Cold, Flu, or Allergy?

You’re feeling pretty lousy. You’ve got sniffles, sneezing, and a sore throat. Is it a cold, flu, or allergies? It can be hard to tell them apart because they share so many symptoms. But understanding the differences will help you choose the best treatment.

“If you know what you have, you won’t take medications that you don’t need, that aren’t effective, or that might even make your symptoms worse,” says NIH’s Dr. Teresa Hauguel, an expert on infectious diseases that affect breathing.

Cold, flu, and allergy all affect your respiratory system, which can make it hard to breathe. Each condition has key symptoms that set them apart.

Colds and flu are caused by different viruses. “As a rule of thumb, the symptoms associated with the flu are more severe,” says Hauguel. Both illnesses can lead to a runny, stuffy nose; congestion; cough; and sore throat. But the flu can also cause high fever that lasts for 3-4 days, along with a headache, fatigue, and general aches and pain. These symptoms are less common when you have a cold.

“Allergies are a little different, because they aren’t caused by a virus,” Hauguel explains. “Instead, it’s your body’s immune system reacting to a trigger, or allergen, which is something you’re allergic to.” If you have allergies and breathe in things like pollen or pet dander, the immune cells in your nose and airways may overreact to these harmless substances. Your delicate respiratory tissues may then swell, and your nose may become stuffed up or runny.

“Allergies can also cause itchy, watery eyes, which you don’t normally have with a cold or flu,” Hauguel adds.

Allergy symptoms usually last as long as you’re exposed to the allergen, which may be about 6 weeks during pollen seasons in the spring, summer, or fall. Colds and flu rarely last beyond 2 weeks.

Most people with a cold or flu recover on their own without medical care. But check with a health care provider if symptoms last beyond 10 days or if symptoms aren’t relieved by over-the-counter medicines.

To treat colds or flu, get plenty of rest and drink lots of fluids. If you have the flu, pain relievers such as aspirin, acetaminophen, or ibuprofen can reduce fever or aches. Allergies can be treated with antihistamines or decongestants. See the “Wise Choices” box for more details.

Be careful to avoid “drug overlap” when taking medicines that list 2 or more active ingredients on the label. For example, if you take 2 different drugs that contain acetaminophen—one for a stuffy nose and the other for headache—you may be getting too much acetaminophen.

“Read medicine labels carefully—the warnings, side effects, dosages. If you have questions, talk to your doctor or pharmacist, especially if you have children who are sick,” Hauguel says. “You don’t want to overmedicate, and you don’t want to risk taking a medication that may interact with another.”


Symptoms Cold Flu Airborne Allergy
Fever Rare Usual, high (100-102 °F), sometimes higher, especially in young children); lasts 3-4 days Never
Headache Uncommon Common Uncommon
General Aches, Pains Slight Usual; often severe Never
Fatigue, Weakness Sometimes Usual, can last up to 3 weeks Sometimes
Extreme Exhaustion Never Usual, at the beginning of the illness Never
Stuffy, Runny Nose Common Sometimes Common
Sneezing Usual Sometimes Usual
Sore Throat Common Sometimes Sometimes
Cough Common Common, can become severe Sometimes
Chest Discomfort Mild to moderate Common Rare, except for those with allergic asthma
Treatment Get plenty of rest.
Stay hydrated. (Drink plenty of fluids.)
Aspirin (ages 18 and up), acetaminophen, or ibuprofen for aches and pains
Get plenty of rest.
Stay hydrated.
Aspirin (ages 18 and up), acetaminophen, or ibuprofen for aches, pains, and fever
Antiviral medicines (see your doctor)
Avoid allergens (things that you’re allergic to)
Nasal steroids
Prevention Wash your hands often.
Avoid close contact with anyone who has a cold.
Get the flu vaccine each year.
Wash your hands often.
Avoid close contact with anyone who has the flu.
Avoid allergens, such as pollen, house dust mites, mold, pet dander, cockroaches.
Complications Sinus infection middle ear infection, asthma Bronchitis, pneumonia; can be life-threatening Sinus infection, middle ear infection, asthma

Managing Insulin in an Emergency

From wildfires to hurricanes, disasters seem to be getting more and more common. Being prepared for an emergency is important for everyone, but it’s even more important if you have a chronic health condition like diabetes. Routines suddenly change, supplies and medicines can be hard to get and hard to store, and added stress makes it harder to manage your blood sugar. Read on for important information about storing and using insulin in an emergency.

