A person with diabetes needs to control the number of calories and carbohydrates they eat each day.

Eating well and healthily involves:

• Eating small amounts at each meal.
• Eat a diet high in fiber. Eat cereals, breads, and pasta made with whole grains instead of white flour. Substitute brown rice for white rice and sweet potatoes for white potatoes.
• Read labels on foods and choose those containing at least 3 grams of fiber per serving.
• Eat 6 to 9 servings a day of a variety of brightly-colored, low calorie fruits and vegetables. Good choices include leafy greens, broccoli, red peppers, carrots, berries, apples, and oranges. Choose fruit canned in its own juice instead of sugary syrup.
• Drink water or unsweetened tea instead of fruit juices, soft drinks, or other drinks high in sugar.
• Avoid eating highly processed and prepared foods. These foods are often loaded with fat, calories, and salt. They often have unhealthy things, like saturated fats and a lot of sugar.
• At fast food restaurants, choose the salad option (with low-fat dressing). At family-style restaurants, choose broiled poultry, fish, or lean meat entrees with steamed vegetables. Skip cheesy, buttery, or creamy sauces. Choose oil and vinegar dressings on salads.
• Limit the amount of alcohol you drink.
• Make sure that less than 35 percent of total, daily calories come from fat. The healthiest fats are found in foods like avocados, walnuts, almonds, sunflower seeds, peanut butter, and fatty fish (such as salmon, sardines, and trout).
• Choose olive and canola oil for cooking and salads.
• Choose foods high in protein, including eggs, low-fat dairy products, lean meats, poultry, fish, beans, and nuts.
• Save desserts and other sweet treats for special occasions.

Exercise is important for losing weight and controlling blood glucose levels. Even small increases in physical activity can help.

People with pre-diabetes or diabetes should exercise 20 to 30 minutes at least three times a week. Even more benefits come from exercising 20 to 30 minutes on most days.

Activities include:

• Doing yard work or cleaning the house, especially if they raise the heart rate
• Walking
• Swimming and water aerobics

Exercise classes are fun in a group. A teacher can help a person prevent injuries. Classes are at many local hospitals, community and senior centers, and adult education programs. Check with your insurance plan to see if you are eligible for a Silver Sneakers program. This program provides people 65 and over with free access to local fitness centers.

Medicare pays for a visit with a diabetes educator once every year. A healthcare provider can give you a referral. The educator will teach you how to manage your blood glucose and will work with you to develop a self-management program.

Ask the diabetes educator questions so that you fully understand how to manage your diabetes. Common questions involve meal size and eating carbohydrates. A tool known as the glycemic index might be helpful to guide food choices because it ranks foods according to how they affect blood glucose.

Caregivers may need training to take over a person’s self-management program if the person with diabetes has disabilities.

Extreme or chronic stress can raise blood glucose levels. Though you can’t avoid stress, you can learn to manage your reaction to it.

These tips can help:

• Don’t put unnecessary demands on yourself.
• Schedule time for things you enjoy.
• Keep a positive attitude and focus on the things in your life that are going well.
• Talk to someone about the things you find stressful.
• Exercise. It can relieve stress.
• Learn and use simple relaxation techniques, like listening to soft music or meditating.

Cardiovascular disease is a major cause of illness and death for people with diabetes. So, the healthcare provider will check for other things that can cause heart trouble, such as:

• Smoking
• High blood pressure
• Overweight
• High cholesterol
• Family history of heart problems

Preventing and managing risks for heart disease in older adults with diabetes is especially important. These steps include:

• Losing weight if necessary.
• Increasing physical activity.
• Taking statins for high cholesterol, when needed.
• Quitting smoking. The benefits of quitting are high in people with diabetes.

Diabetes can cause problems with blood vessels and circulation. People with diabetes have a high risk for serious foot problems, which can even lead to amputation. Taking care of your feet is important, and you should:

• Examine your feet every day
• Take good care of toenails. If you need help, see a podiatrist (foot doctor)
• Your healthcare provider needs to examine your feet at least once a year

Looking at your feet daily with the aid of a small handheld mirror can help catch foot problems early. Diabetes-related nerve damage can prevent you from feeling the damage. You need to see a healthcare professional right away about any changes to your feet or any signs of damage. These include sores, ulcers, or discolored toes.

Diabetes-related blood vessel and circulation problems can affect your eyes. You need an eye examination at least once a year. An ophthalmologist can identify problems early when there are more treatment options available.

Older adults who have diabetes are at risk for depression. Depression can interfere with the ability to enjoy life and control your diabetes. So, when you feel sad or hopeless for more than a couple of weeks, it’s time to get help. Other signs of depression include:

• Having trouble sleeping, concentrating, or remembering
• Feeling more tired than usual
• Sudden weight gain or loss
• Losing pleasure in doing things you usually enjoy

If you are experiencing any of these symptoms, talk with your healthcare provider. Treatment can help you feel better quickly.

Problems with memory and brain function are more common in older people with diabetes. Let your provider know if:

• You experience memory problems
• Others have told you they’re concerned about your memory
• You’re having trouble managing any of your daily activities (for example, balancing your checkbook or taking your medications).

Your healthcare provider will likely do memory tests and check your medications.

Older women with diabetes have a high risk for urinary incontinence. Talk to your healthcare provider. They can help find a treatment for incontinence that works for you. 

Many things put older adults with diabetes at greater risk of falling.

These include medication side effects, loss of feeling in the legs or feet, low blood sugar, or poor vision. The home can also cause falls if it has poor lighting, loose rugs, and clutter.

Be sure to let your healthcare provider know if you’ve had a fall.

Diabetes can lead to pain caused by poor circulation or nerve damage.

Tell your healthcare provider about any pain you may be feeling, especially if it gets in the way of your daily activities or quality of life. Never let pain go untreated.