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Diabetes management is a lifelong commitment that extends far beyond daily blood sugar checks. Achieving and maintaining long-term blood sugar control—often measured through a test called HbA1c—is the cornerstone of preventing serious complications and preserving quality of life. Whether you’ve been recently diagnosed or have been managing diabetes for years, understanding the science behind blood glucose regulation, the tools available for monitoring, and the lifestyle strategies that support metabolic health can empower you to take control of your condition. This comprehensive guide explores the essential aspects of long-term diabetes management, from understanding different types of diabetes to implementing evidence-based strategies that keep blood sugar levels stable over months and years.
Understanding Diabetes: Types, Mechanisms, and Metabolic Impact
Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels resulting from defects in insulin production, insulin action, or both. The condition affects hundreds of millions of people worldwide and represents one of the most significant public health challenges of the 21st century. To manage diabetes effectively, it’s essential to understand not just the diagnosis, but the underlying mechanisms that cause blood sugar dysregulation.
Type 1 diabetes is an autoimmune condition in which the body’s immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. This destruction typically occurs over months or years, eventually leaving the body unable to produce sufficient insulin—the hormone responsible for allowing glucose to enter cells for energy. Type 1 diabetes usually develops in childhood or adolescence, though it can occur at any age. People with Type 1 diabetes require lifelong insulin therapy through injections or an insulin pump, as their bodies cannot produce this critical hormone naturally.
Type 2 diabetes, which accounts for approximately 90-95% of all diabetes cases, develops when the body becomes resistant to insulin’s effects or when the pancreas cannot produce enough insulin to overcome this resistance. Unlike Type 1, Type 2 diabetes typically develops gradually and is strongly associated with lifestyle factors including obesity, physical inactivity, poor diet, and genetic predisposition. Initially, the pancreas compensates by producing more insulin, but over time, beta cell function declines, leading to progressively higher blood glucose levels. Type 2 diabetes can often be managed through lifestyle modifications, oral medications, and sometimes insulin therapy.
There are also other forms of diabetes, including gestational diabetes (which develops during pregnancy), monogenic diabetes (caused by single gene mutations), and secondary diabetes (resulting from other medical conditions or medications). Each type requires a tailored management approach, but the fundamental goal remains the same: maintaining blood glucose levels within a target range to prevent both immediate symptoms and long-term complications.
Why Long-term Blood Sugar Control Matters: The HbA1c Connection
While daily blood glucose monitoring provides valuable snapshots of your current metabolic state, long-term blood sugar control is best assessed through a test called hemoglobin A1c (HbA1c or simply A1c). This blood test measures the percentage of hemoglobin proteins in red blood cells that have glucose attached to them, providing an average picture of blood sugar levels over the previous two to three months. The higher your blood glucose levels have been during this period, the higher your A1c percentage will be.
For most adults with diabetes, the American Diabetes Association recommends an A1c target of less than 7%, though individualized goals may vary based on age, duration of diabetes, presence of complications, and other health factors. Maintaining A1c levels within target range significantly reduces the risk of developing diabetes-related complications. Landmark studies have demonstrated that every percentage point reduction in A1c correlates with substantial decreases in the risk of microvascular complications such as retinopathy, nephropathy, and neuropathy.
The importance of long-term glycemic control cannot be overstated. Chronically elevated blood glucose levels cause damage through multiple mechanisms, including increased oxidative stress, inflammation, and the formation of advanced glycation end products (AGEs) that accumulate in tissues throughout the body. This cumulative damage affects virtually every organ system, leading to complications that can profoundly impact quality of life and longevity.
Diabetes Complications: Understanding the Risks of Poor Blood Sugar Control
Uncontrolled diabetes can lead to a cascade of serious health complications affecting multiple organ systems. Understanding these risks provides powerful motivation for maintaining consistent blood sugar control and adhering to management strategies.
Cardiovascular disease represents the leading cause of death among people with diabetes. High blood glucose levels damage blood vessels and the nerves that control the heart, significantly increasing the risk of coronary artery disease, heart attack, stroke, and peripheral artery disease. People with diabetes are two to four times more likely to develop heart disease compared to those without diabetes. Managing blood sugar, along with blood pressure and cholesterol levels, is essential for cardiovascular protection.
