Please read the answers as education, not as personal advice. A short answer cannot know your medicines, your kidneys, your eyes, or your history. Where an answer says "ask your care team", it means that the safe next step really does depend on you.
Section 19.1 answers the questions, grouped by theme. Section 19.2 collects the numbers. Section 19.3 lists resources from around the world, and how to judge what you find online.
19.1 Frequently Asked Questions
Diabetes and what it means
Can diabetes be cured? Type 1 diabetes cannot be cured today. Type 2 diabetes can go into remission in some people, which is not the same as a cure. One definition of remission is an HbA1c below 6.5 percent at least three months after stopping glucose-lowering medicines, with regular follow-up afterwards.[@riddle2021] In the DiRECT trial, adults with type 2 diabetes for six years or less, who were not on insulin, followed a supervised low-calorie diet of 825 to 853 kilocalories a day for three to five months, and 46 percent were in remission at 12 months, against 4 percent in the comparison group.[@lean2018] Those numbers describe a specific programme in specific people, and remission needs ongoing support. Chapter 3 explains more.
Is diabetes my fault? No. Diabetes has many causes, including genes, age, and the environment you live in (Chapters 2 and 3). Blame is part of the problem, not the solution: an international panel reported that about four in five adults with diabetes experience stigma, and that blame is one of its drivers.[@speight2024stigma] If words such as "cheating" or "bad control" hurt, you may say so to your team, and Chapter 16 gives you words to use.
I feel fine. Do I need to be tested? Prediabetes often has no symptoms, and many risk factors are silent.[@ada2026] Chapter 4 lists the tests and who should be screened.
Food
Do I have to give up rice, bread, or my traditional foods? No. The plate in Chapter 6 keeps your staples but limits the size of their quarter, and Chapters 7 and 17 show how to measure portions and swap starches. About 106 grams of cooked white rice and 149 grams of cooked lentils each carry roughly 30 grams of carbohydrate, with very different fibre (calculated from USDA values, Chapter 17).
Can I eat fruit? Yes. Fruit sits in the carbohydrate quarter of the plate, so the amount matters.[@adaplate] European guidance advises whole fruit rather than fruit juice.[@easd2023]
Are artificial sweeteners safe? What about honey or jaggery? The WHO's 2023 guideline conditionally advises against using non-sugar sweeteners to control weight, and it does not apply to people with pre-existing diabetes; a study of erythritol found an association with heart events, which is not proof of cause (Chapter 8).[@who2023sweet][@witkowski2023] In a small crossover trial in adults with type 2 diabetes, coconut jaggery did not differ significantly from cane sugar or glucose in its effect on glucose.[@thilanka2022] "Natural" sweeteners are not a licence to use more.
Do I need to count carbohydrate? It depends on your treatment. For many people with type 2 diabetes managed with food and possibly tablets, the plate and household measures are enough, and a plate-method trial found results at least as good as counting.[@zhang2022] People who take mealtime insulin are often taught to count, by their diabetes team (Chapter 7).
Movement, sleep, and stress
How much exercise do I need? The WHO advises adults, including those with type 2 diabetes, at least 150 to 300 minutes of moderate activity a week (or 75 to 150 minutes of vigorous activity), plus muscle-strengthening on two or more days.[@who2020pa] Any amount is better than none, and Chapter 9 shows how to start smaller. If you take insulin or medicines that can cause lows, talk to your team about exercise first.
Does poor sleep really raise my glucose? Sleep and glucose are linked. Population studies associate both short and long sleep with a higher risk of type 2 diabetes,[@shan2015] and small laboratory studies of a few nights of short sleep show lower insulin sensitivity, though the size of the effect varies (Chapter 10).
Why is my morning reading high? There are several possible reasons, including the rise in hormones before waking known as the dawn phenomenon,[@monnier2013] and, less often, a rebound after a low in the night. A sensor is the best way to tell them apart (Chapters 10 and 12). Do not change your evening medicine on your own.
Medicines and monitoring
Does needing insulin mean I have failed? No. Type 2 diabetes tends to progress as beta-cell function declines, and treatment plans are expected to change. The ADA advises clinicians not to use insulin as a threat or to describe it as personal failure.[@ada2026s9] Chapter 11 explains.
My numbers are better. Can I stop my medicine? Do not stop or reduce medicines on your own. Better numbers are often a sign that the treatment is working. If you want to reduce a medicine, ask your team; some medicines are changed when weight, kidney function, or glucose improve, and that is a decision to make with them (Chapter 11).
