HealthNotes

It is recommended that everyone with diabetes aged 6 months and older, as well as their close household contacts and out-of-home caregivers, should be vaccinated against the flu each year.

People with type 1 diabetes who engage in regular exercise have better blood sugar control and require less insulin. They also enjoy better overall health, and may have a lower risk of cardiovascular complications.¹³ However, in the short term, exercise can induce low blood sugar or, if performed first thing in the morning before eating, high blood sugar.¹⁴ Therefore, people with type 1 diabetes should never begin a new exercise program without consulting a healthcare professional.

The American Diabetes Association (ADA) recommends that people with diabetes limit their per day alcohol consumption to one drink for women and two drinks for men.¹⁵ The Centers for Disease Control defines one drink as equivalent to a 12 ounce can of beer, 8 ounces of malt liquor, 5 ounces of wine, and 1.5 ounces of hard liquor (spirits). In higher amounts, alcohol is likely to be more harmful than beneficial. Drinking alcohol can make it more difficult to regulate blood glucose levels in people with type 1 diabetes.¹⁶ Although the evidence is far from conclusive, it appears different types of alcohol have different effects on health for people with type 1 diabetes: regular consumption of spirits was reported to increase risk of microvascular complications such as kidney and eye diseases, while moderate consumption of wine was reported to be protective.^{17, 18} Since no benefits have been clearly established, it is not advised that people who do not drink alcohol begin doing so simply for its possible health effects. Ask your doctor what is best for you, taking into account your personal medical history.

People with diabetes who smoke are at higher risk for kidney damage, nerve damage, heart disease, and other diabetes-related health problems.¹⁹ Therefore, it's important for people with diabetes who smoke 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 blood glucose and laboratory value goals. Now, technological advances have brought continuous glucose monitoring devices along with continuous subcutaneous insulin infusion pumps that can replace SMBG and insulin injections in order to further refine regulation of blood sugar and insulin levels.^{20, 21, 22, 23} In the context of rapidly changing technologies for monitoring blood glucose control, it is important to talk with your doctor about what form of glucose monitoring is right for you.