The main aim of management of diabetes is to prevent complication due to diabetes and treat complications appropriately if already occurred. The objective of appropriate management of diabetes can be met by a set of complex self-management skills of the diabetes patient and a structured approach by health care providers. Diabetes and its complications produce a wide range of symptoms and signs. Some of the symptoms are secondary to acute hyperglycemia and may occur at any stage of the disease, whereas some are related to chronic complications and begin to appear during the second decade of disease (hyperglycemia).

Approximately 50% of type-2 diabetes patients have some complication at the time of diagnosis of the disease. The history and physical examination should be done to assess symptoms or signs of acute hyperglycemia and also screened for the detection of chronic complications and conditions at the time of diagnosis of diabetes.

The basic principle of treatment/management of diabetes, both type-1 as well as type-2 diabetes and also other types of diabetes is to achieve goals of treatment of diabetes, which are (1) remove symptoms due to hyperglycemia (2) to allow the patient to live as normal a life as possible and (3) reduce or eliminate the long-term vascular complications (micro-vascular as well as macro-vascular complications) of diabetes.

To achieve the above goals in diabetes treatment the doctor need to set a target level of glycemic control (plasma glucose level) for each patient and for that the doctor should provide the diabetic patient with the pharmacological and educational support necessary to reach the target level, and also monitor as well as treat diabetes related complications, which may occur. The symptoms of diabetes due to hyperglycemia usually disappear when blood glucose level is below 11.1 mmol/Liter (200 mg/100 ml) and that is why the treatment of diabetes is generally focused on achieving the 2^nd and 3^rd goals.

Patient education is an essential aspect of optimal management of diabetes. Patient education is required for type-1 as well as for type-2 diabetes and the topics includes general knowledge of diabetes, nutrition, exercise, care of diabetes during illness, adherence to diabetes medications, lifestyle changes, and if possible self-monitoring of blood glucose. Patient education is essential for diabetes patients for improving compliance to the treatment regimen and helping the patient to understand that he/she should take the responsibility for their own care.

Educating patients of diabetes is not a one time education (should not be one or two visits to a diabetes educator), rather it is an ongoing continuous process, which should include regular contact with the diabetes patients for reinforcement of the aspects which the diabetes patients learn.

The goal of educating diabetes patients is to improve their individual self-efficacy and their self-management ability, as diabetes is a complex metabolic disorder which ultimately the patient has to learn to manage. The main aim of imparting diabetes education for diabetes patients is to improve control of plasma glucose, reduce/prevent the complications of diabetes and to improve the overall quality of life of diabetes patients.

Diabetes mellitus has reached epidemic proportions and can be prevented and controlled with diet, exercise and lifestyle changes. Regular physical exercise (especially aerobic physical activity) has a great role to play in the management of diabetes mellitus, both for type-1 diabetes as well as for type-2 diabetes.

The ADA (American Diabetes Association) recommends 150 minutes of aerobic physical activity per week, which should be distributed over at least 3 days a week. In addition patients with type-2 diabetes resistance training should be included in the exercise regimen.

There are several positive benefits of exercise in diabetes. The multiple positive benefits of regular aerobic physical activity in diabetes are reduction in the risk of cardiovascular diseases, reduced blood pressure, maintenance of muscle mass, reduction in body fat, and weight loss. All of these have positive impact in diabetes management. Exercise is useful for lowering plasma glucose (during and following exercise) as well as for increasing insulin sensitivity, both in type-1 and type-2 diabetes individuals.

Diet (nutrition) plays an important role in the management/treatment of diabetes, as well as for preventing and/or delaying the development of type-2 diabetes. Dietary approach can be used alone (in case of the beginning of type-2 diabetes and in mild hyperglycemia cases) or in combination with oral hypoglycemic drugs or insulin. Key to successful management of diabetes (especially type-2 diabetes) in a patient depends to a great extent in making the diabetes patient understand and follow a good dietary principle. The management of diabetes becomes simpler and easier for the treating physician as well as for the diabetes patient, if the patient understands and follows the dietary principles taught to him/her by the doctor or certified nutritionist/dietician.

Sometimes success or failure of management of diabetes may depend on the knowledge of the diabetes patient about the dietary principles in diabetes. The major aims of dietary management of diabetes are: