Number

Prevent diabetes problems

in a
Series
of 7

Keep your diabetes

under control

National Diabetes Information

Clearinghouse

Prevent diabetes problems:

Keep your diabetes
under control

Contents

What are diabetes problems?................................. 1

Will I have diabetes problems? .............................. 1
What should my blood glucose numbers be? ....... 2
How can I find out what my average blood
glucose is? ................................................................ 3

What should my blood pressure be? ..................... 5

What should my cholesterol be?............................ 6

What does smoking have to do with diabetes

problems?................................................................. 7

What else can I do to prevent diabetes

problems?................................................................. 8

Things to Check for Good Diabetes Care ............ 9

How to Use the Daily Diabetes Record Page..... 14

Pronunciation Guide............................................. 19

For More Information .......................................... 20

More in the Series ................................................. 23

Acknowledgments ................................................. 24

What are diabetes problems?

Too much glucose* 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.

Will I have diabetes problems?

Maybe. You may have one or more diabetes
problems or none at all. 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.

*See page 19 for tips

on how to say the
words in bold type.

Be active to prevent
diabetes problems.

What should my blood glucose

numbers be?
Keeping your blood glucose on target can prevent
or delay diabetes problems. The chart below
shows target blood glucose levels for most people
with diabetes.
Target Blood Glucose Levels

for People with Diabetes

Before meals
70 to 130
1 to 2 hours after
the start of a meal

less than 180

Talk with your health care provider about what

your blood glucose numbers should be and write
them here:
My Target Blood Glucose Levels
Before meals
______ to ______
1 to 2 hours after

the start of a meal

less than _______

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.
2

Keep track of your blood glucose checks using

the record page in this booklet on pages 16 and
17. 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.

The A1C target for most people with diabetes is

below 7 percent. Ask your health care provider if
this target is right for you. Then write your A1C
target here:
My A1C target is ____________ percent.

If your A1C test result is on target, 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 too high, 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 Your A1C Result Means

My A1C Result My Average Blood Glucose

6% . . . . . . . . . . . . . . . . . 135

7% . . . . . . . . . . . . . . . . . 170

8% . . . . . . . . . . . . . . . . . 205

9% . . . . . . . . . . . . . . . . . 240

10% . . . . . . . . . . . . . . . . . 275

11% . . . . . . . . . . . . . . . . . 310

12% . . . . . . . . . . . . . . . . . 345

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 140 and the
second number should be below 80, unless your
doctor sets a different target for you. 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 checked
at every visit.

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 blood fat
targets:
Target Blood Fat Levels
for People with Diabetes
Total cholesterol
below 200

LDL cholesterol

below 100

HDL cholesterol

above 40 (men)
above 50 (women)

Triglycerides

below 150

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, youll 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?

You can do many things 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.

Check your feet each day

to keep them healthy.

Make sure your doctor

checks your urine for
protein every year. 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 page 10
for what you can do each
day to stay healthy with
diabetes. See pages 11
to 13 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 teamdoctor, 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

(see page 10)
things for your health care provider to look
at every time you have a checkup (see pages
11 and 12)
things for you or your health care provider
to do at least once or twice a year (see pages
12 and 13)

Keep a daily record of blood glucose check results.

Make copies of the Daily Diabetes Record on
pages 16 and 17 in this booklet. 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.
Dont smoke.

10

Things for Your Health Care Provider to Look

at Every Time You Have a Checkup
Your blood
Show your records to your
glucose records health care provider.
Tell your health care provider
if you often have 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 below 140/80.
Ask your health care provider
about ways to reach your goal.

Your
medicines

Talk with your health care

provider about any problems
you have had with your
medicines.

Your feet

Ask your health care provider

to check your feet for problems.

11

Your physical
activity plan

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.

Things for You or Your Health Care Provider

to Do at Least Once or Twice a Year
A1C test

12

Have this blood test at least

twice a year (see pages 3 and
4). 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 cholesterolaim for
below 200
LDLaim for below 100
HDLmen: aim for above 40;
women: aim for above 50
triglyceridesaim for
below 150

These test results will help you plan

how to prevent heart attack and stroke.
Kidney
function tests

Dilated eye
exam
Dental exam
Foot exam

Flu shot
Pneumonia
vaccine

Once a year, get a urine test to

check for protein. At least
once a year, get a blood test
to check for creatinine. The
results will tell you how well
your kidneys are working.
See an eye care professional
once a year for a complete
eye exam.
See your dentist twice a year
for a cleaning and checkup.
Ask your health care provider
to check your feet to make
sure your foot nerves and your
blood circulation are OK.
Get a flu shot each year.
Get one; if youre over 64 and
your shot was more than 5
years ago, get one more.
13

How to Use the Daily Diabetes

Record Page
Use copies of the record page on pages 16 and 17
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 provider.

