Everyone with diabetes aged 6 months and older should get a seasonal flu shot. Close household contacts and out-of-home caregivers of people with diabetes should also get the vaccines.
People with type 1 diabetes who engage in regular exercise require less insulin.1 However, in the short term, exercise can induce low blood sugar or even occasionally increased blood sugar.2 Therefore, people with type 1 diabetes should never begin an intensive exercise program without consulting a healthcare professional.
The American Diabetes Association (ADA) recommends that people with diabetes limit their daily alcohol consumption to one drink for women and two drinks for men.3 Similar to research on healthy people, preliminary studies in adults with diabetes find reduced risk of heart disease with light to moderate drinking.4 Drinking alcohol with type 1 diabetes can result in hypoglycemia or hyperglycemia, depending on the circumstances, but moderate amounts of alcohol ingested with food does not affect blood glucose levels.5 People with diabetes who drink two or more drinks per day were reported to have a high risk for eye damage in one preliminary study,6 but another, larger study found no association between alcohol use and eye damage.7
People with diabetes who smoke are at higher risk for kidney damage,8heart disease,9 and other diabetes-linked problems. Smokers are also more likely to develop diabetes,10 so it's important for diabetic smokers to quit.
Most healthcare providers agree on the necessity of self-monitoring of blood glucose (SMBG) by people with type 1 diabetes. Advocates of SMBG, such as the ADA, have observed that SMBG by people with diabetes has revolutionized management of the disease, enabling them to achieve and maintain specific goals.11 These observations are well-supported in the medical literature.12 Detractors point out that indiscriminate use of self-monitoring is of questionable value and adds enormously to healthcare costs.13 The ADA acknowledges that accuracy of SMBG is instrument- and technique-dependent. Errors in technique and inadequate use of control procedures have been shown to lead to inaccurate test results.14 Nevertheless, it is likely that self-monitoring of blood glucose, if used properly, can have a positive effect by increasing patient involvement in overall diabetes care.15 Pharmacists and healthcare practitioners can teach people with diabetes certain skills that will enhance their ability to properly self-manage blood glucose.