Growing up, Carol Gee saw the side effects of type 2 diabetes firsthand. “One family member had to get a limb amputated, and another always came down with yeast infections,” says Gee, who lives in the Atlanta area. She was told that too much sugar was the culprit, so she always watched how many sweets she ate.

So it came as a shock when she was diagnosed with diabetes herself in 2009, when she was in her 50s. “First, I had a pity party,” she laughs. Then she worked with a diabetes educator to learn how she could avoid the same complications as her loved ones. 

After learning that carbs are broken down into sugar in the body, Gee scaled back on breads, pastas, and baked goods and added more fruits and veggies to her plate. She also made exercise part of her regular routine. “I’ve been living with diabetes for 13 years now and I’ve never felt healthier,” she says. “I learned from my family members that taking medicine is important, but it’s not enough. It’s about lifestyle, too.”   

Medication alone isn’t enough to manage diabetes. Your diet, physical activity, and stress affect blood sugar, says Ajay Rao, MD, an associate professor in the Center for Metabolic Disease Research at the Lewis Katz School of Medicine at Temple University. 

Over time, high blood sugar can lead to issues like gum disease, nerve damage, vision loss, heart problems, and more. Having healthy habits can prevent these complications. In fact, one study found that people with type 2 diabetes who had the healthiest lifestyles were half as likely to get heart disease, compared to those with the worst. 

Weight loss and exercise can help your cells respond better to insulin, the hormone that helps your body use and store blood sugar, says Lauren Plunkett, a diabetes educator and spokesperson for the Association of Diabetes Care and Education Specialists. For some people, making lifestyle changes can put the disease in remission, so they no longer need to take medicine.

Ready to take charge of your diabetes? Consider these smart moves.

Eat for diabetes. There’s no one eating plan for diabetes. A diet full of fresh fruits and vegetables, whole grains, and lean protein can help you reach a healthy weight – and keep your blood sugar in check.

  • Skip sugary beverages. Sodas, sports drinks, and other sweetened beverages pack in about nine teaspoons’ worth of sugar in a 12-ounce serving. They also tack on calories, which can lead to weight gain. Instead, sip water or unsweetened tea.
  • Focus on nonstarchy vegetables. These vegetables are low in carbohydrates and calories, says Rao. They also deliver important vitamins, minerals, and fiber. Examples include broccoli, carrots, leafy greens, tomatoes, green beans, and squash. The American Diabetes Association recommends filling half of your plate with these nonstarchy veggies. Then divide the rest of the space between lean protein and carbohydrate foods, such as whole grains, dairy products, beans, and fruit.
  • Pay attention to portion sizes. Americans underestimate their portions by as much as 46%. This can cause overeating and weight gain. One serving of dry cereal, cooked pasta, beans, or a starchy vegetable (like corn) is a half-cup, while a 1-ounce slice of bread or corn tortilla counts as a serving. Try measuring your portions at home, so you can eyeball the right amount when you’re out.
  • Limit added sugars and refined grains. These carbs can cause a jump in your blood sugar. Swap refined grains for whole grains, which contain fiber to slow digestion. But you don’t need to swear off dessert. That can just lead to cravings, says Plunkett.

Get moving. Physical activity doesn’t just burn calories. It can lower your blood sugar for as much as 24 hours. Each time you contract a muscle, it uses glucose for energy. It also makes your cells more sensitive to insulin.

You don’t have to hit the gym for hours. Start by moving your body every 30 minutes, even if it’s just to stand up or do a quick stretch. “Research shows that short bouts of physical activity are beneficial for blood glucose control,” says Viola Holmes, the associate director of nutrition for the American Diabetes Association. 

Try adding 10-minute bursts of movement throughout your day. Choose something you enjoy, such as stretching, dancing, playing with your kids, strength training, or walking. For Gee, that’s gardening. “I also like to park farther away from the store to get in some extra steps.” Over time, aim to get 150 minutes of moderate-intensity activity a week, or about 30 minutes, five times a week.

Find ways to de-stress. Managing diabetes can be stressful, so it’s important to find ways to relax. Stress causes the release of cortisol, a hormone that tells your liver to release glucose. Over time, chronic stress raises your blood sugar levels and causes your cells to become resistant to insulin, says Holmes. 

Exercising is one way to ease the tension. Others include:

  • Try different ways to relax, such as deep breathing, yoga, or dancing. Also find ways to do things you enjoy throughout your day. 
  • Talk to someone about how you’re feeling. You may want to reach out to a friend or loved one, or join a diabetes support group. People with diabetes are also two to three times more likely to have depression, so talk to your doctor if you haven’t felt like yourself. 
  • Make enough time for sleep. Not getting enough shut-eye can raise stress and dampen your mood. It may also increase insulin resistance and up your hunger, making it harder to lose weight. You need at least 7 hours of sleep a night. Try going to bed and waking up around the same time each day.
  • Stop smoking. Nicotine causes changes in cells so they don’t respond to insulin. This can worsen your blood sugar. Smoking also raises your risk for complications, such as heart disease and kidney failure.   

Get regular checkups. Having diabetes can raise your risk for different health issues. It’s important to stay on top of routine health screenings, such as eye exams, dental visits, and blood pressure checks, says Rao. Talk to your health care provider about what screenings you need and how often you should get them. 

Find the right support. You should work closely with your health care team to keep your diabetes in check. That’s especially important if you’re a person of color. Racial and ethnic minorities are more likely to have complications and worse diabetes control. There are many reasons why, but a lack of access to health care, cultural mindsets, and social and economic status are all factors. 

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