Living Well with Diabetes

Diabetes, a disease marked by high levels of sugar in the blood, is more common than ever before. In the United States, the prevalence of diabetes has more than quadrupled in the past two decades. Not only are more people being diagnosed with diabetes, they’re also developing the disease at younger ages.

That’s worrisome, because the risks of complications from this common disease — which include heart attack, stroke, blindness, kidney failure, and amputation — become greater the longer you have diabetes. But you can delay or even prevent the development of debilitating long-term complications. It starts with getting your blood sugar goals. And thanks to innovations such as high-tech monitoring devices, improved medications, and nearly painless insulin injectors it's easier than ever to be successful.

This special health report will help you better understand and manage your diabetes. It includes detailed, updated information about medications and alternative treatments for diabetes, and a special section on weight-loss strategies. By reading this report, you’ll also learn the basics of how your body metabolizes sugar, how and when to monitor your blood sugar, and how to cope with both short- and long-term complications of the disease. Perhaps most importantly, you’ll see that it’s not just possible to live with diabetes; it’s possible to live well.

Prepared by the editors of Harvard Health Publishing in collaboration with David M. Nathan, MD Professor of Medicine, Harvard Medical School; Founder, Diabetes Center, and Director, Clinical Research Center, Massachusetts General Hospital. 49 pages. (2025)

Who should be tested for diabetes?

The American Diabetes Association (ADA) recommends that all adults be tested for diabetes beginning at age 35. Because being overweight or obese is so closely connected to diabetes, the ADA advises that younger adults with a body mass index of 25 or higher (or 23 or higher for Asian Americans) also get tested if they have one of the following additional risk factors:

• You have a mother, father, brother, or sister with diabetes.
• You are African American, Asian American, Hispanic American, Native American, or of Pacific Islander descent.
• You have a history of cardiovascular disease, such as a heart attack or stroke.
• You have blood pressure of 130/80 millimeters of mercury (mm Hg) or higher or are being treated with medication to lower blood pressure.
• You have abnormal blood lipid levels, such as low HDL cholesterol (below 35 mg/dL) or high triglycerides (over 250 mg/dL).
• You are physically inactive.
• You have polycystic ovary syndrome or a condition linked to insulin resistance, such as severe obesity, the skin condition acanthosis nigricans, or metabolic dysfunction–associated fatty liver disease.

If your results are normal, repeat the tests in three years. If you have prediabetes (an A1c level of 5.7% to 6.4% or a fasting blood sugar level of 100 to 125 mg/dL), get tested again in one year.

• What is diabetes?
  • How the body regulates blood sugar
  • When blood sugar regulation goes awry: Type 2 diabetes
  • When the immune system attacks the pancreas: Type 1 diabetes
  • Who’s at risk for type 2 diabetes?
• Diagnosing and testing for diabetes
  • Blood tests for diabetes
• Managing your diabetes: An overview
  • Monitoring blood sugar levels
  • Staying healthy
  • A team approach
• Medications and surgery for diabetes
  • Oral medications
  • Injectable medications
  • Insulin
  • Obesity treatments to help diabetes
• SPECIAL BONUS SECTION: Lifestyle strategies for managing diabetes
• Dealing with diabetes emergencies
  • Hypoglycemia
  • Diabetic ketoacidosis
  • Hyperosmolar coma
• Pregnancy and diabetes
  • Managing diabetes during pregnancy
  • Gestational diabetes
• Long-term complications of diabetes
  • Cardiovascular disease
  • Eye problems
  • Nerve damage (neuropathy)
  • Kidney disease (nephropathy)
  • Damage to the feet and legs
  • Hand and shoulder abnormalities
  • Depression
  • Memory, thinking, and dementia
  • Hearing loss
  • Cancer
• Resources
• Glossary

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