Using Insulin

In a power outage when refrigerated insulin isn’t available:

  • Try to keep your insulin as cool as possible, but make sure not to freeze it. Insulin that has been frozen can break down and will be less effective.
  • Keep your insulin away from direct heat and out of direct sunlight, which also make it less effective.
  • For up to 4 weeks, you can use insulin in opened or unopened vials that have been stored at room temperature (between 59°F and 86°F).
  • Realistically, you may have to use insulin that has been stored above 86°F. If so, monitor your blood sugar regularly. If you’re living in an emergency shelter, let someone in charge know if your blood sugar is too high or low, so they can get help if needed. Contact your doctor as soon as the emergency is over.

Switching Insulin

In an emergency, you may need to use a different insulin brand or type instead of your usual insulin. You should work with your doctor if you need to switch insulin brands or types, but that might not be possible in crisis conditions. In that case, follow this emergency guidance from the US Food & Drug Administration (FDA) and be sure to monitor your blood sugar closely and get medical attention as soon as possible.

Using an Insulin Pump

If you use an insulin pump, you may be able to substitute another insulin for your usual insulin. Check the instructions for your pump to see which insulin types will work. The guidance also explains which insulin types you can use instead of your usual insulin if you need to switch from using your pump to using injectable insulin (taken with a needle).

Getting Back to Normal

When you can get your usual insulin and store it properly, throw away any insulin that was stored at room temperature or exposed to very high or low temperatures. Plan to visit your doctor if you have questions about managing your diabetes going forward or have any other health concerns.


5 Healthy Eating Tips for the Holidays

Your recipe for staying on track no matter what’s cooking.

‘Tis the season for family, festivity, and food—lots of food. Temptations are everywhere, and parties and travel disrupt daily routines. What’s more, it all goes on for weeks.

How do you stick to your diabetes meal plan when everyone around you seems to be splurging? Here are 5 tips that can help:

1. Holiday-Proof Your Plan

You may not be able to control what food you’re served, and you’re bound to see other people eating a lot of tempting treats. Meet the challenges armed with a plan:

  • Eat close to your usual times to keep your blood sugar steady. If your meal is served later than normal, eat a small snack at your usual mealtime and eat a little less when dinner is served.
  • Invited to a party? Offer to bring a healthy dish along.
  • If you have a sweet treat, cut back on other carbs (like potatoes and bread) during the meal.
  • Don’t skip meals to save up for a feast. It will be harder to keep your blood sugar in control, and you’ll be really hungry and more likely to overeat.
  • If you slip up, get right back to healthy eating with your next meal.

Holiday Hacks

  • Have pumpkin pie instead of pecan pie. Even with a dollop of whipped cream, you’ll cut calories and sugar by at least a third.
  • Break physical activity up into smaller chunks so it fits into your schedule, like walking 10 minutes several times a day.
  • Schedule some “me” time every day—a nap, dog walk, or hot bath to get your energy back for the next celebration.

2. Outsmart the Buffet

When you face a spread of delicious holiday food, make healthy choices easier:

  • Have a small plate of the foods you like best and then move away from the buffet table.
  • Start with vegetables to take the edge off your appetite.
  • Eat slowly. It takes at least 20 minutes for your brain to realize you’re full.
  • Avoid or limit alcohol. If you do have an alcoholic drink, have it with food. Alcohol can lower blood sugar and interact with diabetes medicines.

Also plan to stay on top of your blood sugar. Check it more often during the holidays, and if you take medicine, ask your doctor if the amount needs to be adjusted.

