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HomeMemberHelpful ToolsDiabetes

Diabetes

Diabetes is a disease that happens when your body cannot use insulin the right way. Insulin helps move sugar from your blood into your cells for energy. If your body does not make enough insulin or cannot use it well, too much sugar stays in your blood. This can cause health problems over time. People with diabetes face a higher risk of heart disease, stroke, chronic kidney disease (CKD), blindness (retinopathy), nerve damage (neuropathy), and foot problems. People with diabetes can take steps to stay healthy and lower the chance of serious problems. If you or someone in your family has diabetes or was just diagnosed, Fidelis Care can help.



Identifying the Types of Diabetes

There are different types of diabetes, each with different causes, but they all share the common problem of having too much sugar (glucose) in your bloodstream. Select a class in the dropdown to learn more.

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Type 1 Diabetes

Type 1 Diabetes occurs when the pancreas does not make enough insulin. People with Type 1 diabetes are usually diagnosed as children or adolescents, and depend on insulin therapy and other treatments to make up for the lack of insulin.

Type 2 Diabetes
Type 2 Diabetes occurs when the pancreas makes some insulin, but it’s not enough to meet the body’s needs. People with Type 2 diabetes are usually diagnosed as adults and are not dependent on insulin therapy.
Gestational Diabetes
Gestational Diabetes can occur in pregnant women. While it doesn’t mean a woman had diabetes before pregnancy or will have diabetes after birth, her doctor’s advice should be followed to remain healthy.
Prediabetes

Prediabetes means you have a higher than normal blood sugar level.  Unmanaged prediabetes can lead to Type 2 diabetes. Prediabetes doesn’t always have symptoms, so it’s crucial to get blood sugar levels tested, especially if you’re at high risk. Losing weight, exercising regularly and healthy eating habits can reverse prediabetes and prevent Type 2 diabetes.

Other Types of Diabetes

According to the American Diabetes Association (ADA), about 2% of people have rarer types of diabetes. Including MODY, LADA, cystic fibrosis-related diabetes, and diabetes caused by rare syndromes.

  • MODY ➤ MODY (Maturity Onset Diabetes of the Young) is caused by a mutation in a single gene. If a parent has this gene mutation, any child they have, has a 50% chance of inheriting it from them. If a child does inherit the mutation, the symptoms of MODY are often established before the age of 25, regardless of their weight or lifestyle.  It’s estimated that 90% of those diagnosed with MODY are mistakenly diagnosed with type 1 or type 2 diabetes at first.

  • LADA  ➤ LADA (Latent Autoimmune Diabetes in Adults) is a type of diabetes which straddles type 1 and type 2 diabetes. The symptoms reported of this variant correspond with each Type 1 and Type 2 diabetes, which is why some people call it type 1.5 diabetes or type 1 ½ diabetes. Whereas being overweight is a major risk factor for type 2 diabetes, people with LADA tend to have a healthy weight.

  • CFRD ➤ CFRD (Cystic Fibrosis-related Diabetes) is a type of diabetes that is unique to children and adults with cystic fibrosis (CF). The accumulation of sticky mucus caused by CF can sometimes lead to inflammation and scarring of the pancreas. This can damage the cells that produce insulin, leading to high blood glucose (sugar) levels. When the pancreas can’t produce enough insulin, blood sugar levels may continue to rise and develop into CFRD.



Managing Diabetes

Controlling your diabetes starts with understanding your body. Regular doctor visits and testing are important ways to stay healthy, make informed decisions, and prevent serious complications.

Recommended tests for diabetes management include:

A1C Blood Sugar - At least twice per year

This blood test measures the average amount of blood sugar in a 2-3-month period. A result below 7 percent helps lower your risk of eye, nerve, and kidney damage. 

LDL Cholesterol - At least once per year

This blood test measures “bad” cholesterol (low-density lipoprotein cholesterol) levels in the blood. A result below 100 mg/dL helps lower your risk of heart disease and stroke.  

