Prevent Diabetes Problems: Keep Your Diabetes Under Control
On this page:
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.
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Be active to prevent diabetes problems.
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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.
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What should my blood glucose numbers be?
Keeping your blood glucose on target will prevent or delay diabetes problems.
For most people, target blood glucose levels are
Before meals |
90 to 130
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1 to 2 hours after the start of a meal |
Less than 180
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Talk with your health care provider about what your blood
glucose numbers should be. Print out this chart and record them.
Before meals |
______ to ______
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1 to 2 hours after the start of a meal |
Less than______
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You and your health care provider will agree on 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. 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 health care appointments so you can talk about reaching your glucose goals.
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How can I find out what my average blood glucose is?
Ask your health care provider to do an 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 as good as it should be, your health care provider will do this test more often to see if it 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 getting eye, nerve, and kidney damage.
If your test result is more than 8 percent, you 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 exercise plan.
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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. 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, you may want even lower blood pressure to protect your kidneys.
Meal planning, medicines, and exercise can help you reach your blood pressure target.
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Have your blood pressure
checked at every visit.
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What should my cholesterol be?
Normal cholesterol 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 cholesterol level checked at least once a year. Meal planning, exercise, and medicines can help you reach your cholesterol targets:
Total cholesterol
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under 200
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LDL cholesterol
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under 100
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HDL cholesterol
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above 40 (men)
above 50 (women)
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Triglycerides
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under 150
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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.
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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 an aspirin every day to lower your risk for heart disease. To keep your eyes healthy, visit an eye doctor 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. 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 to check for good diabetes care.
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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:
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.
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Follow the healthy eating plan that you and your doctor or dietitian have worked out. |
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Be active a total of 30 minutes most days. Ask your doctor what activities are best for you. |
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Take your diabetes medicines at the same times each day. |
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Check your blood glucose every day. Each time you check your blood glucose, write the number in your record book. |
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Check your feet every day for cuts, blisters, sores, swelling, redness, or sore toenails. |
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Brush and floss your teeth and gums every day. |
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Don't smoke. |
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Things for Your Health Care Provider to Look at Every Time You Have a Checkup
Your blood glucose records |
Show your records to your health care provider. Tell your health care provider if you often have hypoglycemia (low blood glucose) or high blood glucose. |
Your weight |
Talk with your health care provider about how much you should weigh. Talk about ways to reach your goal that will work for you. |
Your blood pressure |
The goal for most people with diabetes is less than 130/80. Ask your health care provider about ways to reach your goal. |
Your diabetes medicines plan |
Talk to your health care provider about any problems you have had with your diabetes medicines. |
Your feet |
Ask your health care provider to check your feet for sores. |
Your plan for exercise |
Talk with your health care provider about what you do to stay active. |
Your meal plan |
Talk about what you eat, how much you eat, and when you eat. |
Your feelings |
Ask your health care provider about ways to handle stress. If you are feeling sad or unable to cope with problems, ask about how to get help. |
Your smoking |
If you smoke, talk with your health care provider about how you can quit. |
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Things for You or Your Health Care Provider to Do at Least Once or Twice a Year
A1C test |
Have this blood test at least twice a year (See "How can I find out what my average blood glucose is?") Your result will tell you what your average blood glucose level was for the past 2 to 3 months. |
Blood lipid (fats) lab tests |
Get a blood test to check your
- total cholesterol--aim for under 200
- LDL--aim for under 100
- HDL--men: aim for above 40; women: aim for above 50
- triglycerides--aim for under 150
These test results will help you plan how to prevent heart attack and stroke.
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Kidney function tests |
Ask for tests to check your urine for protein. The results
will tell you how well your kidneys are working. |
Dilated eye exam |
See your eye doctor once a year for a complete eye exam. |
Dental exam |
See your dentist twice a year for a cleaning and checkup. |
Flu shot |
Get a flu shot each year. |
Foot exam |
Ask your health care provider to check your feet
to make sure your foot nerves and your blood circulation are
OK. |
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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.
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Name and Address |
Phone Number |
Doctor
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Diabetes Dietitian Educator
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Diabetes Nurse Educator
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Eye Doctor
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Dentist
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Foot Doctor
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Pharmacist
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Counselor
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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 www.diabeteseducator.org
and click on "Find a Diabetes 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 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 or (301) 654-3327
Fax: (301) 907-8906
Email: ndic@info.niddk.nih.gov
Internet: www.diabetes.niddk.nih.gov
National Diabetes Education Program
1 Diabetes Way
Bethesda, MD 20892-3600
Phone: 1-800-438-5383
Fax: (301) 907-8906
Internet: http://ndep.nih.gov
American Diabetes Association
1701 North Beauregard Street
Alexandria, VA 22311
Phone: 1-800-342-2383
Internet: www.diabetes.org
Juvenile Diabetes Research Foundation International
120 Wall Street
New York, NY 10005-4001
Phone: 1-800-533-2873
Internet: www.jdrf.org
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More in the Series
The "Prevent Diabetes
Problems" series includes seven booklets that can help
you learn more about how to prevent diabetes problems.
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 or (301) 654-3327
Fax: (301) 907-8906
Email: ndic@info.niddk.nih.gov
These booklets are also available at www.diabetes.niddk.nih.gov
on the Internet.
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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: ndic@info.niddk.nih.gov
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 under 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. 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 e-text is not copyrighted. The clearinghouse encourages users of
this e-pub to duplicate and distribute as many copies as desired.
NIH Publication No. 03-4349
September 2003
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