Diabetes: A Silent Epidemic We Can Act On

(MENAFN- Awareness Marketing Management) Diabetes: A Silent Epidemic We Can Act On
Practical Steps to Improve Blood Sugar and Prevent Progression
PART A
Improving Glucose Control Through Food Choices and Post-Meal Activity
By Dr. Fayaz Shawl, MD, FACC, FACP, FSCAI
Clinical Professor of Medicine, George Washington University
Interventional Cardiologist practising in the United States and Dubai
Founder, The Fayaz Shawl Philanthropic Foundation
The magnitude of diabetes in the UAE and the Middle East
Diabetes is one of the largest chronic-disease challenges of our time. The World Health Organization reports that approximately 830 million people worldwide are living with diabetes. The Middle East and North Africa have the highest proportion of adults with diabetes of any world region: about 1 in 6 adults, or 85 million people, according to the International Diabetes Federation (IDF). In the United Arab Emirates, the IDF estimates that about 1.3 million adults were living with diabetes in 2024, an age-adjusted prevalence of 20.7 per cent. Each of these people is at risk of heart attack, stroke, kidney disease, vision loss, neuropathy and premature death. [1,2]
No community is protected. The IDF estimates that nearly two-thirds of adults with diabetes in the UAE have not been diagnosed, and more than a million more have impaired fasting glucose or impaired glucose tolerance, the stages that often come before diabetes. The risk affects Emiratis and the country's large expatriate communities alike, and people of South Asian descent can develop diabetes at a lower body weight. This is why the Fayaz Shawl Philanthropic Foundation is developing this education series: to promote earlier testing and practical guidance on food, portions, meal sequence, medication safety and activity alongside medical care. [2]
A family experience
For more than 40 years as a cardiologist, my philosophy has been to care for every patient as I would care for my own family. If you treat everyone like family, you will do your best for them. That principle guided the experience I describe here.
When someone close to us develops poorly controlled diabetes, prompt action matters, and so does accuracy. After reviewing the research on meal sequence, the first person with whom I applied these principles was my own sister. She had an HbA1c of 8.9 per cent, well above the usual treatment target. Her seven-day continuous glucose monitor (CGM) report for September 6–12, 2026 showed an average glucose of 181 mg/dL (10.0 mmol/L), with evening averages reaching 205 and 220 mg/dL (11.4 and 12.2 mmol/L).
Alongside her medical care, we made structured changes to meal composition, portion size, food order and post-meal activity, with close supervision and continuous glucose monitoring. Her next seven-day report, for September 14–20, 2026, showed an average glucose of 133 mg/dL (7.4 mmol/L), a fall of 48 mg/dL (2.7 mmol/L), with three-hour averages between 115 and 147 mg/dL (6.4 and 8.2 mmol/L). As her glucose improved, her glucose-lowering medication, including insulin, was reduced under close medical supervision.
Before dietary recommendationsAfter dietary recommendations

September 6–12, 2026
Average glucose 181 mg/dLSeptember 14–20, 2026
Average glucose 133 mg/dL
Glucose-lowering medication, including insulin, reduced under close medical supervision
Figure 1. Anonymised before-and-after seven-day CGM reports from my sister. Average glucose fell from 181 mg/dL (September 6–12, 2026) to 133 mg/dL (September 14–20, 2026) after the dietary programme. During the same period, her glucose-lowering medication, including insulin, was reduced under close medical supervision. This is not a controlled trial and does not establish cause and effect. Images reproduced with her permission.
The response is encouraging, but medication, activity, adherence, sleep, illness and other factors also affect glucose. It is not proof that diabetes has been cured or reversed. HbA1c reflects glucose exposure over about three months, so a repeat laboratory HbA1c is essential. International consensus defines type 2 diabetes remission as an HbA1c below 6.5 per cent for at least three months without glucose-lowering medication, and even then, continued monitoring is necessary because high blood sugar can return. [3]
A CGM is useful for recognising patterns and testing how an individual responds to meals. It does not by itself diagnose remission, and a single low or normal reading should never be treated as proof that diabetes has disappeared.
My purpose in sharing this experience is practical: relatively simple habits can improve daily glucose patterns, but they must complement appropriate medical treatment rather than replace it.
