Managing diabetes is a part of the daily life of over 29 million Americans. Diabetes is the condition in which the body does not properly process food for use as energy. The food we eat mostly turns into the sugar glucose, and then the hormone insulin gets the glucose from our bloodstream to our cells so they have energy. Diabetes is grouped into three types – Type 1, Type 2, and gestational diabetes. A person whose body doesn’t produce enough insulin is diagnosed with Type 1 diabetes, and a person whose body is not using insulin properly is diagnosed with Type 2 diabetes. Gestational diabetes occurs during pregnancy.
Three numbers that help with diabetes management come from monitoring your blood sugar level, your blood pressure, and your cholesterol levels. These numbers, known as the ABCs of diabetes, can help you keep your distance from the risk of heart attacks, stroke, kidney problems, nerve damage, oral health issues, and eye problems.
A – A1c Testing
Managing diabetes is about managing the sugar content of your blood. Hemoglobin, the primary protein in red blood cells, contains a component which glucose sticks to, called Hemoglobin A1c (HbA1c). HbA1c levels reflect how much glucose is in the blood. The A1c test is conducted every three months since red blood cells live for approximately three months. Proper diabetes management requires daily personal testing, which the A1c test does not replace.
The A1c test results in a percentage based on the concentration of HbA1c; those with a percentage higher than 6.5 percent are diagnosed as diabetic, those between 5.7 and 6.4 percent are regarded as having prediabetes (which affects another 86 million adults), and those below 5.7 are regarded as having normal blood sugar levels. People will have different target percentages depending on their diabetes history and their general health. Those submitting to A1c testing do not need to fast beforehand, so experts are hoping its relative convenience will encourage more people to get tested, decreasing the number of people with undiagnosed diabetes (estimated to be 8.1 million people). The A1c test is not usually used during pregnancy but may be used at the first visit to see if women with risk factors had undiagnosed diabetes before becoming pregnant.
B – Blood Pressure
Diabetes management involves careful watch of blood pressure. High blood pressure is a concern for 25% of people with Type 1 diabetes and 80% of people with Type 2 diabetes. Having high blood pressure raises your risk of heart disease, stroke, kidney disease and other health problems. If you have both diabetes and high blood pressure, the risk of health problems becomes even greater.
Blood pressure is the force of blood pushing against artery walls as the heart pumps blood. High or low blood pressure is this force being too high or low. Blood pressure changes during sleep, when you wake up, and when you are excited, anxious, stressed, or engage in physical activity. Blood pressure readings show systolic (during heart beats) and diastolic (when the heart is at rest) pressures. Normal blood pressure is 120 systolic and 80 diastolic (read as “120 over 80”). Prehypertension is when either the first number (systolic) reaches the 120–139 range or the second number (diastolic) reaches 80–89; stage 1 high blood pressure is either 140–159 or 90–99; and stage 2 high blood pressure is either 160 and above or 100 and above. Doctors often expect people with diabetes to keep their blood pressure below 130/80.
C – Cholesterol
Monitoring cholesterol levels is an important part of managing diabetes. Cholesterol is a fat found in the blood, and there are two types – HDL and LDL. LDL levels should be kept low, while HDL is healthy. HDL helps clear fatty deposits in blood vessels and protects your heart. People with diabetes are more likely to have unhealthy levels of LDL, which can narrow or block blood vessels. This keeps blood from reaching some areas of the heart, increasing the chances of a heart attack or stroke.
Milligrams of cholesterol per deciliter of blood is the standard measurement for cholesterol. Most adults with diabetes should aim for less than 100 mg/dl of LDL, while HDL levels should be greater than 40 mg/dl for men and greater than 50 mg/dl for women with diabetes. Diet and exercise play a significant role in managing HDL and LDL cholesterol levels.
How can you cope with diabetes? What are some practical life adjustments that can better your health? These will be discussed in part II of this series.