3. Fit in Favorites

No food is on the naughty list. Choose the dishes you really love and can’t get any other time of year, like Aunt Edna’s pumpkin pie. Slow down and savor a small serving, and make sure to count it in your meal plan.

If you plan for it, no food needs to be on the naughty list.

4. Keep Moving

You’ve got a lot on your plate this time of year, and physical activity can get crowded out. But being active is your secret holiday weapon; it can help make up for eating more than usual and reduce stress during this most stressful time of year. Get moving with friends and family, such as taking a walk after a holiday meal.

5. Get Your Zzz’s

Going out more and staying out later often means cutting back on sleep. Sleep loss can make it harder to control your blood sugar, and when you’re sleep deprived you’ll tend to eat more and prefer high-fat, high-sugar food. Aim for 7 to 8 hours per night to guard against mindless eating.

Most of all, remember what the season is about—celebrating and connecting with the people you care about. When you focus more on the fun, it’s easier to focus less on the food.

Find the Right Workout Buddy

Trying to get more physically active? You don’t have to go it alone. How about working out with a little help from your friends?

Buddies With Benefits

When you work out with a partner, you’re likely to:

  • Feel more motivated. When you and your buddy encourage each other, you’ll work harder (and get better results!). And there’s nothing wrong with a little friendly competition.
  • Be more adventurous. It’s easier to try new things with a buddy. You may just find an activity you love, one that feels more like fun and less like a workout.
  • Be more consistent. When someone else is counting on you to show up, you won’t want to let them down.

To enjoy all those benefits, you’ll need the right workout buddy. Look for someone with the same goals, schedule, and commitment you have. Someone who makes you feel positive and inspires you to hit the trail or treadmill on a regular basis.

How do you find the right fit? Talk to friends, co-workers, neighbors, people at the gym. Or find a buddy closer to home: What about a hike with your dog, who thinks every walk is the best walk ever? Now quality time is also fitness time. Good move!

You already have your phone with you. Why not make it work? Try a social media workout app to connect with friends and others that share your goals and can help keep you motivated.

Even if you like to work out alone, changing things up with a buddy every once in a while can help you work out harder and learn new things. You can switch back to solo workouts any time.

Dealing with Diabetes Burnout

So far, you’ve had diabetes; it hasn’t had you. You’ve been watching what you eat, making time for physical activity, taking meds, checking your blood sugar, checking your blood sugar again. But then something takes the wind out of your sails. Maybe you’ve been trying hard but not seeing results. Or you developed a health problem related to diabetes in spite of your best efforts.

When you feel discouraged and frustrated, you may slip into unhealthy habits, stop monitoring your blood sugar, even skip doctor’s appointments. It happens to many—if not most—people with diabetes, often after years of good management. You’re in the land of diabetes burnout. How can you get back to healthy living as soon as possible?

Get Your Team Involved

Call on your primary care doctor, eye doctor, podiatrist, dietitian, diabetes educator—anyone and everyone—to help you refocus on your goals. It’s easier for you to see what’s not working instead of what you’re doing right. Your team can remind you of the progress you’ve made and help you with new ideas and strategies.

Don’t Let Perfect be the Enemy of Good

Perfect blood sugar control isn’t necessary and may not even be possible. And sometimes seeing the little picture is better than the big one. Try taking small steps—such as lowering your A1c by 1%—instead of focusing on big goals. You’re still headed in the same direction, but you’ll have more successes along the way.

Connect with People Who Get You

Tap into encouragement, insights, and support from people who’ve been there.

7 Helpful Tips for Checking Your Blood Sugar and Caring for Your Meter

Most meters come with three parts:

  • Lancet – A needle that is used to get a drop of blood from your finger or another part of your body.
  • Test Strip – The strip where you put the blood you are checking.
  • Control Solutions – Liquid used to make sure your meter is working properly.

Meters come in different sizes. Meters also come with different features. Some meters let you track and print out your results, you can upload them to a cloud service or they can get transferred to your smartphone via bluetooth. Others have audio and larger screens to help people who have problems seeing. The meter you choose should fit your lifestyle and your needs. We are now seeing more and more meters providng the option of report creation and data analysis, this is extremely helpful to identify patterns and make the needed changes.

