy. It can also damage blood vessels, reducing blood flow to the feet and making it harder for wounds to heal. Together, poor circulation and loss of sensation increase the risk of foot ulcers, infections, Charcot foot (a weakening of the bones and joints of the foot), and, in severe cases, amputation. Keeping diabetes under good control is one of the best ways to prevent these complications.
How Is Diabetes Diagnosed?
Many people with diabetes have no symptoms when the condition first develops. Others may notice increased thirst, frequent urination, increased hunger, blurred vision, fatigue, slow-healing cuts, or unexplained weight loss. Doctors diagnose diabetes using blood tests that measure blood sugar levels. These include a fasting blood glucose test, a random blood glucose test, an oral glucose tolerance test, or a hemoglobin A1C (HbA1C) test. The HbA1C test measures the average blood sugar level over the previous two to three months and is one of the most useful ways to monitor diabetes over time. In general, an HbA1C level below 5.7% is considered normal, 5.7% to 6.4% indicates prediabetes, and 6.5% or higher is consistent with diabetes. Doctors also use HbA1C levels to judge how well diabetes is being controlled. For many adults with diabetes, the goal is to keep the HbA1C below 7%, although the target may vary depending on the individual. During routine visits, doctors also check for signs of nerve damage, poor circulation, kidney disease, and eye problems to determine whether diabetes is causing complications.
Diabetes Treatment
The goal of diabetes treatment is to keep blood sugar levels as close to normal as possible while preventing long-term complications. Treatment usually involves a combination of healthy lifestyle choices, medications, and regular medical follow-up. Specific treatment strategies include:
Healthy Diet
A healthy diet is one of the most important parts of diabetes management. Patients are encouraged to eat balanced meals that include vegetables, fruits, lean proteins, whole grains, and healthy fats while limiting sugary drinks, sweets, and highly processed carbohydrates. Learning how different foods affect blood sugar helps many people better control their diabetes.
Regular Exercise
Regular physical activity helps the body use insulin more effectively and lowers blood sugar levels. Most adults should aim for at least 150 minutes of moderate exercise each week, along with exercises that improve strength two or more days each week. Exercise also helps maintain a healthy weight and improves heart health.
Weight Management
For people with Type 2 diabetes who are overweight, losing even a modest amount of weight can significantly improve blood sugar control and reduce the need for medication.
Medications
Many people with Type 2 diabetes can initially control their blood sugar with lifestyle changes, but many eventually require medication. Several different types of oral medications and injectable medications are available to help lower blood sugar. Newer medications, such as GLP-1 receptor agonists and SGLT2 inhibitors, can also reduce the risk of heart disease and kidney disease in many patients.
People with Type 1 diabetes require lifelong insulin therapy because their bodies no longer produce insulin. Some patients with Type 2 diabetes also need insulin if other treatments no longer provide adequate blood sugar control.
Blood Sugar Monitoring
Many patients regularly check their blood sugar using a finger-stick blood glucose meter or a continuous glucose monitor (CGM). These devices help patients and their healthcare team adjust medications, diet, and activity to keep blood sugar within a healthy range. HbA1C testing is usually repeated every three to six months to monitor long-term control.
Foot Care
Good foot care is especially important for people with diabetes. Patients should inspect their feet every day for cuts, blisters, redness, swelling, sores, or ulcers. They should wear properly fitting shoes, avoid walking barefoot, and seek medical attention promptly if they notice any wounds or signs of infection. Regular foot examinations by a healthcare professional can identify problems before they become serious.
Summary
Diabetes is a common condition that causes high blood sugar because the body either does not make enough insulin or cannot use insulin properly. Over time, poorly controlled diabetes can damage the nerves, blood vessels, eyes, kidneys, heart, and feet. Doctors diagnose diabetes with blood tests, especially the HbA1C test, which measures average blood sugar over the previous two to three months. Treatment focuses on healthy eating, regular exercise, maintaining a healthy weight, medications when needed, and careful monitoring of blood sugar levels. For people with diabetes, taking good care of their feet and keeping blood sugar under good control are two of the most important steps in preventing serious complications and maintaining long-term health.
Edited by Stephen Pinney MD, July 16th, 2026.
Previously Edited by Tonya Dixon MD, Jean Brilhault, MD, Judith Smith, MD and Timothy Charlton MD