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Diabetes can present two main categories of problems, in the form of short term ill-effects and longer term harm. Minimizing both areas requires discipline.

Rapid spikes or dips in blood glucose level can result in several unpleasant effects: dizziness, disorientation, muscle weakness, nausea and others. For some diabetics, it’s very difficult to prevent this from happening at some time. But there are practices that can improve the odds.

Monitoring is vital. Pricking your finger three times a day is wearisome, but worth the effort. Some new glucose monitoring devices don’t require painful pricks.

Some contain tiny, powerful lasers that create a hole through which blood oozes. They produce only a mild tingling sensation. One recent device senses glucose level through the skin using an infrared beam, requiring no blood sample at all.

The intent of monitoring is to keep the glucose-insulin balance near normal. In people without diabetes, the fasting blood glucose level is under 99 mg/dL. Eating a big meal may cause the level to rise to above 200 mg/dL, but normal functioning releases enough insulin to bring the level down within a few hours. So a little variation in the glucose reading is normal; keeping the proper balance is the goal.

Part of a long-term glucose monitoring strategy should encompass regular physician visits with a quarterly A1C test. Several tests exist to measure blood glucose level at a given time. The A1C test provides a picture averaged over a period of months. The name comes from HbA1c, an abbreviation for glycated hemoglobin.

Hemoglobin’s role is to carry oxygen from the red blood cells to the tissues. Hemoglobin is glycated when there is extra glucose in the blood. The A1C test can give an average glucose level, because glycated hemoglobin remains.

The effects of diabetes continue over the long-term. In the past, many diabetics would suffer from kidney damage, blindness, nerve damage and ills within a decade or so of the condition’s onset. Luckily this need not occur. Modern medical knowledge enables most diabetics to lead nearly normal lives, with few ill effects.

Much of this management is disciplined exercise and diet. Many diabetics can keep their glucose-insulin balance nearly normal through diet and exercise, without medicine.

This is possible because the lowering of body fat with exercise and diet helps the body maintain a better balance on its own. Body fat affects hormone production and release and it affects how the body responds to glucose levels. There is a definite correlation between body fat and the degree of diabetes, although researchers don’t understand all the factors involved.

One part of the puzzle is role lowering body fat plays in lowering the blood pressure. Chronic hypertension (high blood pressure) is a major contributor to the cardiovascular and nerve problems experienced by some diabetics.

With a well-disciplined self-management routine, a diabetic can achieve a practically normal life. The pain of monitoring the disease is minor compared to the enormous benefits that result from doing so.