7 Helpful Tips for Checking Your Blood Sugar and Caring for Your Meter

  • Read the directions for the meter and the test strips before you start using them.
  • Wash your hands before you check your blood sugar. Food, juice or dirt on your fingers may affect your blood sugar result.
  • Use the right strip for your meter and callibration code if needed. The meter may give you the wrong results if you use the wrong test strip or wrong callibration code.
  • Write down your results and the date and time you checked. Do this even if your meter tracks your numbers. Take the results with you when you go to your doctor.
  • Clean your meter as directed. Glass cleaners, ammonia and other cleaning products may damage your meter.
  • Talk to your health care provider about how your medicines will affect your blood sugar. Other medications can affect your blood sugar reading.
  • Take your meter with you when you go to your doctor. This way you can check your blood sugar in front of the doctor or nurse to make sure you are doing it the right way. Your health care provider may be able to print out your blood sugar results from your meter.

Insulin, Medicines, & Other Diabetes Treatment

Taking insulin or other diabetes medicines is often part of treating diabetes. Along with healthy food choices and physical activity, medicine can help you manage the disease. Some other treatment options are also available.

What medicines might I take for diabetes?

The medicine you take will vary by your type of diabetes and how well the medicine controls your blood glucose levels, also called blood sugar. Other factors, such as your other health conditions, medication costs, and your daily schedule may play a role in what diabetes medicine you take.

Type 1 diabetes

If you have type 1 diabetes, you must take insulin because your body no longer makes this hormone. You will need to take insulin several times during the day, including with meals. You also could use an insulin pump, which gives you small, steady doses throughout the day.

Type 2 diabetes

Some people with type 2 diabetes can manage their disease by making healthy food choices and being more physically active. Many people with type 2 diabetes need diabetes medicines as well. These medicines may include diabetes pills or medicines you inject under your skin, such as insulin. In time, you may need more than one diabetes medicine to control your blood glucose. Even if you do not take insulin, you may need it at special times, such as during pregnancy or if you are in the hospital.

Gestational diabetes

If you have gestational diabetes, you should first try to control your blood glucose level by making healthy food choices and getting regular physical activity. If you can’t reach your blood glucose target, your health care team will talk with you about diabetes medicines, such as insulin or the diabetes pill metformin, that may be safe for you to take during pregnancy. Your healthcare team may start you on diabetes medicines right away if your blood glucose is very high.

No matter what type of diabetes you have, taking diabetes medicines every day can feel like a burden sometimes. You may also need medicines for other health problems, such as high blood pressure or high cholesterol, as part of your diabetes care plan. View resources that may help you manage your medication plan.

What are the different types of insulin?

Several types of insulin are available. Each type starts to work at a different speed, known as “onset,” and its effects last a different length of time, known as “duration.” Most types of insulin reach a peak, which is when they have the strongest effect. Then the effects of the insulin wear off over the next few hours or so.

What are the different ways to take insulin?

The way you take insulin may depend on your lifestyle, insurance plan, and preferences. You may decide that needles are not for you and prefer a different method. Talk with your doctor about the options and which is best for you. Most people with diabetes use a needle and syringe, pen, or insulin pump. Inhalers, injection ports, and jet injectors are less common.

Needle and syringe

You’ll give yourself insulin shots using a needle and syringe. You will draw up your dose of insulin from the vial, or bottle, into the syringe. Insulin works fastest when you inject it in your belly, but you should rotate spots where you inject insulin. Other injection spots include your thigh, buttocks, or upper arm. Some people with diabetes who take insulin need two to four shots a day to reach their blood glucose targets. Others can take a single shot.

Photo of an insulin vial and a syringe.
Insulin shots involve drawing insulin from a vial into a syringe and then injecting it under your skin.


An insulin pen looks like a pen but has a needle for its point. Some insulin pens come filled with insulin and are disposable. Others have room for an insulin cartridge that you insert and then replace after use. Insulin pens cost more than needles and syringes but many people find them easier to use.

