The ABCs of Diabetes Management

Diabetes significantly increases the risk of heart disease. In fact, people with type 2 diabetes are 2 to 4 times more likely to have heart disease and stroke than people who do not have diabetes, and approximately two-thirds of people with diabetes who are 65 years of age or older die of complications, such as heart attack. That’s why it’s important to control blood pressure and cholesterol levels as well as blood sugar levels.

How can you get started? It’s simple — just learn your ABCs!

  • A1C (average blood sugar over the last 2-3 months)
  • Blood pressure
  • Cholesterol

Paying attention to all 3 of the ABCs is important. Talk to your doctor about how to manage your ABCs to help reduce your risk of diabetes-related complications, like heart disease. Click on each of the ABCs below to learn more!

You can help control your ABCs in a variety of ways, including healthy eating, getting more active, taking medication, if prescribed, and keeping track of your ABC goals. Talk to your doctor about an ABC management plan that’s right for you. Click on each of the options below to learn more!

Download and print this Daily Diabetes Management Journal to keep track of your blood sugar levels, eating and exercise between doctor appointments.

Bring this Checkup Chart to every doctor appointment to keep track of your current health and future goals.

A1C

The A1C test is a simple blood test taken at your doctor’s office, which shows what your average blood sugar has been over the last 2-3 months. It’s an estimate of your blood sugar levels over time and the result is crucial in helping your doctor to determine the appropriate diabetes treatment plan or whether your current treatment plan is working or needs to be changed.

For many people with diabetes, the AACE-recommended A1C is 6.5 percent or less, but some people may need a higher A1C. Ask your doctor what A1C goal is right for you. Guidelines recommend that you get an A1C test 2 to 4 times a year.

With nearly half of diabetes patients not at the AACE-recommended A1C of less than 6.5%, it is essential that you know your A1C and talk with your doctor about setting and developing a plan to attain your own A1C goal. Keep in mind that diet, exercise, and medication (if prescribed by a doctor) are all important components to help you reach your A1C goal.

Blood Pressure

When your blood pressure is taken, your doctor is measuring the force of your blood as it presses against the inside walls of your blood vessels. When blood moves through these vessels with too much force, your blood pressure is high, called hypertension, and your heart has to work harder.

AACE-recommended blood pressure goal: Less than 130/80 mm Hg  
Systolic pressure (mm Hg)
(the pressure as your heart beats)
130
Diastolic pressure (mm Hg)
(the pressure when your blood vessels relax between heart beats)
80

If you are not meeting your blood pressure goals, your risk for diabetes-related complications can increase. Hypertension may not cause symptoms, but over time it can damage the heart and blood vessels and other organs such as kidneys and eyes and increase your risk of heart disease and stroke.

Get your blood pressure checked at every office visit and talk with your doctor about your blood pressure goals.

Cholesterol

Cholesterol is a fat-like substance in the blood that is important for your body to function properly. For example, it helps you digest food, produce hormones, and build new cells. However, if certain types of cholesterol are too high, it can lead to heart attack or stroke.

There are two different types of cholesterol your doctor measures:

    • LDL (bad) cholesterol increases your risk for heart attack
    • HDL (good) cholesterol works to reduce your risk for heart attack

Your doctor will also measure your triglycerides, a type of fat in the blood, on a regular basis. Most fat from food and in the body exists as triglycerides. When you eat food, it may be converted to triglycerides and stored in fat cells.

Cholesterol goals for most people with diabetes include an LDL of less than 100 mg/dl, an HDL of more than 40 mg/dl for men or more than 50 mg/dl for women, and triglyceride levels less than 150 mg/dL. Lowering LDL cholesterol levels can reduce the risk of heart disease. Talk with your doctor about specific cholesterol and triglyceride goals for you.

Healthy Eating

Maintaining a healthy, balanced diet full of fruits, vegetables, whole grains, low-fat dairy, and lean proteins is especially important for people with type 2 diabetes. Eating these foods at the right times and in the right amounts can help get you to your ABC goals.