Diabetic neuropathy, or nerve damage, affects up to 50% of people with diabetes. High blood sugar levels damage the small blood vessels that nourish nerves, particularly in the legs and feet. This can cause tingling, numbness, burning sensations, or pain that typically begins in the toes and gradually moves upward. Autonomic neuropathy can affect nerves controlling the digestive system, heart rate, blood pressure, and bladder function, leading to a range of symptoms from gastroparesis to orthostatic hypotension.
Diabetic nephropathy, or kidney damage, develops when high blood glucose levels damage the delicate filtering units in the kidneys called nephrons. Over time, this damage can progress to chronic kidney disease and eventually kidney failure requiring dialysis or transplantation. Diabetes is the leading cause of kidney failure in many developed countries. Early detection through regular urine albumin testing and blood creatinine measurements allows for interventions that can slow disease progression.
Diabetic retinopathy occurs when high blood sugar damages the blood vessels in the retina, the light-sensitive tissue at the back of the eye. This condition is a leading cause of blindness in working-age adults. Retinopathy often develops without symptoms in its early stages, making regular comprehensive eye examinations essential. Advanced cases can lead to vision loss, retinal detachment, and glaucoma.
Additional complications include increased susceptibility to infections, slow wound healing, diabetic foot problems that can lead to amputation, skin conditions, hearing impairment, cognitive decline, and depression. The good news is that maintaining blood glucose levels within target range dramatically reduces the risk of developing these complications or slows their progression if they’ve already begun.
Blood Glucose Monitoring: Tools and Techniques for Effective Tracking
Regular blood glucose monitoring forms the foundation of effective diabetes management, providing the data needed to make informed decisions about food, physical activity, and medication. The frequency and method of monitoring depend on the type of diabetes, treatment regimen, and individual circumstances.
Traditional blood glucose meters require a small blood sample obtained by pricking the fingertip with a lancet. The blood is applied to a test strip inserted into the meter, which displays the glucose reading within seconds. For people with Type 1 diabetes or those using intensive insulin therapy, checking blood sugar four or more times daily—before meals and at bedtime—is typically recommended. Those with Type 2 diabetes not using insulin may monitor less frequently, though the specific schedule should be determined in consultation with healthcare providers.
Continuous glucose monitors (CGMs) represent a significant technological advancement in diabetes care. These devices use a small sensor inserted under the skin to measure glucose levels in interstitial fluid continuously throughout the day and night. CGMs provide real-time glucose readings, trend arrows showing the direction and speed of glucose changes, and customizable alerts for high and low glucose levels. This technology offers unprecedented insight into glucose patterns, helping users understand how food, activity, stress, and medications affect their blood sugar. Many CGMs can share data with smartphones and allow caregivers or healthcare providers to remotely monitor glucose levels.
Regardless of the monitoring method used, maintaining a detailed log of blood glucose readings, along with notes about meals, physical activity, medications, and any symptoms experienced, helps identify patterns and trends. Many modern glucose meters and CGMs automatically store this data and can generate reports showing average glucose levels, time in target range, and glucose variability. Reviewing these patterns with your healthcare team enables adjustments to your management plan that can improve glycemic control.
Understanding target blood glucose ranges is equally important. For most adults with diabetes, the American Diabetes Association recommends fasting or pre-meal glucose levels of 80-130 mg/dL and post-meal levels (one to two hours after eating) below 180 mg/dL. However, targets should be individualized based on factors such as age, pregnancy status, presence of complications, hypoglycemia awareness, and overall health status.
Nutrition Strategies for Blood Sugar Management
Diet plays a pivotal role in diabetes management, directly influencing blood glucose levels and long-term metabolic health. While there’s no single “diabetes diet” that works for everyone, certain nutritional principles have been shown to support blood sugar control and overall health.
Carbohydrate awareness is fundamental to blood sugar management because carbohydrates have the most significant impact on glucose levels. All carbohydrates—whether from grains, fruits, vegetables, dairy products, or sweets—are broken down into glucose during digestion. Understanding the quantity and quality of carbohydrates consumed helps predict and manage blood sugar responses. Complex carbohydrates from whole grains, legumes, and vegetables are generally preferable to refined carbohydrates and added sugars because they’re digested more slowly, contain more fiber and nutrients, and cause more gradual blood sugar increases.