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 when to check here:
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________

14

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 page 2 for information about target blood
glucose levels.

Medicines
Under the heading marked Medicine, write the
names 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

exercisingwrite down what kind and for

how long
being sick or upset about somethingbeing
under stress
going to a social event or other special event, or
being on vacation

15

Week Starting ___________

Daily Diabetes Record*

Other
blood
glucose

Breakfast Medicine
blood

glucose

Lunch
blood
glucose

Medicine Dinner

blood

glucose

Medicine

Bedtime
blood
glucose

Medicine

Notes:
(Special events, sick days, exercise)

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

*Keep this copy clean. Make photocopies and write on the copies.

16

17

My Health Care Team Members

Name and Address

Doctor

Diabetes
dietitian
educator
Diabetes
nurse
educator
Eye care
professional
Dentist

Foot doctor

Pharmacist

Counselor

18

Phone Number

Pronunciation Guide
A1C (AY-WUHN-SEE)
cholesterol (koh-LESS-tur-ol)
circulation (SUR-kyoo-LAY-shuhn)
creatinine (kree-AT-ih-neen)
glucose (GLOO-kohss)
triglycerides (try-GLISS-ur-eyedz)

19

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
18003383633, or look
on the Internet at www.
diabeteseducator.org and click
on Find a Diabetes Educator.
Dietitians
To find a dietitian near you, contact the Academy
of Nutrition and Dietetics at www.eatright.org and
click on Find a Registered Dietitian.

20

To get more information about taking care of

diabetes, contact
National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 208923560
Phone: 18008608747
TTY: 18665691162
Fax: 7037384929
Email: [email protected]
Internet: www.diabetes.niddk.nih.gov
National Diabetes Education Program
1 Diabetes Way
Bethesda, MD 208149692
Phone: 1888693NDEP (18886936337)
TTY: 18665691162
Fax: 7037384929
Email: [email protected]
Internet: www.ndep.nih.gov
www.yourdiabetesinfo.org

21

American Diabetes Association

1701 North Beauregard Street
Alexandria, VA 22311
Phone: 1800DIABETES (18003422383)
Email: [email protected]
Internet: www.diabetes.org
JDRF
26 Broadway, 14th Floor
New York, NY 10004
Phone: 1800 533CURE (18005332873)
Fax: 2127859595
Email: [email protected]
Internet: www.jdrf.org

22

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 208923560
Phone: 18008608747
TTY: 18665691162
Fax: 7037384929
Email: [email protected]
These booklets are also available at
www.diabetes.niddk.nih.gov on the Internet.
23

Acknowledgments
Publications produced by the Clearinghouse are
carefully reviewed by both NIDDK scientists
and outside experts. The National Diabetes
Information Clearinghouse thanks the people who
helped review or field-test the original version of
this publication:
For the 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 the 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 the Centers for
Medicare & Medicaid
Services
Baltimore, MD

Jan Drass, R.N., C.D.E.

24

For the 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 the 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 the 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 the Medlantic
Research Center
Washington, DC
Resa Levetan, M.D.
For the Texas Diabetes
Council
Texas Department of
Health
Austin, TX
Luby Garza-Abijaoude,
M.S., R.D., L.D.

National Diabetes Education Program

1 Diabetes Way
Bethesda, MD 208149692
Phone: 1888693NDEP (18886936337)
TTY: 18665691162
Fax: 7037384929
Email: [email protected]
Internet: www.ndep.nih.gov
www.yourdiabetesinfo.org
The National Diabetes Education Program is a
federally funded program sponsored by the U.S.
Department of Health and Human Services
National Institutes of Health and the Centers for
Disease Control and Prevention and includes over
200 partners at the federal, state, and local levels,
working together to reduce the morbidity and
mortality associated with diabetes.

25

National Diabetes
Information Clearinghouse
1 Information Way
Bethesda, MD 208923560
Phone: 1800 860 8747
TTY: 1866 5691162
Fax: 703 738 4929
Email: [email protected]
Internet: ww w.diabetes.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 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.

This publication is not copyrighted. The Clearinghouse

encourages users of this publication to duplicate and
distribute as many copies as desired.
This publication is available at www.diabetes.niddk.nih.gov.

This publication may contain information about medications and,

when taken as prescribed, the conditions they treat. When prepared,
this publication included the most current information available.
For updates or for questions about any medications, contact the
U.S. Food and Drug Administration toll-free at 1888INFOFDA
(18884636332) or visit www.fda.gov. Consult your health care
provider for more information.

NIH Publication No. 134349

August 2013
The NIDDK prints on recycled paper with bio-based ink.