Photo of an insulin pen
An insulin pen is a convenient way to take insulin


An insulin pump is a small machine that gives you small, steady doses of insulin throughout the day. You wear one type of pump outside your body on a belt or in a pocket or pouch. The insulin pump connects to a small plastic tube and a very small needle. You insert the needle under your skin and it stays in place for several days. Insulin then pumps from the machine through the tube into your body 24 hours a day. You also can give yourself doses of insulin through the pump at mealtimes. Another type of pump has no tubes and attaches directly to your skin, such as a self-adhesive pod.

Photo of a woman holding an insulin pump with the tube connected to a patch on her stomach, where the needle is inserted.
Insulin pumps deliver insulin 24 hours a day.


Another way to take insulin is by breathing powdered insulin from an inhaler device into your mouth. The insulin goes into your lungs and moves quickly into your blood. Inhaled insulin is only for adults with type 1 or type 2 diabetes.

Injection port

An injection port has a short tube that you insert into the tissue beneath your skin. On the skin’s surface, an adhesive patch or dressing holds the port in place. You inject insulin through the port with a needle and syringe or an insulin pen. The port stays in place for a few days, and then you replace the port. With an injection port, you no longer puncture your skin for each shot—only when you apply a new port.

Jet injector

This device sends a fine spray of insulin into the skin at high pressure instead of using a needle to deliver the insulin.

What oral medicines treat type 2 diabetes?

You may need medicines along with healthy eating and physical activity habits to manage your type 2 diabetes. You can take many diabetes medicines by mouth. These medicines are called oral medicines.

Most people with type 2 diabetes start medical treatment with metformin pills. Metformin also comes as a liquid. Metformin lowers the amount of glucose that your liver makes and helps your body use insulin better. This drug may help you lose a small amount of weight.

Other oral medicines act in different ways to lower blood glucose levels. You may need to add another diabetes medicine after a while or use a combination treatment. Combining two or three kinds of diabetes medicines can lower blood glucose levels more than taking just one.

Read about different kinds of diabetes medicines from the Food and Drug Administration (FDA).

What other injectable medicines treat type 2 diabetes?

Besides insulin, other types of injected medicines are available. These medicines help keep your blood glucose level from going too high after you eat. They may make you feel less hungry and help you lose some weight. Other injectable medicines are not substitutes for insulin. Learn more about noninsulin injectable medicines.

What should I know about side effects of diabetes medicines?

Side effects are problems that result from a medicine. Some diabetes medicines can cause hypoglycemia, also called low blood glucose, if you don’t balance your medicines with food and activity.

Ask your doctor whether your diabetes medications can cause hypoglycemia or other side effects, such as upset stomach and weight gain. Take your diabetes medicines as your health care professional has instructed you, to help prevent side effects and diabetes problems.

Do I have other treatment options for my diabetes?

When medicines and lifestyle changes are not enough to manage your diabetes, a less common treatment may be an option. Other treatments include bariatric surgery for certain people with type 1 or type 2 diabetes, and an “artificial pancreas” and pancreatic islet transplantation for some people with type 1 diabetes.

Bariatric surgery

Also called weight-loss surgery or metabolic surgery, bariatric surgery may help some people with obesity and type 2 diabetes lose a large amount of weight and regain normal blood glucose levels. Some people with diabetes may no longer need their diabetes medicine after bariatric surgery. Whether and for how long blood glucose levels improve seems to vary by the patient, type of weight-loss surgery, and amount of weight the person loses. Other factors include how long someone has had diabetes and whether or not the person uses insulin.1

Recent research suggests that weight-loss surgery also may help improve blood glucose control in people with type 1 diabetes who are obese.2

Researchers are studying the long-term results of bariatric surgery in people with type 1 and type 2 diabetes.

