Know Your Diabetes ABCs – A1C, Blood Pressure and Cholesterol

Talk to your health care team about how to manage your A1C (blood glucose or sugar), Blood pressure, and Cholesterol. This will help lower your chances of having a heart attack, a stroke, or other diabetes problems. Here’s what the ABCs of diabetes stand for:

A for the A1C test

The A1C Test shows you what your blood glucose has been over the last three months. The A1C goal for many people is below 7. High blood glucose levels can harm your heart and blood vessels, kidneys, feet, and eyes.

B for Blood pressure.

The blood pressure goal for most people with diabetes is below 140/90. It may be different for you. Ask what your goal should be.

High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.

C for Cholesterol.

Ask what your cholesterol numbers should be.

LDL or “bad” cholesterol can build up and clog your blood vessels. It can cause a heart attack or a stroke. HDL or “good” cholesterol helps remove cholesterol from your blood vessels.

Actions you could take:

  • Ask your health care team:
    • What your A1C, blood pressure, and Cholesterol numbers are
    • What should your ABC numbers should be
    • What you can do to reach your targets

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Diabetes and heart health

To protect your heart and blood vessels, eat right, get physical activity, don’t smoke, and maintain healthy blood glucose, blood pressure, and cholesterol levels. Choose a healthy diet, low in salt. Work with a dietitian to plan healthy meals. If you’re overweight, talk about how to safely lose weight. Ask about a physical activity or exercise program. Quit smoking if you currently do. Get a hemoglobin A1C test at least twice a year to determine what your average blood glucose level was for the past 2 to 3 months. Get your blood pressure checked at every doctor’s visit, and get your cholesterol checked at least once a year. Take medications if prescribed by your doctor.

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How to manage your diabetes?

 

Healthy eating, physical activity, and insulin injections are the basic therapies for type 1 diabetes. The amount of insulin taken must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose testing.

Healthy eating, physical activity, and blood glucose testing are the basic therapies for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication, insulin, or both to control their blood glucose levels.

People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high.

People with diabetes should see a health care provider who will monitor their diabetes control and help them learn to manage their diabetes. In addition, people with diabetes may see endocrinologists, who may specialize in diabetes care; ophthalmologists for eye examinations; podiatrists for routine foot care; and dietitians and diabetes educators who teach the skills needed for daily diabetes management.

 

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Type 2 Diabetes

A diagnosis of type 2 diabetes can be unexpected for many, it brings doubts, fears and there is no better way to start this path other than knowing the correct information. Learning about your health condition will give you the necessary tools to have an active role in your healthcare.

We have compiled a list of valuable information, to help you in the learning process.

 

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Why do I need to know my blood sugar numbers?

Your blood sugar numbers show how well your diabetes is managed. And managing your diabetes means that you have less chance of having serious health problems, such as kidney disease and vision loss.

As you check your blood sugar, you can see what makes your numbers go up and down. For example, you may see that when you are stressed or eat certain foods, your numbers go up. And, you may see that when you take your medicine and are active, your numbers go down. This information lets you know what is working for you and what needs to change.

How is blood sugar measured?

There are two ways to measure blood sugar.

Blood sugar checks that you do yourself. These tell you what your blood sugar level is at the time you test.

The A1C (A-one-C) is a test done in a lab or at your provider’s office. This test tells you your average blood sugar level over the past 2 to 3 months.

How do I check my blood sugar?

You use a blood glucose meter to check your blood sugar. This device uses a small drop of blood from your finger to measure your blood sugar level. You can get the meter and supplies in a drugstore or by mail.

What are target blood sugar levels for people with diabetes?

A target is something that you aim for or try to reach. Your health care team may also use the term goal. People with diabetes have blood sugar targets that they try to reach at different times of the day. These targets are:

Right before your meal: 80 to 130

Two hours after the start of the meal: Below 180

Talk with your health care team about what blood sugar numbers are right for you.

How often should I check my blood sugar?

The number of times that you check your blood sugar will depend on the type of diabetes that you have and the type of medicine you take to treat your diabetes. For example, people who take insulin may need to check more often than people who do not take insulin.

The common times for checking your blood sugar are when you first wake up (fasting), before a meal, 2 hours after a meal, and at bedtime. Talk with your health care team about what times are best for you to check your blood sugar.

What should I do if my blood sugar gets too high?

High blood sugar is also called hyperglycemia (pronounced hye-per-gly-see-mee-uh). It means that your blood sugar level is higher than your target level or over 180. Having high blood sugar levels over time can lead to long-term, serious health problems.

If you feel very tired, thirsty, have blurry vision, or need to pee more often, your blood sugar may be high.

Call your health care team if your blood sugar is high more than 3 times in 2 weeks and you don’t know why.

What should I do if my blood sugar gets too low?

Low blood sugar is also called hypoglycemia (pronounced hye-poh-gly-see-mee-uh). It means your blood sugar level drops below 70. Having low blood sugar is dangerous and needs to be treated right away. Anyone with diabetes can have low blood sugar. You have a greater chance of having low blood sugar if you take insulin or certain pills for diabetes.