Kidney Damage - At least once per year

This urine test measures how well kidneys work. The test works by measuring protein in urine, a sign of kidney damage, which can happen if diabetes is not managed. Kidney damage can result in kidney failure and the need for dialysis. 

Eye Exam - At least once per year

A retinal or dilated eye exam by an eye care professional is recommended for people who have diabetes. The eye exam checks the nerves and small blood vessels of your eyes for damage caused by diabetes. This test should be done once a year even if your eyesight seems normal. If left undetected, this damage can lead to blindness.  

Care Management

Fidelis Care offers Care Management services to support members who need extra help with their health. These services help members manage their care, understand their health conditions, and connect with local resources

Learn More


Living with Diabetes

Taking care of your diabetes helps you live a healthy and active life. When you learn how to check and control your blood sugar, make smart choices about food and exercise, and follow your doctor’s advice, you can prevent problems and improve your overall health.

Healthy Eating
A balanced diet rich in whole grains, lean proteins, healthy fats, and fiber supports stable blood sugar and overall health.
Physical Activity
Regular exercise improves insulin sensitivity and helps manage weight, blood pressure, and cholesterol levels.
Medication Adherence
Taking insulin or oral medications as prescribed is vital to maintaining blood glucose within your target range.
Regular Checkups
Routine visits with your healthcare provider help catch potential issues early and ensure your treatment plan stays on track.  To search for a medical professional, service, or facility in the Fidelis Care Network, use our Find a Doctor tool.
Monitoring Blood Glucose

Regular testing helps track your blood sugar levels and identify patterns, making it easier to adjust meals, medication, and activity. For guidance on blood sugar targets for diabetes types and time of day, view our "Recommended Blood Sugar Targets," below. Talk to your provider and diabetes educator about the best goals for you.

Recommended Blood Sugar Targets

For people with type 1 diabetes, the American Diabetes Association recommends that blood sugar targets be based on a person's needs and goals, including whether they are pregnant. Talk to your provider and diabetes educator about the best goals for you. 

General guidelines are:

Before meals, your blood sugar should be:

  • From 90 to 130 mg/dL (5.0 to 7.2 mmol/L) for adults
  • From 90 to 130 mg/dL (5.0 to 7.2 mmol/L) for children, 13 to 19 years old
  • From 90 to 180 mg/dL (5.0 to 10.0 mmol/L) for children, 6 to 12 years old
  • From 100 to 180 mg/dL (5.5 to 10.0 mmol/L) for children under 6 years old

After meals (1 to 2 hours after eating), your blood sugar should be:

  • Less than 180 mg/dL (10 mmol/L) for adults

At bedtime, your blood sugar should be:

  • From 90 to 150 mg/dL (5.0 to 8.3 mmol/L) for adults
  • From 90 to 150 mg/dL (5.0 to 8.3 mmol/L) for children, 13 to 19 years old
  • From 100 to 180 mg/dL (5.5 to 10.0 mmol/L) for children, 6 to 12 years old
  • From 110 to 200 mg/dL (6.1 to 11.1 mmol/L) for children under 6 years old

For people with type 2 diabetes, the American Diabetes Association also recommends that blood sugar targets be individualized. Talk to your provider and diabetes educator about the best goals for you. 

General guidelines are:

Before meals, your blood sugar should be:

  • From 80 to 130 mg/dL (4.4 to 7.2 mmol/L) for adults

After meals (1 to 2 hours after eating), your blood sugar should be:

  • Less than 180 mg/dL (10.0 mmol/L) for adults

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Obesity and Diabetes

Being overweight or having obesity can make it more difficult to manage your diabetes and may compound into additional health problems, including heart disease and high blood pressure. If you are overweight and have diabetes, adopting a healthy eating plan with fewer calories and more physical activity often will lower your blood glucose levels and reduce your need for medicines.