Artificial Pancreas

The NIDDK has played an important role in developing “artificial pancreas” technology. An artificial pancreas replaces manual blood glucose testing and the use of insulin shots or a pump. A single system monitors blood glucose levels around the clock and provides insulin or a combination of insulin and a second hormone, glucagon, automatically. The system can also be monitored remotely, for example by parents or medical staff.

In 2016, the FDA approved a type of artificial pancreas system called a hybrid closed-loop system. This system tests your glucose level every 5 minutes throughout the day and night, and automatically gives you the right amount of insulin.

You still need to manually adjust the amount of insulin the pump delivers at mealtimes. But, the artificial pancreas may free you from some of the daily tasks needed to keep your blood glucose stable—or help you sleep through the night without the need to wake and test your glucose or take medicine.

The hybrid closed-loop system is expected to be available in the U.S. in 2017. Talk with your healthcare provider about whether this system might be right for you.

The NIDDK has funded several important studies on different types of artificial pancreas devices to better help people with type 1 diabetes manage their disease. The devices may also help people with type 2 diabetes and gestational diabetes.

Pancreatic islet transplantation

Pancreatic islet transplantation is an experimental treatment for poorly controlled type 1 diabetes. Pancreatic islets are clusters of cells in the pancreas that make the hormone insulin. In type 1 diabetes, the body’s immune system attacks these cells. A pancreatic islet transplant replaces destroyed islets with new ones that make and release insulin. This procedure takes islets from the pancreas of an organ donor and transfers them to a person with type 1 diabetes. Because researchers are still studying pancreatic islet transplantation, the procedure is only available to people enrolled in research studies. Learn more about islet transplantation studies.

Healthy aging with diabetes

As older adults live longer, they may have more than one chronic disease.  Or, they may have a health problem that can lead to another condition or injury if not properly managed.   The older adult may also experience healthcare in various settings, such as the hospital, assisted living facility, or at home. These situations can affect the health and function of the older adult and therefore require careful management to ensure proper care and improve or maintain the quality of life.

Diabetes and Other Conditions

Having high levels of glucose (sugar) in your bloodstream puts you at risk for a variety of other health issues. That can make diabetes an especially challenging disease for older adults to manage. Having diabetes increases the chances of having heart attacks, strokes, or kidney or eye problems. And if you have diabetes, it is likely that you may be treated for other health problems, such as high blood pressure, high cholesterol, or arthritis.

When you know what to expect, you can often prevent or limit the impact these problems can have on your life. Your healthcare provider will probably ask you about these conditions, or order tests to see if you have any of their signs. Don’t hesitate to discuss any symptoms you may experience, even if they seem minor to you.

Medication Interactions

If you have diabetes, it is likely that your healthcare provider is also treating you for other problems.  That means you could be taking several different medications, which can put you at risk for medication interactions.

Here’s how to steer clear of problems:

  • Make a list of all your medications and their dosages. Make sure you include any vitamins, herbs, over-the-counter medicines, or other dietary supplements you take. It is important that you keep this with you at all times, especially in the case of a medical emergency.
  • When you visit your healthcare provider, bring your actual medications with you. This way they can be sure the directions on the bottles are up-to-date.
  • Make sure you know why you are taking each medicine, how and when to take it, and what the common side effects are.
  • If possible, have all your prescriptions filled at the same pharmacy. This way, your pharmacist can alert you if the medications you are prescribed could interact with each other.
  • Read the information that comes with your medications. Ask your healthcare provider or pharmacist if you have questions.


For reasons we don’t fully understand, older adults who have diabetes are at risk for depression. In fact, as many as a third of all people with diabetes may experience depression. Yet, only 25 to 50 percent of diabetic patients are formally diagnosed with depression. You might not take depression seriously. You may think that it’s “just the blues,” or that it’s not important enough to discuss with your healthcare provider. But depression can interfere with your ability to enjoy life, as well as your ability to watch and control your diabetes. So it is important to recognize the signs of depression and treat it as you would any illness. It is normal to feel grief after a loss, or have occasional days of “feeling blue.” But when you feel sad or hopeless for more than a couple of weeks, it’s time to get help.