A practical evidence-based regimen
1Begin with a medical assessment. Confirm the type of diabetes and review HbA1c, fasting glucose, kidney function, urine albumin, blood pressure, lipids, weight and current medication. An HbA1c of 7 per cent or higher deserves active treatment and follow-up. Lifestyle measures may improve control, but medication may still be necessary to protect the heart, kidneys, eyes and nerves.
2Use nuts as a measured food. Walnuts and almonds provide unsaturated fat, fibre, magnesium and protein. A small serving of about 20 grams (roughly 10 almonds and 4 walnut halves) taken 20 to 30 minutes before a meal may reduce the post-meal glucose rise in some people, particularly when it replaces crackers, cookies, chips or pastries. Unsalted pistachios, widely eaten in the region, are a reasonable alternative. A randomised trial in Asian Indians with prediabetes found benefit from 20 grams of almonds taken 30 minutes before meals. [4] Take the nuts with a glass of water and chew them well. Water supports hydration and may help you feel full sooner, but it has not been shown to lower glucose further. People who have been told to restrict their fluids should follow the advice in step 7. Nuts are calorie-dense and should be counted within the daily food plan. People with a nut allergy should avoid them.
3Eat vegetables and protein before starch. Small crossover studies show that eating non-starchy vegetables and protein before carbohydrate can reduce the immediate rise in glucose and insulin after a meal. [5] Fibre, protein and fat slow digestion, so glucose enters the blood more gradually. A practical sequence is a salad, such as fattoush with little or no fried bread, tabbouleh or a green salad, or cooked vegetables such as okra, spinach or grilled vegetables, first, alone or with a modest serving of plain unsweetened yoghurt or labneh; then protein, such as shish taouk, a mixed grill skewer, grilled fish or lean lamb; and a limited amount of rice or khubz last.
4Choose plain yoghurt or labneh when it fits the meal. Plain unsweetened yoghurt supplies protein, and strained varieties such as labneh and Greek yoghurt supply even more. They generally cause only a small rise in blood sugar. [6] In my clinical observation with CGMs, mixing a modest serving of plain yoghurt with greens or other non-starchy vegetables at the start of the meal was associated with a smaller post-meal glucose rise. In practice, this can be a spoonful of yoghurt or labneh with salad or vegetables, or a yoghurt-and-cucumber salad (khiyar bi laban). This combination has not been tested in a controlled trial, so it is a practical observation rather than a proven treatment. Avoid flavoured yoghurts and sweetened laban drinks, which often contain added sugar, and do not add honey or date syrup. Portion size and total calories still matter. People with lactose intolerance or dairy allergy need an alternative.
5Reduce rapidly digested carbohydrate without unnecessary prohibitions. White rice, khubz and other white breads, manakish, pasta, sugary cereals, pastries and sweets can cause large glucose rises, especially in generous portions. The most important step is to reduce quantity and frequency. A small measured serving of brown rice, whole-wheat khubz or bulgur may fit an individual plan when eaten after vegetables and protein. Luqaimat, kunafa, baklava, Umm Ali and other sweets should be occasional foods, not daily staples. Dates are nutritious but rich in natural sugar: one or two dates eaten at the end of a meal fit better than a handful on an empty stomach.
6Walk after meals. A 10- to 15-minute walk soon after a meal can lower post-meal glucose. Working muscles draw sugar out of the blood, partly without needing insulin. This helps, but it does not replace diabetes treatment. A randomised crossover study found that short walks after each main meal improved post-meal glucose more than a single daily walk. [7]
7Stay appropriately hydrated. Water is preferable to sweetened drinks, and dehydration can worsen illness when blood sugar is very high. Fluid intake must be individualised in people with heart failure, kidney disease, liver disease or a tendency toward low sodium. In the UAE's heat, fluid needs rise, especially for people who work or exercise outdoors.
8Measure the result over time. Review CGM patterns over at least 10 to 14 days when available, confirm unexpected readings with a finger-stick meter, and repeat HbA1c after about three months. Follow weight, waist circumference, blood pressure, kidney health and medication needs as well as glucose.
