These are a clue your blood sugar and heart are healthy.
You work hard to manage your diabetes—you eat well, stay active, and you take your medication. But if you’re not staying up to date on certain key health metrics (from your A1C to your cholesterol levels to your BMI), you’re missing out on a chance not only to better manage your diabetes in the long run, but also to reduce your risk of heart attack, stroke, or other diabetes-related complications. Here are the main numbers that you need to know for ultimate diabetes control.
1. Know your A1C. “One of the most important tests that we do to assess your diabetes control is checking your A1C,” says Sonal Chaudhry, MD, an endocrinologist at NYU Langone Health. A1C is a blood test that shows your average blood glucose level over the past three months; it’s different from the blood sugar checks you may do on a daily basis. Ideally, you want your A1C to be less than 7. “If it’s 9 or above you probably need stronger medication,” says Sandra Arévalo, RDN, CDE, a spokesperson for the American Association of Diabetes Educators.
2. Know your fasting blood sugar. Not every type 2 diabetic needs to test their blood sugar throughout the day, but if your doctor wants you to, he’ll likely want you to test your blood sugar first thing in the morning. This number should be less than 100 to 130.
3. Know your post-meal blood sugar. Another common time doctors may want you to assess your blood sugar is within a two-hour window of eating meals. This number shouldn’t be more than 180 one to two hours after the start of a meal.
4. Know your blood pressure. Blood pressure is the force of your blood against the wall of your blood vessels. “It’s important for you to have normal blood pressure if you have diabetes, because if your blood pressure is high it increases your risk of cardiovascular disease,” says Dr. Chaudhry. A healthy blood pressure reading is considered less than 120/80. Anything above that is considered elevated blood pressure. Readings 130-139/80-89 are considered stage I hypertension. Blood pressure readings 140/90 or greater are considered stage II hypertension. This stage is more likely to be treated with medication, especially if you have other heart disease risk factors.
5. Know your cholesterol. “Too much cholesterol can be bad for you especially if you have diabetes,” says Dr. Chaudhry. It can increase your risk of plaque in arteries.” There are two kinds of cholesterol in the blood: LDL is the “bad” cholesterol, which can build up and clog your blood vessels, and HDL is the “good” cholesterol, which helps get rid of the “bad.” Your goal LDL number should be less than 100. The good stuff, HDL, should be 60 or higher. Triglycerides, another measure of fat in the blood, should be less than 150.
6. Know your BMI. Being overweight or obese increases your risk of many health issues, including type 2 diabetes, heart disease, and kidney disease. Knowing your body mass index (BMI)—a measurement of the relationship between your height and weight—can help you and your doctor assess your risk. “[A high BMI] means you’re accumulating a lot of fat in your abdominal area, close to your heart, and that puts you at a higher risk,” says Arévalo. A healthy BMI is between 19 to 25. A BMI between 25 and 30 means you’re overweight, and 30 and above means you’re obese.
When it comes to managing your diabetes, knowledge is power. “If you know these numbers, you’re more of a partner with your doctor in terms of these health care decisions,” says Paul Knoepflmacher, MD, a clinical instructor in medicine at Mount Sinai Hospital in New York City.
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There are a series of numbers that I think
is very important that my patients know.
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These provide metrics or ways to measure
how someone is doing with their health and
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they're a place to have
a conversation about prevention.
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One of the most important tests that
we do to assess your diabetes control is
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checking your A1C.
A1C is the average blood sugar that
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you have had in the past three months.
This value should be,
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in most cases, under 7%.
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And if it's over 7, that means your
diabetes isn't optimally controlled and
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you have a little bit of work to do.
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If your doctors determine that you
should be checking your blood sugars at
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home as well, your fasting blood
sugar should be under 100 to 130.
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If you're checking after meals, your after
meal blood sugar shouldn't exceed 180.
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Blood pressure is a measure of
your pressure in your circulation,
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it's measuring the elasticity
of your arteries.
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It's important for you to have normal
blood pressure if you have diabetes
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because if you're blood pressure is high,
it increases your risk of
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cardiovascular disease further.
When we're talking about normal
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blood pressure, we're talking about
less than 120 over less than 80.
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When we're discussing
elevated blood pressure,
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we're talking about 120-129 on the top and
less than 80 on the bottom.
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Stage One high blood pressure or
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hypertension, it's 130-139 on the top,
or 80-89 on the bottom.
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When we're talking about
Stage Two high blood pressure,
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we're talking about a systolic of 140 or
greater, or a diastolic of 90 or greater.
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You don't know if you have
high cholesterol necessarily,
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you don't feel anything.
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So the only way to test it
is through a blood test.
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When we're talking about
a cholesterol profile or
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a lipid panel, there are several different
measurements that are important there.
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The first is the total cholesterol.
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For the average risk person, the total
cholesterol should be less than 200.
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The LDL cholesterol, or so
called bad cholesterol,
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if a person has diabetes, than it should
be less than 100 and possibly much lower.
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The HDL cholesterol is the quote,
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So we want that as high as possible and
it should be 60 or greater.
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And when we talk about the final
measurement, these are triglycerides, and
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in the fasting specimen,
we'd like those to be less than 150.
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BMI, many people might not know this,
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but it's the relationship
that your weight has for
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Normal weight is considered a BMI of
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18.5 to 24.9, overweight is
considered a BMI of 25 to 29.9,
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and obesity is a BMI of 30 or greater.
That means that you are accumulating
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a lot of fat in your abdominal area,
close to your heart and
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that puts you at a higher risk.
These numbers are what
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the doctors use to
decide how you're doing.
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So if your hemoglobin A1C is
rising despite treatments,
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then your doctor may say,
hey look, we need to change this.
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Or if your cholesterol is rising,
then you need to eat less of this or
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do more exercise.
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So if you know these numbers,
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you're more of a partner with your doctor
in terms of these healthcare decisions.
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Effect of BMI on Lifetime Risk for Diabetes in the U.S. Atlanta, GA: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2007. (Accessed on January 8, 2018 at http://care.diabetesjournals.org/content/30/6/1562)
4 Steps to Manage Your Diabetes for Life. National Institute of Diabetes and Digestive and Kidney Diseases, 2016. (Accessed on January 8, 2018 at https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes/4-steps)