Type 2 Diabetes Management Guide | Lower A1C & Control Blood Sugar

Understanding Type 2 Diabetes

Type 2 diabetes is a chronic condition where your body either resists the effects of insulin or doesn't produce enough insulin to maintain normal blood sugar levels. It develops over years and is often preceded by prediabetes.

Key Facts

Prevalence: Over 37 million Americans have diabetes, 90-95% have type 2
Risk Factors: Age 45+, overweight, family history, physical inactivity
Reversible Factors: Weight, diet, exercise, sleep quality

Blood Sugar Monitoring

Daily Monitoring

For most patients:

Check fasting blood sugar (before breakfast)
Check 2 hours after meals (occasionally)
Keep a log of readings and related activities

Target ranges:

Time	Target Range
Fasting	80-130 mg/dL
2 hours after eating	Less than 180 mg/dL
Before bedtime	100-140 mg/dL

A1C Testing

Your A1C test shows your average blood sugar over the past 2-3 months:

A1C Level	Status
Below 5.7%	Normal
5.7% - 6.4%	Prediabetes
6.5% and above	Diabetes
Below 7%	Good control (most adults)

Get your A1C tested every 3-6 months.

Diet and Nutrition

The Plate Method

A simple approach to balanced meals:

Half your plate: Non-starchy vegetables (broccoli, spinach, peppers)
Quarter of plate: Lean protein (chicken, fish, tofu, beans)
Quarter of plate: Carbohydrates (whole grains, starchy vegetables)

Carbohydrate Counting

If you take insulin or certain medications:

Learn to read nutrition labels
1 carbohydrate serving = 15 grams of carbs
Most adults need 45-60 grams per meal (adjust based on your plan)

Foods to Emphasize

Vegetables: Leafy greens, broccoli, cauliflower, peppers
Whole grains: Oats, quinoa, brown rice, whole wheat
Lean proteins: Chicken, fish, eggs, tofu, legumes
Healthy fats: Olive oil, nuts, seeds, avocado

Foods to Limit

Sugary drinks and juices
White bread, pasta, and rice
Processed snacks and sweets
Fried foods
Alcohol (moderate consumption)

Physical Activity

Recommended Amount

Minimum: 150 minutes of moderate-intensity exercise per week
Ideal: 30 minutes, 5 days per week
Plus: Strength training 2-3 times per week

Exercise Ideas

Type	Examples	Duration
Aerobic	Brisk walking, swimming, cycling	30 min/day
Strength	Resistance bands, weights, bodyweight	20-30 min
Flexibility	Stretching, yoga	10-15 min

Exercise Safety

Check blood sugar before and after exercise
Carry fast-acting glucose if taking insulin
Wear proper footwear
Stay hydrated

Medications

First-Line: Metformin

Most people start with metformin:

Reduces liver glucose production
Improves insulin sensitivity
Usually taken twice daily with meals
Common side effect: GI upset (improves over time)

Other Medication Classes

Class	How It Works	Examples
Sulfonylureas	Stimulate insulin release	Glipizide, Glyburide
SGLT2 Inhibitors	Remove glucose via urine	Empagliflozin, Dapagliflozin
GLP-1 Agonists	Increase insulin, reduce appetite	Semaglutide, Liraglutide
DPP-4 Inhibitors	Help body make more insulin	Sitagliptin, Linagliptin
Insulin	Replace missing insulin	Various types

Work with your doctor to find the right medication combination.

Preventing Complications

Regular Screenings

Test	Frequency	Purpose
Eye exam	Yearly	Diabetic retinopathy
Kidney function	Yearly	Nephropathy
Foot exam	Every visit	Neuropathy, ulcers
Cholesterol	Yearly	Cardiovascular risk
Blood pressure	Every visit	Hypertension

Foot Care

Inspect feet daily for cuts, blisters, red spots
Keep feet clean and dry
Never go barefoot
See a podiatrist regularly

When to Seek Help

Call your healthcare provider if:

Blood sugar consistently above 300 mg/dL
Blood sugar below 70 mg/dL that doesn't respond to treatment
Signs of infection (fever, wound that won't heal)
Numbness or tingling in hands or feet
Vision changes
Chest pain or shortness of breath

Managing type 2 diabetes is a journey. Small, consistent changes lead to significant improvements over time. Work closely with your healthcare team and don't hesitate to ask questions.