Know Your Numbers — ABCs of Diabetes

Knowing your numbers is an important part of managing diabetes and understanding your diabetes symptoms. While your daily blood sugar results may come to mind first, there are other numbers to familiarize yourself with, which are sometimes referred to as the ABC's of diabetes. 

Keeping track of these important health numbers can help to lower your risk of serious complications. They are:

• A1C (HbA1c)
• Blood pressure
• Cholesterol 

Here’s a helpful breakdown of what numbers matter most, what your numbers should be, and what they mean as part of your treatment plan.
 

Checking your blood sugar levels on a daily basis can help you see how well you’re managing your diabetes, which can potentially lower your risk of developing more serious health problems. It can also show you what is making your daily blood sugar levels go up or down. For example, you may notice that they decrease when you’re more active, or increase when you eat certain foods or feel stressed.

In order to check your blood sugar levels and get an accurate reading, you’ll need to use a blood glucose meter.

The American Diabetes Association suggests the following targets for most nonpregnant adults with diabetes:¹

• Before a meal (preprandial plasma glucose): 80–130 mg/dL
• 1-2 hours after beginning of the meal (postprandial plasma glucose): Less than 180 mg/dL

Keep in mind that blood glucose targets are individualized, so a more or less stringent glycemic goal may be appropriate for you. Work with your health care team to find a personalized target goal that works best for you and your body.

If you’re wondering what A1c is or what your results are used for, here’s a simple explanation: A1c tests are performed by your doctor during your regular visits, and measure your average blood sugar levels by taking a sample of hemoglobin A1c cells—a component of your red blood cells. 

The results, which are reported as a percentage, can be used to diagnose diabetes or gauge the efficacy of your treatment plan as it provides an overall picture of your average blood glucose level over the past 2 to 4 months.²

Your doctor may refer to this test by another name, such as the: 

• HbA1c test
• Hemoglobin A1c test
• Glycated hemoglobin test
• Glycosylated hemoglobin test

Here are a few important things to know about A1c tests and results:

• The ADA recommends an A1c test at least 2 times a year for those who are in good control. For those who have changed their therapy or who are not in good control and not meeting glycemic goals, an A1c test is recommended quarterly. Your doctor will help you decide what's right for you.²
• For most adults with diabetes, the A1c target level is 7% or lower — which corresponds to an estimated average blood sugar of 154 mg/dL.²
• When it comes to the numbers, there's no one-size-fits-all target. A1C target levels can vary by each person's age and other factors, and your target may be different from someone else's.Talk to your doctor about the right goal for you.²

The only way to get a complete picture of your blood sugar control is by reviewing your day-to-day self-checks along with your regular A1c tests, and working closely with your healthcare team to interpret the results. Learn more about calculating your A1c levels.

You’ve probably had your blood pressure taken at a doctor’s visit, but you might not know what is actually being measured. When the health care professional shares your blood pressure numbers, it represents the force at which blood is pumping through your arteries when your heart beats, in the following format:³

• Systolic pressure: The first or top number, which represents the pressure as your heart beats and pushes blood through the vessels.
• Diastolic pressure: The second or bottom number, which represents the pressure when the vessels relax between heartbeats.

The American Diabetes Association suggests the following interpretation of results:³

• Healthy blood pressure: below 120/80
• Early high blood pressure: between 120/80 and 130/80
• High blood pressure: 130/80 or higher

High blood pressure is a “silent,” but prevalent problem within the diabetes community– people with diabetes are twice as likely to have high blood pressure, but they may not even know they have it unless they’ve been checked for it.⁴ On top of that, when left untreated, high blood pressure can increase the risk of heart attack, stroke, eye problems, and kidney disease– it will not simply go away on its own.³ That is why, as a person with diabetes, it is important to have your blood pressure checked at each regular doctor visit, and ensure you’re not at risk of developing additional complications. 

People with diabetes tend to have lower “good” (HDL) cholesterol levels and higher “bad” (LDL) cholesterol levels, which increases the risk for heart disease and stroke.⁵ That is why your doctor might recommend that you have a cholesterol test (also called a lipid panel or lipid profile) regularly. This test measures the amount of several types of fats in your blood:

• Low-density-lipoprotein (LDL) cholesterol or "bad" cholesterol:  High LDL cholesterol levels can lead to plaque buildup in your arteries, increasing your risk of heart disease or stroke.⁶
• High-density lipoprotein (HDL) or “good” cholesterol: HDL cholesterol absorbs “bad” cholesterol in the blood and carries it back to the liver. The liver then flushes it from the body. High levels of HDL cholesterol can lower your risk for heart disease and stroke, while low levels can do the opposite.⁶
• Triglycerides: The most common type of fat in your blood. High triglyceride levels combined with low HDL (“good”) cholesterol or high LDL (“bad”) cholesterol levels can cause a buildup of fatty deposits in the artery walls, increasing the risk for heart attack, peripheral artery disease (PAD) and stroke.⁵
• Total cholesterol: The total amount of cholesterol in your blood based on your HDL, LDL, and triglycerides numbers.⁷

Like high blood pressure, high cholesterol is another risk factor for heart disease that people with diabetes should keep an eye on. Talk with your doctor about your health history and how often you need to have your cholesterol checked to prevent complications and stay on track.

Now that you know your diabetes numbers, these tips can help you take the next steps  toward making informed decisions about your health:

• Keep your diabetes numbers in one location (like an app on your phone or in a journal).
• Talk to your healthcare team about your personalized numbers and target goals and work together to meet them.
• Build healthy habits that will make a difference, from following treatment plans and eating well, to getting more active. 
• Surround yourself with a strong support team full of the people in your life who are dedicated to your success. They can help you stay motivated as you work toward your goals.

Sources:

1. American Diabetes Association https://diabetes.org/living-with-diabetes/treatment-care/checking-your-blood-sugar Accessed October 24, 2023.
2. American Diabetes Association https://diabetes.org/about-diabetes/a1c Accessed October 24, 2023. 
3. American Diabetes Association https://diabetes.org/about-diabetes/complications/high-blood-pressure Accessed October 24, 2023 
4. Petrie, J. R., Guzik, T. J., & Touyz, R. M. (2018). Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms. The Canadian journal of cardiology, 34(5), 575–584. https://doi.org/10.1016/j.cjca.2017.12.005 Accessed October 24, 2023.
5. American Heart Association https://www.heart.org/en/health-topics/diabetes/diabetes-complications-and-risks/cholesterol-abnormalities--diabetes Accessed October 24, 2023.
6. Centers for Disease Control and Prevention https://www.cdc.gov/cholesterol/ldl_hdl.htm Accessed October 24, 2023.
7. Centers for Disease Control and Prevention https://www.cdc.gov/cholesterol/cholesterol_screening.htm Accessed October 24, 2023.