There are specific signs of depression to look out for. These include having trouble sleeping, concentrating, or remembering, feeling more tired than usual, having sudden weight gain or loss, or 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 pretty quickly. The earlier depression is treated, the better.

Memory Loss

Problems with memory and brain function can be more common in older people with diabetes. Your healthcare provider may do some tests to check for memory loss. Be sure to let your provider know if you experience memory problems, if others have told you they’re concerned about your memory, or if you’re having trouble managing any of your daily activities (for example, balancing your checkbook or taking your medications).

Urinary Incontinence (Loss of Bladder Control)

Older women with diabetes are at increased risk for urinary incontinence, which is a common condition among older women. In fact, nearly 70% of all women experience problems from time to time, so there’s no need to feel embarrassed if it happens to you. The good news is that there are simple approaches to manage incontinence. Your healthcare provider can help find a treatment that works for you. Be sure to discuss any bladder control problems you experience so you can get the help you need.


Many factors 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. Home factors such as poor lighting and clutter can also contribute to falls. Be sure to let your healthcare provider know if you’ve had a fall.

Chronic Pain

Diabetes can lead to pain caused by poor circulation or nerve damage. This can be a very difficult by-product of diabetes to deal with. Therefore, it’s very important to 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 the pain go untreated. And don’t feel like you’re complaining or bothering your healthcare provider when you bring it up.


Family Health History Quiz

Family health history is an important risk factor for developing a number of serious diseases, including type 2 diabetes. In fact, most people with type 2 diabetes have a family member – such as a mother, father, brother, or sister – with the disease.

We encourage you to take advantage of family gatherings to share information about their health history – especially when it comes to diabetes.

Knowing your family health history is important because it gives you and your health care team information about your risk for type 2 diabetes and other health problems.

Four Questions You Should Ask Your Family About Diabetes & Family Health History

Knowing your family health history is important. Here are some questions to help you learn more about your family history of diabetes.

  • Does anyone in the family have type 2 diabetes? Who has type 2 diabetes?
  • Has anyone in the family been told they might get diabetes?
  • Has anyone in the family been told they need to lower their weight or increase their physical activity to prevent type 2 diabetes?
  • Did your mother get diabetes when she was pregnant? This is also known as gestational diabetes (GDM).

If the answer to any of these is yes, or you have a mother, father, brother, or sister with type 2 diabetes, you may be at an increased risk for developing type 2 diabetes.

True or false? If my parent or sibling has type 2 diabetes, I am at an increased risk to develop type 2 diabetes.

True – A family history of type 2 diabetes is a strong risk factor for the disease. If you have a mother, father, brother, or sister with diabetes, you are at risk for type 2 diabetes. But even if you have a family history of type 2 diabetes, there are many things you can do to lower your risk. If you’re overweight, losing five to seven percent of your body weight (for example, 10 pounds if you weigh 200 pounds) by exercising 30 minutes a day, five days a week and making healthy food choices can help to prevent or delay type 2 diabetes.

True or false? My mother has been told by her health care team that she is at high risk for diabetes, or that she has prediabetes, so she will get diabetes very soon.

False – Studies have shown that people at high risk for diabetes or with prediabetes can turn back the clock to delay or even prevent a diagnosis of diabetes by losing five to seven percent of your body weight if overweight (for example, 10 pounds if you weigh 200 pounds). You and your family can lose a modest amount of weight through simple lifestyle changes, such as increasing physical activity to about 30 minutes a day, five days a week and make healthy food choices. For some people with prediabetes, intervening early can actually return elevated blood glucose levels to the normal range.

True or false? Type 2 diabetes runs in my family, so there is nothing I can do to prevent getting the disease.

False – Even though a family history of type 2 diabetes is a strong risk factor for developing the disease, some of this risk is a result of lifestyle. Being overweight, making unhealthy food choices, and not getting enough exercise can increase your risk for type 2 diabetes. If you are overweight, losing five to seven percent of your body weight (for example, 10 pounds if you weigh 200 pounds) by making healthy food choices and increasing physical activity to about 30 minutes a day, five days a week can help lower your risk for type 2 diabetes. Adopting healthy habits as an individual or as a family is good for everyone.

