Prevent diabetes problems: Keep your diabetes under control

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What are diabetes problems?

Too much glucose (sugar) in the blood for a long time can cause diabetes problems. This high blood glucose (also called blood sugar) can damage many parts of the body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes. You can do a lot to prevent or slow down diabetes problems.

Be active to prevent diabetes problems.

Will I have diabetes problems?

Maybe. You may have one or more diabetes problems or none at all. It is hard to know if or when your diabetes will cause problems. If you get diabetes when you are young, you may not have diabetes problems for many years. If you find out you have diabetes as an adult, you may already have diabetes problems. Either way, keeping your blood glucose, blood pressure, and cholesterol under control can prevent diabetes problems.

What should my blood glucose numbers be?

Keeping your blood glucose on target can prevent or delay diabetes problems. For most people, target blood glucose levels are shown here:

Talk with your health care provider about what your blood glucose numbers should be and write them here:

Talk with your health care provider about when you need to check your blood glucose using a blood glucose meter. You will do the checks yourself. Your health care provider can teach you how to use your meter.

Keep track of your blood glucose checks using the record page in this booklet on page 16. Make copies yourself or ask your health care provider for a blood glucose record book. Your blood glucose check results will help you and your health care provider make a plan for keeping your blood glucose under control. Always bring your record book to your doctor visits so you can talk about reaching your glucose goals.

How can I find out what my average blood glucose is?

Ask your health care provider for the A1C test. This blood test shows the average amount of glucose in your blood during the past 2 to 3 months. Have this test done at least twice a year. If your A1C result is not on target, your health care provider may do this test more often to see if your result is improving as your treatment changes. Your A1C result plus your blood glucose meter results can show whether your blood glucose is under control.

Aim for a result below 7 percent. If your A1C test result is below 7 percent, then your blood glucose is in a desirable range and your diabetes treatment plan is working. The lower your A1C is, the lower your chance of having health problems.

If your result is more than 8 percent, you may need a change in your diabetes plan. Your health care team can help you decide what part of your plan to change. You may need to change your meal plan, your diabetes medicines, or your physical activity plan.

What should my blood pressure be?

Normal blood pressure will help prevent damage to your eyes, kidneys, heart, and blood vessels. Blood pressure is written with two numbers separated by a slash. For example, 120/70 is said as “120 over 70.” The first number should be below 130 and the second number should be below 80. Keep your blood pressure as close to these numbers as you can. If you already have kidney disease, ask your doctor what numbers are best for you.

Meal planning, medicines, and physical activity can help you reach your blood pressure target.

Have your blood pressure

What should my cholesterol be?

Normal cholesterol and blood fat levels will help prevent heart disease and stroke, the biggest health problems for people with diabetes. Keeping cholesterol levels under control can also help with blood flow. Have your blood fat levels checked at least once a year. Meal planning, physical activity, and medicines can help you reach your cholesterol targets:

What does smoking have to do with diabetes problems?

Smoking and diabetes are a dangerous combination. Smoking raises your risk for diabetes problems. If you quit smoking, you'll lower your risk for heart attack, stroke, nerve disease, and kidney disease. Your cholesterol and your blood pressure levels may improve. Your blood circulation will also improve.

If you smoke, ask your health care provider for help in quitting.

What else can I do to prevent diabetes problems?

Check your feet each day to keep them healthy.

There are other things that you can do either each day or one or more times a year to prevent diabetes problems. For example, to keep your feet healthy, check them each day. Ask your health care team whether you should take a low dose aspirin every day to lower your risk for heart disease. To keep your eyes healthy, visit an eye care professional once a year for a complete eye examination that includes using drops in your eyes to dilate the pupils.

Once a year, your urine should be tested for protein. At least once a year, your blood creatinine level should be checked. Also once a year, your health care provider should do a complete foot exam. See Things to Do Every Day for Good Diabetes Care for what you can do each day to stay healthy with diabetes. See Things for Your Health Care Provider to Look at Every Time You Have a Checkup for other things for your health care provider to check for good diabetes care.