 

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How Obesity Affects Diabetes

Obesity-and-Diabetes

Diabetes & Heart Disease

According to the National Institute of and Digestive and Kidney Diseases (NIDDK), individuals with diabetes are more likely to develop heart disease. People with diabetes are also more likely to have certain risk factors, such as high blood pressure or high cholesterol, that increase their chances of having a heart attack or a stroke.  Learn more below:

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What is the connection between diabetes and heart disease?
  • High blood glucose from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. Over time, this damage can potentially lead to heart disease.

  • People with diabetes also tend to develop heart disease at a younger age than people without diabetes. In fact, adults with diabetes are nearly twice as likely to have heart disease or stroke as adults without diabetes.

  • The good news is that the steps you take to control your diabetes also help lower your chances of developing heart disease.
What other factors increase my chances of heart disease if I have diabetes?
  • Smoking ➤ Smoking raises your risk of developing heart disease.  If you have diabetes, it is important to stop smoking, because both smoking and diabetes narrow blood vessels.  

  • High blood pressure ➤ If you have high blood pressure, your heart has to pump harder to circulate blood. High blood pressure can strain your heart, damage blood vessels, and increase your risk of heart attack and stroke. Consider having your blood pressure checked regularly, and work with your doctor to regulate or lower high blood pressure.

  • Harmful cholesterol levels ➤ Cholesterol is a type of fat produced by your liver. You have two kinds of cholesterol in your blood: LDL and HDL. LDL, often referred to as “bad” cholesterol, can build up and clog your blood vessels. HDL, sometimes referred to as the “good cholesterol.” Higher levels of HDL is linked to lower risk for heart disease and stroke. To improve LDL and HDL balance, try to limit the amount of fat in your eating plan, consume more plant-based foods, and get regular physical activity.

  • Family history of heart disease ➤ Unfortunately, a family history of heart disease may add to your chances of developing the condition. If one or more of your family members had a heart attack before the age of 50, you have double the chance of developing heart disease, compared with diabetics who have no family history of the disease.  


Testing for Diabetes

Common Tests to Determine and Monitor Type 1 Diabetes, Type 2 Diabetes, and Prediabetes

If diagnosed, your doctor will have you take one or more of the following blood tests:

A1C Test

The A1C test measures your average blood sugar level over the past 2 or 3 months.  

  • An A1C below 5.7% is normal
  • An A1C between 5.7 and 6.4% indicates you have prediabetes
  • An A1C 6.5% or higher indicates you have diabetes

*Results for gestational diabetes can differ. Ask your health care provider what your results mean if you’re being tested for gestational diabetes.

Glucose Tolerance Test

This test measures your blood sugar before and after you drink a liquid that contains glucose. You’ll be asked to fast overnight before the test and have your blood drawn to determine your fasting blood sugar level. Then you’ll drink the liquid and have your blood sugar level checked 1 hour, 2 hours, and possibly 3 hours afterward. 

At 2 hours, a blood sugar level of.... 

  • 140 mg/dL or lower is considered normal
  • 140 to 199 mg/dL indicates you have prediabetes
  • 200 mg/dL or higher indicates you have diabetes

*Results for gestational diabetes can differ. Ask your health care provider what your results mean if you’re being tested for gestational diabetes.

Fasting Blood Sugar Test

This test measures your blood sugar after an overnight fast. 

A fasting blood sugar level of...

  • 99 mg/dL or lower is normal
  • 100 to 125 mg/dL indicates you have prediabetes
  • 126 mg/dL or higher indicates you have diabetes

*Results for gestational diabetes can differ. Ask your health care provider what your results mean if you’re being tested for gestational diabetes.

Random Blood Sugar Test

This measures your blood sugar at the time you’re tested. You can take this test at any time and don’t need to fast prior to your appointment. A blood sugar level of 200 mg/dL or higher indicates you have diabetes.

*Results for gestational diabetes can differ. Ask your health care provider what your results mean if you’re being tested for gestational diabetes.