Carbohydrate counting is a meal planning approach that involves tracking the grams of carbohydrates consumed at each meal and snack. This method is particularly useful for people using insulin, as it allows for precise insulin dosing based on carbohydrate intake. Reading nutrition labels, using measuring tools, and learning standard portion sizes are essential skills for accurate carbohydrate counting. Many people find that maintaining consistency in carbohydrate intake from meal to meal helps stabilize blood sugar levels and simplifies medication management.
The glycemic index (GI) and glycemic load (GL) are tools that rank foods based on how quickly they raise blood glucose levels. Low-GI foods cause slower, more gradual increases in blood sugar, while high-GI foods cause rapid spikes. Incorporating more low-GI foods such as non-starchy vegetables, most fruits, legumes, and whole grains can help improve glycemic control. However, the glycemic response to foods varies among individuals and is influenced by factors such as food preparation methods, ripeness, and what other foods are consumed simultaneously.
Balanced plate composition supports stable blood sugar levels. A helpful guideline is to fill half your plate with non-starchy vegetables, one-quarter with lean protein, and one-quarter with complex carbohydrates. Including healthy fats from sources like nuts, seeds, avocados, and olive oil can slow carbohydrate absorption and promote satiety. Protein and fat don’t directly raise blood glucose but can affect insulin sensitivity and should be consumed in appropriate portions.
Meal timing and consistency also influence blood sugar control. Eating at regular intervals helps prevent extreme fluctuations in glucose levels. Skipping meals, particularly if taking diabetes medications, can lead to hypoglycemia, while eating large meals can cause significant blood sugar spikes. Some people with Type 2 diabetes benefit from time-restricted eating or intermittent fasting approaches, though these should only be implemented under medical supervision.
Working with a registered dietitian who specializes in diabetes can be invaluable. These professionals can provide personalized meal plans, teach carbohydrate counting and portion control, help navigate food labels, and offer practical strategies for managing blood sugar in various situations, from dining out to managing sick days. According to the Centers for Disease Control and Prevention, medical nutrition therapy provided by registered dietitians has been shown to reduce A1c levels by up to 2% in people with Type 2 diabetes.
Physical Activity: A Powerful Tool for Glycemic Control
Regular physical activity is one of the most effective non-pharmacological interventions for improving blood sugar control and overall health in people with diabetes. Exercise increases insulin sensitivity, meaning your cells can use available glucose more effectively, and this benefit can last for hours or even days after activity. Physical activity also helps with weight management, reduces cardiovascular risk factors, improves mood and energy levels, and enhances overall quality of life.
The American Diabetes Association recommends that adults with diabetes engage in at least 150 minutes of moderate-intensity aerobic activity per week, spread over at least three days, with no more than two consecutive days without activity. Aerobic exercise—such as brisk walking, cycling, swimming, or dancing—improves cardiovascular fitness and helps lower blood glucose levels both during and after activity. For many people, even a 10-15 minute walk after meals can significantly reduce post-meal blood sugar spikes.
Resistance training, including weightlifting, resistance band exercises, or bodyweight exercises, is equally important. Building and maintaining muscle mass improves insulin sensitivity and glucose metabolism because muscle tissue is a major site of glucose uptake and storage. The ADA recommends resistance training at least two to three times per week on non-consecutive days, targeting all major muscle groups.
Flexibility and balance exercises, such as yoga, tai chi, or stretching routines, complement aerobic and resistance training. These activities can improve range of motion, reduce injury risk, decrease stress, and enhance overall functional capacity, particularly important for older adults with diabetes.
It’s important to understand how different types of exercise affect blood glucose levels. Aerobic activity typically lowers blood sugar during and after exercise, though very intense activity can temporarily raise glucose levels due to stress hormone release. People taking insulin or insulin-stimulating medications may need to adjust doses or consume additional carbohydrates before, during, or after exercise to prevent hypoglycemia. Checking blood glucose before, during (for prolonged activity), and after exercise helps you understand your individual responses and make appropriate adjustments.
For those new to exercise or with diabetes complications, consulting with healthcare providers before starting a new exercise program is essential. Certain complications, such as severe retinopathy, uncontrolled hypertension, or significant neuropathy, may require modifications to exercise routines. A gradual approach, starting with shorter sessions and lower intensity, then progressively increasing duration and intensity, helps build fitness safely while minimizing injury risk.