Medication safety
Do not reduce or stop prescribed medication or insulin on your own. Better food choices and more activity can lower glucose quickly, especially in people taking insulin or sulfonylureas such as glimepiride or gliclazide, and these medicines may need supervised adjustment to prevent hypoglycaemia. In my sister’s case, these adjustments were made under close medical supervision, with continuous glucose monitoring. Other medicines may remain important because they protect the heart and kidneys even when glucose improves.
Fasting during Ramadan
Many people with diabetes in the UAE fast during Ramadan. Anyone with diabetes who plans to fast should see their doctor six to eight weeks beforehand to assess the risk and adjust medication, particularly insulin and sulfonylureas. For some people, such as those who have recently had severe hypoglycaemia or diabetic ketoacidosis, guidelines advise against fasting altogether. Check glucose regularly while fasting; a finger-stick or sensor check does not break the fast. International guidelines advise ending the fast immediately if glucose falls below 70 mg/dL (3.9 mmol/L) or rises above 300 mg/dL (16.7 mmol/L), or if symptoms of low or high blood sugar appear. The same meal principles apply at iftar and suhoor: break the fast with water and one or two dates, then eat vegetables and protein before rice or bread, keep sweets small, choose water over sweetened drinks such as Jallab, Vimto and Qamar al-Din, and take a gentle walk after iftar. [8]
The main lesson
The family experience shows how quickly daily glucose patterns can respond to a disciplined routine. It does not establish a cure. The clinically meaningful questions are whether the improvement is sustained, whether HbA1c falls over the next three months, whether medication can be adjusted safely and whether cardiovascular and kidney risk factors also improve.
PART B
Prediabetes Is a Warning and an Opportunity for Prevention
The magnitude of prediabetes
The population at risk is even larger than the number already diagnosed with diabetes. In the UAE, the IDF estimates that about 17 per cent of adults have impaired fasting glucose and about 18 per cent have impaired glucose tolerance, two overlapping forms of prediabetes. Most people in this intermediate stage have no symptoms, and many do not know that their glucose is abnormal. [2]
Using HbA1c, prediabetes generally means a laboratory value from 5.7 to 6.4 per cent. A value of 5.7 per cent is the lower boundary, not a medical emergency, while 6.5 per cent or higher may meet a diagnostic criterion for diabetes when confirmed. In a person without symptoms, an abnormal result should generally be confirmed with a repeat HbA1c or another laboratory glucose test. Anaemia, kidney disease and some haemoglobin variants can affect HbA1c accuracy. [9]
Prediabetes should not be described as harmless, but neither is progression to diabetes inevitable. It is a warning and, more importantly, an opportunity for prevention.
The International Diabetes Federation estimated that in 2024 approximately 635 million adults worldwide had impaired glucose tolerance and 488 million had impaired fasting glucose. These categories overlap, and they are not identical to HbA1c-defined prediabetes, so the two figures must not be added together. They nevertheless show the enormous global pool of people at increased risk of type 2 diabetes. [10]
This is precisely the population I would like to educate. People with an HbA1c between 5.7 and 6.4 per cent may feel completely well while insulin resistance is progressing. Timely education about familiar, everyday food choices, sensible carbohydrate portions, regular activity, weight management when needed and appropriate medical follow-up can help many of them delay or prevent type 2 diabetes.
During more than four decades as an interventional cardiologist, I have seen the consequences of diabetes in the arteries of the heart, brain, kidneys and legs. Prediabetes deserves attention because it identifies people at increased risk of type 2 diabetes and cardiovascular disease. It is also a stage at which prevention can be highly effective.
Current medical care does not recommend waiting passively for diabetes to develop. It recommends weight management when needed, healthier food choices, regular physical activity and periodic testing. Metformin may also be considered for selected people at particularly high risk.
Prevention is effective, but cure is not the right term
Prediabetes can return to the normal glucose range, and progression to type 2 diabetes can often be delayed or prevented. The word cure is misleading because insulin resistance and future risk may remain. The landmark Diabetes Prevention Program found that an intensive lifestyle programme reduced the development of type 2 diabetes by 58 per cent over approximately three years. Participants aimed for 7 per cent weight loss and at least 150 minutes of physical activity each week. [11] Ask your doctor about structured diabetes education or prevention programmes available through your hospital or clinic.