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What Does Insulin Do?

Insulin allows the cells in the muscles, fat and liver to absorb glucose that is in the blood. The glucose serves as energy to these cells, or it can be converted into fat when needed. Insulin also affects other metabolic processes, such as the breakdown of fat or protein.  Learn more below:

How is insulin created?

Insulin is a hormone created by your pancreas that regulates the amount of glucose in your bloodstream at any given moment. It also helps store glucose in your liver, fat, and muscles. In addition, insulin balances your body’s metabolism of carbohydrates, fats, and proteins.

What happens with insulin when you eat?

When you eat, your blood glucose levels elevate, and this leads a typical person’s pancreas to release insulin, so that the sugar can be stored as energy for later use. Without this pancreatic ability, as a person with either type 1 diabetes or advanced type 2 diabetes, one's blood sugar levels may rise dangerously high, or drop too low.

What happens when insulin no longer works?

Without proper insulin function, your body can’t store glucose in your muscles or liver, but neither can it make any fat.  Instead, the fat breaks down and produces, among other things, keto acids.  If the acid levels grow too high, the imbalance can trigger diabetic ketoacidosis, a potentially fatal condition if not treated immediately.

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More on Diabetes

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Ketoacidosis

• Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening problem that can occur with diabetes.

Read This Article


Eating Healthy on a Budget
3/6/2024 • Posted by Dr. Nicole Belanger-Reynolds, Fidelis Care Medical Director in Health and Wellness

National Nutrition Month

March is National Nutrition Month. Eating nutritious foods is a good way to keep healthy. With higher food prices, it can feel hard to put healthy food on the table. Here are some tips to enjoy nutritious foods without going over your budget.

1.) Plan your weekly meals and snacks.

Write down your meals for the week. Plan out breakfast, lunch, dinner, and snacks. Cooking at home will keep you on budget and can help you eat healthier. Try to keep ingredients in your pantry to prepare balanced meals. Planning in advance will help you know what you need, and put leftovers to good use.

Below are some nutritious, low-cost foods that can be bought year-round:

  • Protein: Dried or canned beans can be made into low-cost chili and soup, or added to salads. Dried lentils do not require soaking and can be made into a great soup, stew, or casserole. Try buying canned tuna, salmon, or sardines. Eggs also are a great source of protein.
  • Vegetables: Carrots, green beans, green lettuces, spinach, and potatoes are nutritious choices.
  • Fruits: Try delicious fruits like apples and bananas.
  • Grains: Choose (brown rice is more nutritious than white rice), oats, barley, and whole grain pasta.
  • Drinks: Fat-free or low-fat milk and water are the best choices. Try to avoid sugary drinks.

See what you already have at home. Look in your freezer, cabinets, and refrigerator. You can save money by using these items in planned meals.

Check store flyers and coupons. Sales flyers usually can be found at the store’s entrance, in the newspaper, or online. Look for lean meats or other proteins, fat-free and low-fat dairy items, and fresh or frozen fruits and vegetables. Try to find coupons to plan low-cost weekly meals and use items on sale.

Plan to use leftovers. Leftovers can save you time and money, and reduce food waste. If possible, make larger meals with enough servings for leftovers. On busy days, heat and serve to enjoy a second serving of the same meal.

Cook once, eat twice. Buying in bulk is often less expensive. Cook larger amounts of food so you can store some for later, and use leftovers to make a new meal. For example, cook one whole chicken and divide it into two equal parts. You can have chicken fajitas one night, and vegetable stir fry with chicken another night.

Go meatless one or more days a week. Using beans instead of meat is a less expensive way to get lean protein. For example, you can add lentils to soups. They are delicious, cook quickly, and are packed with protein and fiber.

Write down recipes to try. Find new ideas for healthy and budget-friendly meals based on what you have, foods your family enjoys, and foods that are good buys.