True or false? My mother was diagnosed with diabetes when she was pregnant with me so she and I are both at an increased risk of developing diabetes.

True – When a woman gets diabetes during pregnancy, called gestational diabetes, she is at an increased risk of developing diabetes for the rest of her life. Additionally, her child is at an increased risk of becoming obese and for developing type 2 diabetes for the rest of his or her life. But there are many ways to lower this risk for both mother and child.

Understanding the A1C

What is the A1C test?

The A1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past 3 months. The A1C test is sometimes called the hemoglobin A1c, HbA1c, or glycohemoglobin test. The A1C test is the primary test used for diabetes management and diabetes research.

How does the A1C test work?

The A1C test is based on the attachment of glucose to hemoglobin, the protein in red blood cells that carries oxygen. In the body, red blood cells are constantly forming and dying, but typically they live for about 3 months. Thus, the A1C test reflects the average of a person’s blood glucose levels over the past 3 months. The A1C test result is reported as a percentage. The higher the percentage, the higher a person’s blood glucose levels have been. A normal A1C level is below 5.7 percent.

A1C Conversion chart

What A1C target should people have?

People will have different A1C targets depending on their diabetes history and their general health. People should discuss their A1C target with their health care provider. Studies have shown that people with diabetes can reduce the risk of diabetes complications by keeping A1C levels below 7 percent.

Maintaining good blood glucose control will benefit those with new-onset diabetes for many years to come. However, an A1C level that is safe for one person may not be safe for another. For example, keeping an A1C level below 7 percent may not be safe if it leads to problems with hypoglycemia, also called low blood glucose.

Less strict blood glucose control, or an A1C between 7 and 8 percent—or even higher in some circumstances—may be appropriate in people who have

  • limited life-expectancy
  • long-standing diabetes and difficulty attaining a lower goal
  • severe hypoglycemia
  • advanced diabetes complications such as chronic kidney disease, nerve problems, or cardiovascular disease

Points to Remember

  • The A1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past 3 months.
  • The A1C test is based on the attachment of glucose to hemoglobin, the protein in red blood cells that carries oxygen. Thus, the A1C test reflects the average of a person’s blood glucose levels over the past 3 months.
  • In 2009, an international expert committee recommended the A1C test be used as one of the tests available to help diagnose type 2 diabetes and prediabetes.
  • Because the A1C test does not require fasting and blood can be drawn for the test at any time of day, experts are hoping its convenience will allow more people to get tested—thus, decreasing the number of people with undiagnosed diabetes.
  • In the past, the A1C test was not recommended for diagnosis of type 2 diabetes and prediabetes because the many different types of A1C tests could give varied results. The accuracy has been improved by the National Glycohemoglobin Standardization Program (NGSP), which developed standards for the A1C tests. Blood samples analyzed in a health care provider’s office, known as point-of-care (POC) tests, are not standardized for use in diagnosing diabetes.
  • The A1C test may be used at the first visit to the health care provider during pregnancy to see if women with risk factors had undiagnosed diabetes before becoming pregnant. After that, the oral glucose tolerance test (OGTT) is used to test for diabetes that develops during pregnancy—known as gestational diabetes.
  • The standard blood glucose tests used for diagnosing type 2 diabetes and prediabetes—the fasting plasma glucose (FPG) test and the OGTT—are still recommended. The random plasma glucose test may be used for diagnosing diabetes when symptoms of diabetes are present.
  • The A1C test can be unreliable for diagnosing or monitoring diabetes in people with certain conditions that are known to interfere with the results.
  • The American Diabetes Association recommends that people with diabetes who are meeting treatment goals and have stable blood glucose levels have the A1C test twice a year.
  • Estimated average glucose (eAG) is calculated from the A1C to help people with diabetes relate their A1C to daily glucose monitoring levels.
  • People will have different A1C targets depending on their diabetes history and their general health. People should discuss their A1C target with their health care provider.