Why I am sharing this message
Prediabetes is a common precursor to type 2 diabetes, although progression is not inevitable. Early action offers a real opportunity to interrupt that progression. In my clinical experience, many patients who closely followed structured dietary recommendations and regular exercise saw their HbA1c return to the normal range, below 5.7 per cent, within approximately six to nine months. This should be confirmed by repeat laboratory testing and does not mean that future diabetes risk has disappeared.
A few of my close friends had an HbA1c of 5.7 per cent. With their permission, I reviewed their CGM patterns. After reducing cereal portions and combining carbohydrate with nuts, berries and unsweetened Greek yoghurt, they saw smaller peaks after breakfast and average glucose levels near 100 mg/dL (5.6 mmol/L). At a typical breakfast in the UAE, the same principle means a smaller piece of khubz or manakish, taken with eggs, foul medames, labneh or a handful of nuts.
These observations are encouraging, but they are not a controlled trial and cannot predict every person’s result. A single CGM value cannot diagnose or exclude prediabetes. Follow-up should include repeat laboratory HbA1c and assessment of weight, waist circumference, blood pressure, lipids and overall cardiovascular risk.
A practical prevention plan
1Know the baseline. Check laboratory HbA1c or fasting glucose and confirm an abnormal result when appropriate. Measure blood pressure, weight, waist circumference and lipids. International guidelines, such as those of the American Diabetes Association, recommend testing all adults from age 35, and earlier for adults with overweight or obesity plus another risk factor, such as a family history, previous diabetes in pregnancy, high blood pressure, abnormal lipids or physical inactivity. People of Asian descent, including the UAE's large South Asian community, should be tested at a lower body weight, a BMI of 23 or higher, because they often develop diabetes at lower weights. [12]
2Change portions before giving up favourite foods. Familiar foods can remain part of a healthy plan. Fill about half the plate with non-starchy vegetables. Keep rice, khubz, pasta and potatoes to small, measured portions, about a quarter of the plate. Reduce karak chai and other sweetened tea and coffee, luqaimat, kunafa and other desserts, cookies and soft drinks. Large rice dishes such as machboos, biryani and ouzi, and fried foods such as falafel, samboosa and shawarma with fries, should be eaten in moderate portions because they may contain large amounts of rice, saturated fat and salt.
3Use food order as an additional tool. Start with vegetables, alone or with a modest serving of plain unsweetened yoghurt or labneh; follow with grilled meat, fish, chickpeas or lentils; and take rice or bread last. This may blunt the post-meal rise, but it does not make an unlimited carbohydrate portion safe.
4Choose snacks that replace refined carbohydrate. A measured portion of unsalted walnuts or almonds can replace chips, crackers or pastries as an afternoon snack. Plain yoghurt or unsweetened laban can also be useful. Arabic coffee (gahwa) and plain tea contain little carbohydrate, but the dates often served with gahwa add up quickly, and karak chai, sweetened mint tea, flavoured coffee drinks and Ramadan drinks such as Jallab, Vimto and Qamar al-Din can contain as much sugar as a dessert. Evidence does not support relying on cinnamon or green tea as diabetes treatment. [13]
5Move after meals and throughout the week. Walk for 10 to 15 minutes after meals when safe. Aim for at least 150 minutes of moderate activity each week and include muscle-strengthening exercise two or three times weekly. People with heart symptoms, severe neuropathy, foot ulcers or major mobility limitations should get individual exercise advice. During the hot months, walk indoors at home, in a building corridor or in an air-conditioned mall, or outdoors early in the morning or after sunset.
6Address the major drivers of risk. If excess weight or abdominal fat is present, even modest weight loss can improve insulin sensitivity. Preserve muscle with adequate protein and strength exercise. Sleep regularly, avoid tobacco and treat high blood pressure and abnormal cholesterol.
7Repeat laboratory testing. Recheck HbA1c about three months after a major lifestyle change. People with confirmed prediabetes should usually be tested at least yearly, with the interval set by their doctor.
8Use AI or a quick search when eating out. Before or during a restaurant meal, or when ordering through a delivery app, give an AI assistant on your phone the name of the restaurant and ask, for example: “I have prediabetes. What should I order at [restaurant name] to avoid a large blood sugar spike?” You can also search a menu item online with the question “Is [dish] good for diabetes?” Many chain restaurants also publish nutrition information, including carbohydrate content, on their websites. Treat these answers as a helpful starting point rather than medical advice: AI tools can make mistakes, and menus and portion sizes change. Then apply the same principles at the table: start with a salad or vegetables, choose a protein-based main dish, skip or limit the bread basket, ask for sauces and dressings on the side, and take part of a large portion home.