Things to Check for Good Diabetes Care

Taking care of diabetes is a team effort between you and your health care team (doctor, diabetes nurse educator, diabetes dietitian educator, pharmacist, and others). You are the most important member of the team.

Take charge of your diabetes by learning what to do for good diabetes care:

• Things to do every day for good diabetes care
  
  
• Things for your health care provider to look at every time you have a checkup
  
  
• Things for you or your health care provider to do at least once or twice a year
  
  

Keep a daily record of blood glucose check results. (Make copies of the Daily Diabetes Record page.) This information will help you see whether you are reaching your blood glucose goals.

You can prevent or slow down diabetes problems by reaching your blood glucose, blood pressure, and cholesterol goals most of the time.

Things to Do Every Day for Good Diabetes Care

	Follow the healthy eating plan that you and your doctor or dietitian have worked out.
	Be active a total of 30 minutes most days. Ask your doctor what activities are best for you.
	Take your medicines as directed.
	Check your blood glucose every day. Each time you check your blood glucose, write the number in your record book.
	Check your feet every day for cuts, blisters, sores, swelling, redness, or sore toenails.
	Brush and floss your teeth every day.
	Control your blood pressure and cholesterol.
	Don't smoke.

Things for Your Health Care Provider to Look at Every Time You Have a Checkup

Things for You or Your Health Care Provider to Do at Least Once or Twice a Year

These test results will help you plan how to prevent heart attack and stroke.

How to Use the Daily Diabetes Record Page

Use copies of the record page to keep track of blood glucose checks, medicines, and notes about things that affect your blood glucose. Make one copy of the record page for each week. This record will help you see whether your diabetes plan is working. Review your record with your health care providers.

Blood Glucose Checks

Talk with your health care provider and decide on the best times to check blood glucose. You may be checking blood glucose before meals, after meals, or at bedtime. Write down your results.

If needed, draw a line in the boxes under "Breakfast," "Lunch," and "Dinner" to make room for blood glucose check results before and after a meal, like this example:

See "What should my blood glucose numbers be?" for information about target blood glucose levels.

Medicines

Under the heading marked "Medicine," write the name of your diabetes medicines and the amounts taken.

Notes

Write down things that affect your blood glucose level. Some examples are

• eating more or less than usual
  
  
• forgetting to take your diabetes medicine
  
  
• exercising (write down what kind and for how long)
  
  
• being sick or upset about something (being under stress)
  
  
• going to a social event or other special event, or being on vacation

Daily Diabetes Record Page

View and print a daily diabetes record page.

My Health Care Provider Team Members

Print out this chart and record names, addresses, and phone numbers.

For More Information

Diabetes Teachers (nurses, dietitians, pharmacists, and other health professionals)

To find a diabetes teacher near you, call the American Association of Diabetes Educators toll-free at 1–800–TEAMUP4 (1–800–832–6874), or look on the Internet at http://www.diabeteseducator.org/ and click on "Find an Educator."

Dietitians

To find a dietitian near you, call the American Dietetic Association toll-free at 1–800–366–1655, or look on the Internet at http://www.eatright.org/ and click on "Find a Nutrition Professional."

To get more information about taking care of diabetes, contact

National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892–3560
Phone: 1–800–860–8747
Fax: 703–738–4929
Email: ndic@info.niddk.nih.gov
Internet: http://www.diabetes.niddk.nih.gov/

National Diabetes Education Program
1 Diabetes Way
Bethesda, MD 20892–3600
Phone: 1–800–438–5383
Fax: 703–738–4929
Internet: http://ndep.nih.gov/

American Diabetes Association
1701 North Beauregard Street
Alexandria, VA 22311
Phone: 1–800–342–2383
Internet: http://www.diabetes.org/

Juvenile Diabetes Research Foundation International
120 Wall Street
New York, NY 10005–4001
Phone: 1–800–533–2873
Internet: http://www.jdrf.org/

More in the Series

The "Prevent Diabetes Problems" series includes seven booklets that can help you learn more about how to prevent diabetes problems.