2.) Make a grocery list and stick to it.

Once you’ve planned your meals for the week, make a shopping list of what you need to buy at the store. Having a list makes shopping easier and faster. It can also help you buy only the items you need.

Buy fresh fruits and vegetables in season when they are least expensive. New York has fresh fruits and vegetables all year long!

Spring: Tender greens like spinach, collard, kale, mustard, and lettuce are coming up. Try fresh rhubarb for a delicious pie, quick bread, or sauce.

Summer: Bring your family to a pick-your-own strawberries farm in early summer. During the late summer, enjoy cherries, melons, and plums. Look for local broccoli, cauliflower, cucumbers, green beans, tomatoes, summer squash, and sweet corn.

Fall: Have fun picking apples. Pears are also in season, along with hearty vegetables like beets, cabbage, potatoes, pumpkins, and sweet potatoes.

Winter: Local fresh fruits and vegetables like apples, cabbage, beets, potatoes, winter squash, onions, and carrots will last a long time, if stored properly.

When local fresh produce isn’t available, look for frozen and canned options. Frozen and canned fruits and vegetables can be just as healthy, and often cost less and last longer.

Be careful with frozen options that have added butter or sauces to avoid extra sugar, salt, and empty calories. Choose fruits canned in water or 100% fruit juice, not syrup. Buy canned vegetables with “low-sodium” or “no salt added” on the label.


3.) Save at the store.

Eat before you shop. Grocery shopping while hungry can lead to impulse buying and unhealthy food choices.

Sign up for the grocery store discount card. Most stores offer a free loyalty program. Get special offers and coupons for being a member.

Choose generic or store brands instead of name brands. Buying generic or store brand items can save money. Items are usually available in a cheaper store brand version.

Buying in bulk can save you money. If your shopping list includes nuts, beans, or grains, buy in bulk to save money and keep your pantry well-stocked for future meals. Compare the unit prices listed on the shelves to get the best price. Often, the larger item has a lower unit price.

Avoid buying expensive snacks. Save time, money, and calories by skipping the soda, chip, and cookie aisles. Choose the checkout lane without the candy shelves.


4.) Use food resources in your community.

It is important that people have access to nutritious food to stay healthy. Food insecurity happens when people have limited access to food. In New York State, one in four adults experience food insecurity. It is associated with poorer health and a greater risk of chronic illness.

The Supplemental Nutrition Assistance Program (SNAP) helps people buy healthy food when money is tight. It used to be known as “food stamps.”

Regional food banks distribute food to local emergency food relief organizations across New York State. Find your regional food bank on an interactive map of New York State to get help.

Additional resources are available at:

Fidelis Care's Social Determinants of Health Web Page: fideliscare.org/sdoh
Find Government Food Assistance: https://www.usa.gov/food-help
Find a Food Bank: https://www.feedingamerica.org/find-your-local-foodbank
Find a Meals on Wheels provider near you: https://www.mealsonwheelsamerica.org/signup/aboutmealsonwheels

Sources:

CDC: https://www.cdc.gov/diabetes/healthy-eating-budget.html

U.S. Department of Agriculture (USDA): https://www.myplate.gov/eat-healthy/healthy-eating-budget/make-plan

NYS SNAP-Ed: https://otda.ny.gov/programs/nutrition/smart-shopping.asp

Just Say Yes (USDA Supplemental Nutrition Education Program (SNAP-Ed): https://jsyfruitveggies.org/whats-in-season/

NYS Department of Health: https://www.health.ny.gov/press/releases/2024/2024-01-03_food_insecurity.htm#:~:text=According%20to%20the%20report%2C%20approximately,11.2%20percent%20to%2039%20percent.

Hunger Solutions New York: https://hungersolutionsny.org/resources-action/hunger-in-nys/

U.S. Department of Health and Human Resources: https://toughstart.org/wp-content/uploads/2021/03/Eating-on-a-Healthy-Budget.pdf