To help manage A1C, watch your intake of calories, especially carbohydrates and sugar. Cut back on refined grains, like white rice and pasta, and added sugars from soda, fruit juices, and processed baked goods.

To help achieve blood pressure control, reduce the amount of calories and salt in your diet. You should be consuming no more than 2,300 mg of salt per day. For individuals with both diabetes and hypertension, further reduction in sodium intake should be individualized. When cooking, season with lemon or lime juice, herbs, and spices instead of salt — you don’t have to sacrifice flavor!

To help achieve your cholesterol goals, limit your intake of calories, including saturated fats, which are found in animal products like meats, cheeses, and butter. Try opting for lean proteins like skinless chicken breast or fish, low-fat dairy, and foods that are baked, grilled, or broiled instead of fried.

Getting More Active

Research has shown that physical activity can lower blood sugar, blood pressure, and LDL (bad) cholesterol, raise HDL (good) cholesterol and help you lose weight.

To get started, make a list of physical activities that you like to do, either alone or with others — you’re more likely to do them more often! Here are a few simple examples:

     Walk 10 to 15 minutes during your lunch break, perhaps getting some errands done as part of
      your walk
     Go on a bike ride, and ask a family member or friend to join you!
     Walk a few laps around the shopping mall

It may also help to start keeping a log of your activities in the Daily Diabetes Management Journal, to help you stay on top of your exercise program. Just remember to check with your doctor before getting started!

Taking Medication

There are medications that you can take to help manage your ABCs. If you haven’t already, talk with your doctor about medications that may be appropriate for you.

If you’re already taking medication to help manage your ABCs, make sure you are taking it as prescribed and do not stop taking it without first talking to your doctor, even if you feel good!

If you often experience symptoms of low blood sugar, talk to your doctor about whether any adjustments are needed in your treatment plan.

Diabetes is a progressive disease and sometimes changes in medication may be needed. If your doctor decides it is time to change your medication, it may not mean you haven’t tried hard enough – many people need to adjust their treatment plan over time to help them reach their blood sugar goals.

Tracking Your Goals

It is important to keep track of your current ABC levels, as well as the target levels you’re working to achieve, so that you and your doctor can determine whether you’re meeting your goals.

You can bring the Checkup Chart to each doctor’s appointment to record current and target levels for your ABCs, blood sugar, diet, exercise, and weight.

You should also talk with your doctor to set a target blood sugar range and determine a schedule for checking your blood sugar regularly.

The Daily Diabetes Management Journal is an easy-to-use, printable resource that you can use to keep track of your blood sugar levels, diet, and exercise between appointments.



Etie Moghissi, MD, FACP, FACE

Dr. Etie Moghissi is a clinical endocrinologist involved in patient care in private practice in Marina del Rey, California, as well as an associate clinical professor of medicine at the University of California, Los Angeles. She is Board Certified in Internal Medicine and Endocrinology and is a member of the board of trustees of the American Collage of Endocrinology.

As a clinical endocrinologist, I treat a number of people with type 2 diabetes and know that managing the disease can be a difficult undertaking. The initial diagnosis is often overwhelming and many patients do not realize that high blood sugar levels over time can lead to serious long-term complications.

That’s why I’m working on the Blood Sugar Basics: Get to Your Goals program to provide you with clear tools and missions that encourage you to know your A1C and talk to your diabetes healthcare team (including your primary care provider, endocrinologist, and/or diabetes educator) about setting and attaining your blood sugar goals.

By working with your diabetes healthcare team, you can develop an individualized treatment plan and learn more about how lifestyle changes, such as meal planning and physical activity, and medication, when prescribed, all play key roles in helping you reach your A1C goal and blood sugar goals. For more advice about type 2 diabetes management and the importance of teaming up with your doctor, click here.

I am very excited about Get to Your Goals and hope that you find it to be a helpful resource. I know how important it is for people with type 2 diabetes to work with their diabetes healthcare team to set personal goals and a plan for achieving them, and that’s exactly where you’ll start with the first mission of Get to Your Goals – Gather Intelligence.