• Keep Your Diabetes Under Control
• Keep Your Eyes Healthy
• Keep Your Feet and Skin Healthy
• Keep Your Heart and Blood Vessels Healthy
• Keep Your Kidneys Healthy
• Keep Your Nervous System Healthy
• Keep Your Teeth and Gums Healthy

For free single copies of these booklets, write, call, fax, or email the

National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892–3560
Phone: 1–800–860–8747
Fax: 703–738–4929
Email: http://www.diabetes.niddk.nih.gov/about/contact.htm

These booklets are also available at http://www.diabetes.niddk.nih.gov/ on the Internet.

Acknowledgments

The National Diabetes Information Clearinghouse thanks the people who helped review or field-test this publication.

For American Association of Diabetes Educators
Lynn Grieger, R.D., C.D.E.
Arlington, VT
Celia Levesque, R.N., C.D.E.
Montgomery, AL
Teresa McMahon, Pharm.D., C.D.E.
Seattle, WA
Barbara Schreiner, R.N., M.N., C.D.E.
Galveston, TX

For American Diabetes Association
Phyllis Barrier, M.S., R.D., C.D.E.
Alexandria, VA
Linda Haas, Ph.C., R.N., C.D.E.
Seattle, WA
Kathleen Mahoney, M.S.N., R.N., C.D.E.
Drexel Hill, PA
Randi Kington, M.S., R.N., C.S., C.D.E.
Hartford, CT

For Centers for Medicare & Medicaid Services
Baltimore, MD
Jan Drass, R.N., C.D.E.

For Diabetes Research and Training Centers
Albert Einstein School of Medicine Norwalk Hospital
Norwalk, CT
Jill Ely, R.N., C.D.E.
Sam Engel, M.D.
Pam Howard, A.P.R.N., C.D.E.

Indiana University School of Medicine
Indianapolis, IN
Madelyn Wheeler, M.S., R.D., F.A.D.A., C.D.E.

VA/JDF Diabetes Research Center
Vanderbilt School of Medicine
Nashville, TN
Ok Chon Allison, M.S.N., R.N.C.S., A.N.P., C.D.E.
Barbara Backer, B.S.
James W. Pichert, Ph.D.
Alvin Powers, M.D.
Melissa E. Schweikhart
Michael B. Smith
Kathleen Wolffe, R.N.

For Grady Health System Diabetes Clinic
Atlanta, GA
Ernestine Baker, R.N., F.N.P., C.D.E.
Kris Ernst, R.N., C.D.E.
Margaret Fowke, R.D., L.D.
Kay Mann, R.N., C.D.E.

For Indian Health Service
Albuquerque, NM
Ruth Bear, R.D., C.D.E.
Dorinda Bradley, R.N., C.D.E.
Terry Fisher, R.N.
Lorraine Valdez, R.N., C.D.E.

Red Lake, MN
Charmaine Branchaud, B.S.N., R.N., C.D.E.

For Medlantic Research Center
Washington, DC
Resa Levetan, M.D.

For Texas Diabetes Council
Texas Department of Health
Austin, TX
Luby Garza-Abijaoude, M.S., R.D., L.D.

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National Diabetes Information Clearinghouse

1 Information Way
Bethesda, MD 20892–3560
Email: http://www.diabetes.niddk.nih.gov/about/contact.htm

The National Diabetes Information Clearinghouse (NDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1978, the Clearinghouse provides information about diabetes to people with diabetes and to their families, health care professionals, and the public. The NDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about diabetes.

Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts.

This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.

NIH Publication No. 06–4349
March 2006

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