A message for the public
Prediabetes is neither a reason for panic nor a reason for inaction. It is an opportunity to intervene early. Sustainable food choices, weight management when needed, regular activity and appropriate medical follow-up can substantially reduce risk. Medication is sometimes appropriate and should never be seen as failure. The goal is lasting metabolic and cardiovascular health, not a perfect single sensor reading.

PART C
How the Programme Works: The Science Behind Each Step
The steps in this programme are not arbitrary. Each one acts on how quickly food leaves the stomach, how quickly starch is digested and absorbed, or how the body clears sugar from the blood after a meal. The explanations below describe what research has shown and, where the evidence is still developing, how these steps are thought to work.
1Nuts before the meal: a natural brake. When the fat and protein in walnuts and almonds reach the upper small intestine, they trigger gut hormones, including cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1). These hormones signal through the nerves of the gut to slow the emptying of the stomach, a feedback system known as the duodenal brake. When the main meal follows, it passes into the intestine more gradually, so its sugar reaches the blood more slowly. Chew the nuts thoroughly, because breaking their cell walls happens in the mouth, not the stomach. A small serving of about 20 grams is enough; the trial in Asian Indians with prediabetes used this amount, taken 30 minutes before meals. [4]
2Vegetables first: thickening the meal. Leafy greens, okra, eggplant, cucumbers, tomatoes and salads such as fattoush and tabbouleh supply fibre. Soluble fibre, such as pectin, absorbs water and makes the stomach contents thicker. Thicker contents empty more slowly and mix less readily with digestive enzymes, so sugar from starch eaten later in the meal is absorbed more gradually. Insoluble fibre adds bulk and fullness. Much of the benefit also comes from the order itself: the starch simply arrives later, after the body's early hormonal response is under way. [5,14]
3Plain yoghurt or labneh: an early protein signal. Plain yoghurt and labneh provide milk proteins, casein and whey; strained varieties such as labneh and Greek yoghurt contain more protein per serving. Eaten at the start of a meal, these proteins stimulate an early release of insulin and GLP-1, so the body is already prepared when the starch arrives. In a clinical trial in type 2 diabetes, a whey protein drink taken before breakfast reduced the rise in glucose after the meal. [15] Casein also forms soft curds in the stomach that empty slowly. As noted earlier, combining yoghurt with vegetables reflects my clinical observation and has not been tested in a controlled trial. [6]
4Protein, lentils or chickpeas: fullness and slower digestion. Protein from fish, chicken, lamb, eggs, lentils or chickpeas slows stomach emptying further and stimulates gut hormones such as peptide YY (PYY), which act on appetite centres in the brain to increase fullness. [16] Feeling satisfied sooner makes it easier to keep the starch portion small. Lentils and chickpeas, including hummus and foul, also contain carbohydrate, so its portion counts toward the total for the meal.
5Starch last: a lower, slower rise. By the time rice or khubz is eaten, the stomach is emptying more slowly and the meal is thicker and richer in fibre, protein and fat. The starch is still digested and absorbed, but more gradually. In studies, eating vegetables and protein before carbohydrate lowered the post-meal glucose peak by roughly a third and reduced the insulin response. [5] Large, repeated swings in glucose after meals are associated with oxidative stress, which can injure blood vessels, so smoothing them may help protect the heart and arteries as well as improving glucose control. [17]
6A note on cooled rice. When cooked rice is refrigerated, part of its starch changes into resistant starch, which is digested more slowly. In one study, white rice cooled for 24 hours and then reheated produced a smaller glucose rise than freshly cooked rice. [18] A similar change occurs when cooked potatoes and pasta are cooled. Food safety matters: cooked rice left at room temperature, especially in a warm climate, can grow bacteria whose toxin survives reheating. Put cooked rice into shallow containers and refrigerate it within two hours, keeping the refrigerator at 4°C or below. Use it within about 24 hours, reheating only the portion you need until it is steaming hot throughout (74°C); eat it promptly, and do not reheat it a second time. Portion size remains more important than cooling.