Medication Management and Insulin Therapy
For many people with diabetes, lifestyle modifications alone are insufficient to achieve target blood glucose levels, making medication an essential component of management. The medication regimen depends on the type of diabetes, disease duration, degree of insulin resistance or deficiency, presence of complications, and individual patient factors.
Type 1 diabetes requires lifelong insulin therapy because the pancreas produces little or no insulin. Insulin therapy aims to mimic the body’s natural insulin secretion pattern, which includes both basal (background) insulin released continuously throughout the day and bolus (mealtime) insulin released in response to food intake. Multiple daily injection regimens typically involve long-acting insulin once or twice daily for basal coverage and rapid-acting insulin before meals. Insulin pumps provide continuous subcutaneous insulin infusion, offering greater flexibility and precision in insulin delivery. Newer hybrid closed-loop systems, sometimes called “artificial pancreas” systems, automatically adjust basal insulin delivery based on CGM readings, significantly improving glycemic control while reducing hypoglycemia risk.
Type 2 diabetes management often begins with lifestyle modifications and metformin, a medication that reduces glucose production by the liver and improves insulin sensitivity. When metformin alone is insufficient, additional medications may be added. These include sulfonylureas and meglitinides (which stimulate insulin secretion), DPP-4 inhibitors (which enhance the body’s natural insulin response to meals), GLP-1 receptor agonists (which stimulate insulin secretion, suppress glucagon, slow gastric emptying, and promote satiety), SGLT2 inhibitors (which cause the kidneys to excrete excess glucose), and thiazolidinediones (which improve insulin sensitivity). Many people with Type 2 diabetes eventually require insulin therapy as beta cell function declines over time.
Medication adherence is critical for achieving glycemic targets. Taking medications as prescribed, at the correct times and doses, ensures optimal effectiveness. Barriers to adherence include cost, side effects, complex regimens, and lack of understanding about medication purposes. Discussing concerns openly with healthcare providers can lead to solutions such as generic alternatives, simplified regimens, or different medication classes with fewer side effects.
Understanding potential side effects and how to manage them is equally important. Hypoglycemia (low blood sugar) is a significant concern with insulin and certain oral medications. Recognizing symptoms—such as shakiness, sweating, confusion, rapid heartbeat, and hunger—and knowing how to treat hypoglycemia promptly with fast-acting carbohydrates can prevent serious complications. The “rule of 15” recommends consuming 15 grams of fast-acting carbohydrate, waiting 15 minutes, rechecking blood glucose, and repeating if necessary until levels normalize.
Stress Management and Mental Health in Diabetes Care
The relationship between stress, mental health, and blood glucose control is complex and bidirectional. Stress triggers the release of hormones such as cortisol and adrenaline, which cause the liver to release stored glucose and can make cells more resistant to insulin, leading to elevated blood sugar levels. Chronic stress can make diabetes management significantly more challenging and is associated with poorer glycemic control.
Beyond the direct physiological effects, stress and mental health challenges can interfere with diabetes self-care behaviors. Depression, anxiety, and diabetes distress—the emotional burden of living with a demanding chronic condition—are more common among people with diabetes than in the general population. These conditions can reduce motivation for healthy eating, physical activity, medication adherence, and blood glucose monitoring, creating a cycle of worsening glycemic control and increased emotional distress.
Stress reduction techniques can improve both psychological well-being and blood sugar control. Mindfulness meditation, which involves focusing attention on the present moment without judgment, has been shown to reduce stress, improve emotional regulation, and may help improve glycemic control. Deep breathing exercises, progressive muscle relaxation, and guided imagery are additional techniques that activate the body’s relaxation response, counteracting stress hormones’ effects.
Regular physical activity serves double duty as both a blood sugar management tool and a powerful stress reducer. Exercise releases endorphins, improves mood, reduces anxiety, and enhances sleep quality. Finding activities you enjoy increases the likelihood of maintaining a consistent exercise routine.
Social support plays a crucial role in diabetes management and emotional well-being. Connecting with family, friends, or diabetes support groups provides opportunities to share experiences, exchange practical tips, and receive encouragement. Many communities and online platforms offer diabetes support groups where people can connect with others facing similar challenges. The American Diabetes Association provides resources for finding local and online support communities.
