The Numbers of Diabetes Management

By Eileen B. Wyner, NP
Bulfinch Medical Group

Sometimes I think missed my professional vocation. I should have been a Bingo caller in Las Vegas. A1c 7, LDL less than 100, Fasting Blood Sugar less than 110…do I have a winner? Some days, it seems that Diabetes management is all about the numbers. We know there’s so much more to it, but make no mistake the numbers are important. This post is going to focus on the numbers of cardiovascular health.

Cardiovascular disease (CVD) is a possible complication for people with Diabetes.  People with Diabetes are at least twice as likely to have a heart attack or stroke and tend to develop CVD at an earlier age.  Women of all ages who have Diabetes have an increased risk of developing CVD, and people with Diabetes who have already had one heart attack have a greater risk of having a second. But here’s the good news:  Diabetes that is well controlled helps lessen the development of CVD, and makes management easier if it does develop. 

That said there are certain CVD risk factors to be aware of.  These include a family history of heart attack or stroke, personal obesity, and smoking. In fact, smoking alone DOUBLES the risk for developing CVD.  The single best thing anyone who smokes can do for their health is stop smoking.

Knowledge of your blood pressure (BP) and cholesterol values is paramount to good Diabetes care.  It’s important to keep your BP under control to help prevent complications such as stroke, heart attack, and renal disease. It’s especially important to have your BP at goal if you have experienced any of those complications in order to prevent any further damage.  For a person with Diabetes, the goal value for blood pressure is less than or equal to 130/80 mmHg.  You should have your BP checked each time you visit your health care provider.  It’s also a good idea to have a home monitor so you can check your own BP weekly (you can work out the specifics with your provider). Also, it’s a good idea to bring your home BP cuff to a medical appointment so your provider can make sure it’s accurate and that you’re using the machine correctly. 

Lifestyle changes are very important to managing your BP, even if you’re at goal or taking medications to lower your BP.  Some examples of these changes include managing your weight, cutting down on your salt intake, and exercising regularly.  It can be difficult to reach and maintain a healthy BP with lifestyle changes alone, so it’s not uncommon to need medication (and perhaps two or more) to reach your BP goal. 

Along with BP, it’s important to be aware of your cholesterol values.  The goal for total cholesterol is less than 200.  Your HDL (“good” cholesterol) should be greater than 45; LDL (“bad” cholesterol) less than 100 (less than 70 IF you’ve had a heart attack) and triglycerides less than 150.  Your cholesterol will be monitored once or twice a year.  As with BP self-management, lifestyle changes are required for managing your cholesterol and you may be prescribed medication to help reach your goal values.

Regular physical activity will not only help your BP and cholesterol, but can help improve your overall Diabetes control. “Physical activity” doesn’t mean running a marathon, but it does mean moving more every day. Try to aim for 30 minutes of activity daily and remember that it doesn’t have to be continuous; little bits of activity throughout the day is sufficient. Try taking the stairs whenever possible instead of the escalator or elevator. Park your car far away from the entrance of your destination. When you’re shopping, walk all the aisles of the store. My new favorite suggestion comes from one of my patients: In the office, get up and walk to your colleagues and ask questions face-to-face instead of sending an email.

I want everyone to remember something about medications. They are often required to reach and maintain good control of your BP and LDL, but needing medication doesn’t mean you have failed in taking care of yourself or that your condition is deteriorating. It just means a little more help is needed to help you take care of your Diabetes.

So, what do you think? Are you ready to join in the numbers game of Diabetes?

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