In a country in which one out of every 12 people has diabetes—and the majority have type 2—the cost of managing the disease is a big deal. People who have been diagnosed with diabetes spend more than twice as much on medical expenses than people who don’t have it, according to the American Diabetes Association. In fact, dealing with diagnosed diabetes (because an estimated seven million cases are undiagnosed) ran the U.S. a whopping $174 billion in 2007, including $116 billion in medical expenditures and $58 billion in decreased national productivity. That’s because when you don’t take care of your type 2 diabetes, the complications—from heart disease to blindness to limb amputation—can leave you sidelined.

But type 2 diabetes doesn’t have to be a total budget buster. Following doctor’s orders now could prevent expensive hospitalizations later, and there are ways to shrink the bottom line on today’s bills. Read on for tips from top experts.

Eat well and work out.

The best advice may well be the cheapest. “Whenever anybody can get away with controlling type 2 diabetes through diet and exercise, that’s a definite winner,” says Jeffrey Tipton, MD, medical director of CareMore Health Plan in Cerritos, CA. “If you’re aggressive with those things, you can do a lot to control the disease.” That’s because diabetes is in large part a vascular ailment—and anything you can do to encourage vascular health is helpful. That means finding a way to control your weight, following a rational diet, and getting a moderate amount of exercise. “Exercise doesn’t have to be racing down a high school track,” says Marvin Lipman, MD, chief medical advisor for Consumer Reports. “It mostly consists of walking, to the tune of about 50 minutes per day. With the use of exercise and diet, which cost nothing, you can get about 80 percent of your patients to where they should be.” 

Ask about generics.

Like any medication, if you can get by with the non-brand-name variety, you’re going to save cash. For instance, metformin, the generic form of Glucophage, is one of the most popular oral medications for type 2 diabetes—and it costs much less. “Many times, patients are reluctant to make the change from brand name drugs to generic,” says Elbert Huang, MD, an associate professor of medicine at the University of Chicago. “But many oral meds for diabetes are now available generically, and there are generic forms of insulin as well. Patients shouldn’t be overly concerned about differences between them.”

Compare costs at drugstores.

If you’re filling all of your prescriptions at the drugstore nearest you, call a few competitors to make sure you can’t get it for less. “Target and Walmart have pharmacies that will provide a lot of the diabetes generic medications for $4 a month, or $10 for a three-month supply,” says Emmy Suhl, a diabetes and nutrition educator with Joslin Diabetes Center, a teaching and research affiliate of Harvard Medical School.

Try mail order.

If your health insurance prescription coverage offers the option, order your medications via mail order and you’ll see significant savings. “Mail order or home delivery is often cheaper, especially over multiple months, compared to going to the pharmacy every month,” Huang says. Mail order programs typically require a prescription for three months of meds at a time, and delivery can take as long as a couple of weeks, so this works best for medications you’re on for the long-term. (Just plan ahead.)

Talk to your doctor about test strips.

If you’re using test strips to measure your blood glucose levels at home, chat with your doctor to determine how often you really need to do it—or if you need to do it at all. “If you’re not actually making changes to your diet or medication based on blood sugar, it’s not clear to me what the role of self glucose monitoring is,” Huang says. “Are you going to use that information? Is your doctor? If not, it may not be necessary to have that.” You may also be able to test less often, or only test on a few days of the month. “A person who’s in good diabetic control and meeting goals really doesn’t have to test more than three to four times a week,” Lipman says.

Get a free glucose meter.

Although there’s no such thing as a generic test strip, it’s possible to get the test strips for less, and to get the meter for nothing. “Never, ever pay money for a meter,” says Andrew Rhinehart, MD, director of the Johnston Memorial Diabetes Care Center in Abingdon, VA. “Most companies will absolutely give you a meter for free as long as you buy the strips. They want you buying the strips for the rest of your life.” Ask your local drugstore whether they offer a glucose meter (such as the one from Walgreen’s) and whether you can get it for free with a rebate. (Or watch for specials.) You can also Google the words “free glucose monitor rebate” and see what pops up—some companies will ship one to you for free, as long as you have a prescription for it.

Use coupons.

If you don’t have great insurance or you’re not able to take an inexpensive generic medication, ask your doctor and local pharmacist about money-off coupons. “I have a file full of coupon cards for medicines,” Rhinehart says. Many pharmaceutical companies also offer medication assistance programs, so it’s worth contacting the company directly to see if you qualify. “If you meet their income requirements, and you don’t have insurance, you can get your medicine for free,” Rhinehart says.

Pay attention during open enrollment.

If you have type 2 diabetes, you shouldn’t pick your health insurance on a whim. Examine your options and do some math to figure out which plan will cost you the least. If you can, gather your medical history for the past couple of years and run it through each plan to see what you would have paid. That includes co-pays for doctor’s visits and prescriptions, coinsurance (if applicable), deductibles, and plan premiums. “Someone with diabetes will go to the doctor frequently, and they’ll be on multiple medications,” Suhl says. “So a plan where there’s not a high deductible or a high co-pay would be advantageous to them.” 

Call your benefits department.

An under-sung benefit of many insurance plans is a disease management program for people diagnosed with type 2 diabetes. Translation: You’ll get access to a personal health coach who can help you navigate the medical system to care for yourself and manage your illness. If you’re not sure whether your plan offers this, give your benefits manager a call. Because the key to saving money over the long haul is to take care of yourself now. “Uncontrolled diabetes is the biggest risk factor for blindness, kidney dialysis, and non-traumatic leg amputation in the U.S.,” Rhinehart says. “The important thing is to jump on it early.”