Professional mental health support should be sought when stress, anxiety, or depression interfere with daily functioning or diabetes management. Psychologists, counselors, and social workers with expertise in chronic disease management can provide cognitive-behavioral therapy, problem-solving skills training, and other evidence-based interventions. Some diabetes care teams include mental health professionals, recognizing the integral role of psychological well-being in successful diabetes management.
Adequate sleep is often overlooked but essential for both metabolic health and stress management. Sleep deprivation increases insulin resistance, affects appetite-regulating hormones, and impairs decision-making abilities related to food choices and self-care. Most adults need seven to nine hours of quality sleep per night. Establishing consistent sleep schedules, creating a relaxing bedtime routine, limiting screen time before bed, and addressing sleep disorders such as sleep apnea can improve both sleep quality and glycemic control.
Preventive Care and Regular Health Monitoring
Comprehensive diabetes care extends beyond blood sugar management to include regular screening for complications and management of cardiovascular risk factors. Preventive care enables early detection of problems when interventions are most effective, potentially preventing or delaying serious complications.
A1c testing should be performed at least twice yearly for people meeting treatment goals and quarterly for those whose therapy has changed or who aren’t meeting targets. This test provides the most important measure of long-term glycemic control and guides treatment adjustments.
Comprehensive eye examinations by an ophthalmologist or optometrist should occur annually for most people with diabetes. These dilated eye exams can detect diabetic retinopathy, cataracts, and glaucoma in their early stages, often before symptoms appear. Early treatment of retinopathy with laser therapy or injections can prevent vision loss. People with Type 1 diabetes should have their first eye exam within five years of diagnosis, while those with Type 2 diabetes should be examined at the time of diagnosis since the condition may have been present for years before detection.
Kidney function monitoring through annual urine albumin testing and serum creatinine measurements helps detect diabetic nephropathy early. The presence of small amounts of albumin in urine (microalbuminuria) indicates early kidney damage, and interventions such as blood pressure control and certain medications can slow progression. Monitoring estimated glomerular filtration rate (eGFR) assesses overall kidney function.
Comprehensive foot examinations should be performed at least annually, with visual inspection at every healthcare visit. Neuropathy and poor circulation make feet vulnerable to injuries that can develop into serious infections or ulcers. Healthcare providers assess sensation using monofilament testing, check pulses, examine skin and nail condition, and look for structural abnormalities. Daily self-examination of feet, proper footwear, prompt treatment of minor injuries, and professional foot care when needed can prevent serious complications. According to the National Institute of Diabetes and Digestive and Kidney Diseases, proper foot care can reduce amputation rates by up to 85%.
Cardiovascular risk assessment is essential given the elevated heart disease risk in diabetes. Blood pressure should be checked at every visit, with a target typically below 140/90 mmHg for most adults with diabetes, though individualized targets may be lower. Lipid panels measuring cholesterol and triglycerides should be obtained at least annually. Many people with diabetes benefit from statin therapy to reduce cardiovascular risk, regardless of baseline cholesterol levels. Aspirin therapy may be recommended for those with elevated cardiovascular risk.
Dental care is often overlooked but important, as diabetes increases the risk of gum disease, which in turn can worsen blood sugar control. Regular dental cleanings and examinations, along with good daily oral hygiene, help maintain oral health. Informing your dentist about your diabetes diagnosis ensures appropriate care.
Immunizations are particularly important for people with diabetes, who are at higher risk for certain infections. Annual influenza vaccination, pneumococcal vaccination, and hepatitis B vaccination (for adults not previously vaccinated) are recommended. Staying current with other routine immunizations, including COVID-19 vaccines, provides additional protection.
Emerging Technologies and Future Directions in Diabetes Care
Diabetes management has been transformed by technological innovations, and the pace of advancement continues to accelerate. Understanding emerging technologies helps people with diabetes and their healthcare providers make informed decisions about incorporating new tools into management plans.
Advanced insulin delivery systems are becoming increasingly sophisticated. Hybrid closed-loop systems integrate CGMs with insulin pumps, using algorithms to automatically adjust basal insulin delivery based on glucose readings and predicted trends. These systems significantly reduce the burden of diabetes management while improving time in target range and reducing hypoglycemia. Fully automated closed-loop systems that also automate bolus insulin for meals are in development and clinical trials.