Do I need a continuous glucose monitor? The ADA recommends CGM from diagnosis, and at any time afterwards, for people who use insulin, and for some people on other medicines or where it would help, while access depends on cost and where you live (Chapter 12).[@ada2026s7] If you cannot get one, structured fingerstick testing on a few chosen days can show many of the same patterns.
Emergencies and safety
What do I do for a low? For a conscious person who can swallow, the ADA's wording is to take 15 grams of fast-acting carbohydrate, wait 15 minutes, and recheck.[@adahypo] If the person is unconscious, having a seizure, or unable to swallow, call your local emergency number and do not put food or drink in their mouth (Chapter 13).
When should I go to hospital? Go for unconsciousness or a seizure, a low that needs another person's help, vomiting with ketones, difficulty breathing, confusion or drowsiness with high glucose, or any illness where you cannot keep fluids down (Chapter 13). If you are unsure, call.
Can I fast, or drink alcohol, or drive? Fasting, including at Ramadan, should be discussed with your care team six to eight weeks before; fasting is not recommended for everyone.[@idfdar2021] Alcohol can cause lows hours after the last drink, especially with insulin or sulfonylureas.[@adaalcohol] Check glucose before driving and stop at the first symptom of a low.[@lorber2014] Chapter 13 has the details.
Complications and check-ups
Which check-ups do I need each year? Your team decides, and Chapter 14's calendar and Form 5 in Chapter 18 list the usual checks: HbA1c, blood pressure, cholesterol, kidneys, eyes, feet, teeth, vaccines, and an emotional wellbeing check. Feet should be checked every day at home and by a professional at least once a year (Chapter 15).
Feelings and everyday life
I am tired of managing diabetes. Is something wrong with me? No. Feeling worn out by diabetes is common. Chapter 16 describes diabetes distress and burnout, what helps, and when to ask for professional help. If you feel hopeless for two weeks or more, or ever think of harming yourself, speak to a doctor or a crisis service in your country now (Chapter 16).
Can I have a normal life? Yes. Diabetes changes some routines, and with information, support, and a good team, many people work, travel, celebrate, and raise families. Keep your emergency card (Chapter 13) and your check-up list (Chapter 18) up to date, and ask for help when you need it.
19.2 The Key Numbers at a Glance
The table repeats the numbers used in the book, with the chapter where each is explained. They are general values for many adults, not personal targets. Your team may set different ones for you.
| Topic | Number (general adult values) | Chapter |
|---|---|---|
| HbA1c target | Below 7.0% (53 mmol/mol) for many adults; personalised, higher for some [@idf2025rec][@adaguide2023] | 4 |
| Glucose before meals | 80 to 130 mg/dL (4.4 to 7.2 mmol/L) [@adaguide2023] | 4 |
| Glucose after meals (peak) | Below 180 mg/dL (10.0 mmol/L), 1 to 2 hours after the start of a meal [@adaguide2023] | 4 |
| Time in range (sensor) | Above 70% of time at 70 to 180 mg/dL; below 4% under 70; below 1% under 54; below 25% over 180; below 5% over 250 [@battelino2019] | 4, 12 |
| Low glucose, level 1 and 2 | Below 70 mg/dL (3.9 mmol/L); below 54 mg/dL (3.0 mmol/L) [@ada2025s6] | 13 |
| Treating a low | 15 g fast-acting carbohydrate, recheck after 15 minutes [@adahypo] | 13 |
| Blood ketones (adult type 1 sick-day guidance) | 1.5 to 2.9 mmol/L: contact team; 3.0 or more: emergency help [@trend2018] | 13 |
| Blood pressure | 130/80 mmHg or lower if it can be reached safely [@ada2026htn] | 14 |
| LDL cholesterol | Below 70 mg/dL (age 40 to 75, primary prevention); below 55 mg/dL with known heart disease [@ada2026lipid] | 14 |
| Kidney: uACR | 30 mg/g (3 mg/mmol) or more is abnormal [@kdigo2024] | 14 |
| Physical activity | 150 to 300 minutes of moderate activity a week, and strength work on 2 or more days [@who2020pa] | 9 |
| Fibre | At least 25 g a day (WHO); at least 35 g (European guidance) [@whodiet][@easd2023] | 6, 17 |
| Free sugars and salt | Free sugars below 10% of energy; salt below 5 g a day [@whodiet] | 6, 8 |
| Insulin without refrigeration | Manufacturer-supplied vials or cartridges can stay 59 to 86 degrees F (15 to 30 degrees C) for up to 28 days [@fdainsulin2017] | 13 |
Values are taken from the sources cited and described in the listed chapters; the mmol/L values for glucose use the conversion mg/dL divided by 18. Sick-day ketone thresholds come from UK guidance for adults with type 1 diabetes and differ for children, in pregnancy, and elsewhere.