7Walking after meals: muscles as a sugar sink. In type 2 diabetes and prediabetes, the body responds poorly to insulin, mainly because the insulin signal inside the cell is impaired. Working muscle has a second route. During walking, signals within the muscle move glucose transporters called GLUT4 to the cell surface without needing insulin, letting sugar pass from the blood into the muscle to be used as fuel. [19] This is why a short walk after meals lowers post-meal glucose and reduces how much insulin the pancreas must produce. [7] Even two to five minutes of light walking helps, [20] and in the summer heat, walking indoors, in an air-conditioned mall or up and down stairs works as well.
What these mechanisms do and do not mean
Together, these steps make the rise in blood sugar after a meal smaller and slower. They do not stop sugar from entering the blood, and they do not make large portions safe. They work best alongside sensible portions, regular activity, weight management when needed and appropriate medical treatment. People taking insulin or sulfonylureas should discuss these changes with their doctor, because lower post-meal glucose may require medication adjustment.
Selected references
1.World Health Organization. Diabetes fact sheet.
2.International Diabetes Federation. IDF Diabetes Atlas, 11th edition: United Arab Emirates country profile and Middle East and North Africa regional data, 2025.
3.Riddle MC et al. Consensus report: definition and interpretation of remission in type 2 diabetes. Diabetes Care, 2021.
4.Gulati S, Misra A, Tiwari R, et al. Beneficial effects of premeal almond load on glucose profile on oral glucose tolerance and continuous glucose monitoring: randomized crossover trials in Asian Indians with prediabetes. European Journal of Clinical Nutrition, 2023.
5.Shukla AP et al. Food order has a significant impact on postprandial glucose and insulin levels. Diabetes Care, 2015;38(7):e98–e99.
6.Wolever TMS. Yogurt is a low-glycemic index food. Journal of Nutrition, 2017;147(7):1462S–1467S.
7.Reynolds AN et al. Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study. Diabetologia, 2016.
8.International Diabetes Federation and DAR International Alliance. Diabetes and Ramadan: Practical Guidelines, 2021.
9.National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The A1C test and diabetes.
10.International Diabetes Federation. IDF Diabetes Atlas, 11th edition, 2025.
11.Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 2002;346:393–403.
12.American Diabetes Association Professional Practice Committee. Diagnosis and classification of diabetes: Standards of Care in Diabetes. Diabetes Care, current edition.
13.National Center for Complementary and Integrative Health (NCCIH). Cinnamon: usefulness and safety.
14.Kubota S, Liu Y, Iizuka K, et al. A review of recent findings on meal sequence: an attractive dietary approach to prevention and management of type 2 diabetes. Nutrients, 2020.
15.Jakubowicz D, Froy O, Ahrén B, et al. Incretin, insulinotropic and glucose-lowering effects of whey protein pre-load in type 2 diabetes: a randomized clinical trial. Diabetologia, 2014.
16.Batterham RL et al. Critical role for peptide YY in protein-mediated satiation and body-weight regulation. Cell Metabolism, 2006.
17.Monnier L et al. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA, 2006.
18.Sonia S, Witjaksono F, Ridwan R. Effect of cooling of cooked white rice on resistant starch content and glycemic response. Asia Pacific Journal of Clinical Nutrition, 2015.
19.Richter EA, Hargreaves M. Exercise, GLUT4, and skeletal muscle glucose uptake. Physiological Reviews, 2013.
20.Buffey AJ et al. The acute effects of interrupting prolonged sitting time in adults with standing and light-intensity walking on biomarkers of cardiometabolic health: a systematic review and meta-analysis. Sports Medicine, 2022.
Disclaimer: My observations come from patients using continuous glucose monitors, sensor patches worn on the arm that send readings to a mobile phone. Glucose may fall substantially after these dietary changes; individual responses vary, and this is not a controlled trial. Patients taking insulin or medicines that can cause hypoglycaemia must coordinate with their treating physician about dose adjustment. During the early dietary change, monitor glucose frequently and do additional finger-stick tests, especially at bedtime, when the sensor shows a low or rapidly falling value, or when symptoms do not match the sensor reading. Do not change medication without guidance from your treating doctor.

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