Smart insulin pens with memory capabilities track insulin doses and timing, helping users and healthcare providers identify patterns and avoid dosing errors. Some connect to smartphone apps that integrate insulin data with CGM readings, carbohydrate logs, and activity information, providing comprehensive diabetes management platforms.
Artificial intelligence and machine learning are being applied to diabetes management in various ways, from predicting glucose trends and recommending insulin doses to identifying patterns in large datasets that can inform personalized treatment approaches. Decision support systems can analyze individual glucose patterns and provide tailored recommendations for medication adjustments, meal planning, and activity timing.
Novel medications continue to expand treatment options. Newer GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists offer powerful glucose-lowering effects along with significant weight loss and cardiovascular benefits. Ultra-rapid-acting insulins more closely mimic physiological insulin secretion. Research into glucose-responsive “smart” insulins that activate only when blood glucose rises could potentially eliminate hypoglycemia risk.
Islet cell and stem cell transplantation research aims to restore natural insulin production in people with Type 1 diabetes. While still largely experimental, advances in immunosuppression protocols and encapsulation technologies that protect transplanted cells from immune attack are bringing these approaches closer to clinical reality.
Building Your Diabetes Care Team
Effective diabetes management requires collaboration among multiple healthcare professionals, each bringing specialized expertise. Building a comprehensive care team and maintaining regular communication with team members optimizes outcomes.
Your primary care physician or endocrinologist serves as the central coordinator of diabetes care, prescribing medications, ordering tests, monitoring for complications, and adjusting treatment plans. Endocrinologists specialize in hormone disorders including diabetes and may be particularly helpful for complex cases, frequent hypoglycemia, or difficulty achieving glycemic targets.
A certified diabetes care and education specialist (CDCES), often a nurse or dietitian with specialized diabetes training, provides education about all aspects of diabetes management, from blood glucose monitoring and medication administration to problem-solving and goal-setting. Diabetes self-management education and support (DSMES) services have been shown to improve clinical outcomes and are covered by most insurance plans.
A registered dietitian nutritionist (RDN) with diabetes expertise provides medical nutrition therapy, creating personalized meal plans, teaching carbohydrate counting, and helping navigate the complex relationship between food and blood glucose. Regular sessions with an RDN, especially after diagnosis or when making significant lifestyle changes, can significantly improve glycemic control.
Additional team members may include ophthalmologists for eye care, podiatrists for foot care, nephrologists if kidney disease develops, cardiologists for cardiovascular risk management, mental health professionals for psychological support, pharmacists who can provide medication counseling and identify potential drug interactions, and exercise physiologists who can design safe, effective physical activity programs.
Regular communication with your care team, bringing glucose logs or CGM reports to appointments, asking questions, and honestly discussing challenges with diabetes management enables your team to provide the most effective support and make appropriate treatment adjustments.
Living Well with Diabetes: A Long-term Perspective
Achieving and maintaining long-term blood sugar control is undoubtedly challenging, requiring daily attention, decision-making, and self-care behaviors that can feel overwhelming at times. However, with the right knowledge, tools, support systems, and mindset, people with diabetes can live full, healthy, and active lives while minimizing complication risks.
Success in diabetes management comes not from perfection but from consistency and persistence. Blood glucose levels will fluctuate despite best efforts—this is the nature of diabetes. What matters most is the overall pattern over time, reflected in A1c levels and time in target range. Learning from experiences, both successes and setbacks, and continuously refining your management approach leads to gradual improvement.
Setting realistic, achievable goals and celebrating progress, no matter how small, maintains motivation for the long journey of diabetes management. Rather than trying to overhaul everything at once, focus on one or two changes at a time, allowing new behaviors to become habits before adding additional goals. Whether it’s adding an extra serving of vegetables daily, taking a 10-minute walk after dinner, or checking blood glucose more consistently, each positive change contributes to better long-term outcomes.
Staying informed about advances in diabetes care, advocating for your needs within the healthcare system, and connecting with the diabetes community provides ongoing support and empowerment. Remember that diabetes management is a marathon, not a sprint, and taking care of your physical and emotional well-being enables you to sustain the effort required for long-term success.
With comprehensive understanding, appropriate tools and medications, lifestyle strategies that support metabolic health, regular preventive care, and a strong support system, long-term blood sugar control is an achievable goal that dramatically reduces complication risks and enables people with diabetes to thrive.