19.3 Global Resources
Where to learn more
The organisations below were opened while this chapter was written, and the descriptions are what each site states about itself. They are examples and not endorsements. Many have material in several languages, but check what is available for your language.
| Organisation | What you will find | Web address |
|---|---|---|
| International Diabetes Federation (IDF) | An umbrella of 264 national associations in 163 countries and territories; the Diabetes Atlas; member associations across eight regions [@idfsite] | idf.org |
| World Health Organization (WHO) | Fact sheet on diabetes, questions and answers, technical guidance [@whosite] | who.int/health-topics/diabetes |
| American Diabetes Association (ADA) | Education, nutrition guidance, tools; English and Spanish [@adasite] | diabetes.org |
| Diabetes UK | Information, helpline, online forums, risk calculators [@diabetesuksite] | diabetes.org.uk |
| Diabetes Australia | Education, care coordination, National Diabetes Services Scheme [@diabetesaussite] | diabetesaustralia.com.au |
| Diabetes Canada | Education, nutrition guidance, community programmes [@diabetescasite] | diabetes.ca |
| NIDDK (US National Institutes of Health) | Health information on diabetes and complications; English and Spanish [@niddksite] | niddk.nih.gov/health-information/diabetes |
| ISPAD | Guidelines and educational materials on children, adolescents and young adults with diabetes [@ispadsite] | ispad.org |
| IWGDF | Evidence-based guidelines and information on the diabetic foot [@iwgdfsite] | iwgdf.org |
| EASD | Professional organisation; mainly for researchers and clinicians, with limited patient content [@easdsite] | easd.org |
Descriptions summarise what each site says about itself; no clinical claim in this book depends on them.
Find help in your own country
Most countries have a national diabetes association, and the IDF site lists its member associations, so start there if you do not see your country above.[@idfsite] Ask your doctor or pharmacist about local diabetes education programmes, clinics, and dietitians. If you feel overwhelmed and need to speak to someone, a directory of verified helplines by country and topic is available at findahelpline.com, which describes itself as covering more than 175 countries.[@findahelpline] This book lists no phone numbers, because they change and differ by country; look up your local emergency number now and write it on your emergency card (Chapter 13).
Judging what you read online
These are suggestions from the author, not results from a study. Look for who runs the site and whether it says how its information is checked. Be wary of anything that promises a cure, tells you to stop your medicines, or sells a product alongside its advice. Check the date. Compare a claim with a guideline from a diabetes association or health ministry. Ask your care team about anything that surprises you, and remember that a story from one person is not evidence about you.
Key Takeaways
- Short answers cannot know your medicines or your history. Use this chapter to orient yourself, and ask your care team where an answer depends on you.
- Type 2 diabetes can go into remission in some people, which is not a cure, and it needs follow-up. Type 1 diabetes cannot be cured today.
- Diabetes is not your fault, and blame and stigma are common and harmful.
- Do not stop or reduce medicines on your own, even when your numbers improve. Talk to your team first.
- For a low, take 15 grams of fast-acting carbohydrate and recheck after 15 minutes. If someone cannot swallow, is unconscious, or is having a seizure, call emergency services and put nothing in their mouth.
- The numbers in Section 19.2 are general values. Your targets are set with your team.
- Reliable help exists in most countries. Start with a national association, your care team, and a verified helpline directory.
Action Points
- Write down your three questions. Choose the questions from this chapter that matter most to you and take them to your next appointment.
- Fill in your own numbers. Ask your team for your personal targets and write them next to the general values in Section 19.2.
- Find your national association. Use the IDF site to find the diabetes association in your country, and note one programme or service you could use.
- Save a helpline. Look up your local emergency number and a crisis helpline for your country, and save them in your phone and on your emergency card.
- Check a source. The next time you read a health claim online, check who wrote it and compare it with a guideline before you act.
This book is intended for education and does not replace personal medical advice. If you have diabetes or take glucose-lowering medication, please consult your healthcare team before changing your diet, exercise, or treatment.