Carry supplies for treating low blood sugar with you. If you feel shaky, sweaty, or very hungry, check your blood sugar. Even if you feel none of these things, but think you may have low blood sugar, check it.

If your meter shows that your blood sugar is lower than 70, do one of the following things right away:

  • chew 4 glucose tablets
  • drink 4 ounces of fruit juice
  • drink 4 ounces of regular soda, not diet soda or
  • chew 4 pieces of hard candy

After taking one of these treatments, wait for 15 minutes, then check your blood sugar again. Repeat these steps until your blood sugar is 70 or above. After your blood sugar gets back up to 70 or more, eat a snack if your next meal is 1 hour or more away.

If you often have low blood sugar, check your blood sugar before driving and treat it if it is low.

What do I need to know about the A1C test?

The A1C test tells you and your healthcare team your average blood sugar level over the past 2 to 3 months. It also helps you and your team decide the type and amount of diabetes medicine you need.

What is a good A1C goal for me?

For many people with diabetes, the A1C goal is below 7. This number is different from the blood sugar numbers that you check each day. You and your healthcare team will decide on an A1C goal that is right for you.

How often do I need an A1C test?

You need to get an A1C test at least 2 times a year. You need it more often if:

  • your number is higher than your goal number
  • your diabetes treatment changes

What if I have trouble getting to my blood sugar goals?

There may be times when you have trouble reaching your blood sugar goals. This does not mean that you have failed. It means that you and your health care team should see if changes are needed. Call your health care team if your blood sugar is often too high or too low. Taking action will help you be healthy today and in the future.

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What is Prediabetes?

 

Prediabetes is a condition in which blood glucose or A1C levels—which reflect average blood glucose levels—are higher than normal but not high enough for a diagnosis of diabetes. Prediabetes is becoming more common in the United States. The U.S. Department of Health and Human Services estimates that at least 86 million U.S. adults ages 20 or older had prediabetes in 2012.1 People with prediabetes are at increased risk of developing type 2 diabetes and CVD, which can lead to heart attack or stroke.

What are the symptoms of insulin resistance and prediabetes?

Insulin resistance and prediabetes usually have no symptoms. People may have one or both conditions for several years without knowing they have them. Even without symptoms, health care providers can identify people at high risk by their physical characteristics, also known as risk factors. The section “Who should be tested for prediabetes?” lists these risk factors.

People with a severe form of insulin resistance may have dark patches of skin, usually on the back of the neck. Sometimes people have a dark ring around their neck. Dark patches may also appear on elbows, knees, knuckles, and armpits. This condition is called acanthosis nigricans.

Who should be tested for prediabetes?

The American Diabetes Association (ADA) recommends that testing to detect prediabetes be considered in adults who are overweight or obese and have one or more additional risk factors for diabetes. The section “Body Mass Index (BMI)” explains how to determine if a person is overweight or obese. However, not everyone who is overweight will get type 2 diabetes. People without these risk factors should begin testing at age 45.

Risk factors for prediabetes—in addition to being overweight or obese or being age 45 or older—include the following:

  • being physically inactive
  • having a parent or sibling with diabetes
  • having a family background that is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American
  • giving birth to a baby weighing more than 9 pounds
  • being diagnosed with gestational diabetes—diabetes that develops only during pregnancy
  • having high blood pressure—140/90 mmHg or above—or being treated for high blood pressure
  • HDL cholesterol level below 35 mg/dL or a triglyceride level above 250 mg/dL
  • having polycystic ovary syndrome (PCOS)
  • having prediabetes, impaired fasting glucose (IFG), or impaired glucose tolerance (IGT) on an earlier testing
  • having other conditions associated with insulin resistance, such as obesity or acanthosis nigricans
  • having CVD

If test results are normal, testing should be repeated at least every 3 years. Testing is important for early diagnosis. Catching prediabetes early gives people time to change their lifestyle and prevent type 2 diabetes and CVD. Health care providers may recommend more frequent testing depending on initial results and risk status.

In addition to weight, the location of excess fat on the body can be important. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance and increases a person’s risk for type 2 diabetes. This is true even if a person’s BMI falls within the normal range.

How to Measure the Waist

To measure the waist, a person should

  • place a tape measure around the bare abdomen just above the hip bone
  • make sure the tape is snug but isn’t digging into the skin and is parallel to the floor
  • relax, exhale, and measure
Drawing of the side silhouettes of a man and a woman with a dotted line through their waists.
https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance

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How to help a loved one cope with diabetes

 

When people have the support of their family and friends, they are able to better manage their diabetes. It is a hard disease to handle alone. You can help your loved one cope with diabetes by showing your support.

Learn about diabetes.

There is a lot to learn about how people can live well with diabetes. Use what you learn to help your loved one manage his or her diabetes.

  • Helping a loved one cope with diabetes begins with talking.
  • Ask your loved one to teach you about how he or she is managing diabetes.
  • Join a support group – in person or online – about living with diabetes. Check with your hospital or area health clinic to find one.
  • Read about diabetes online.
  • Ask your loved one’s health care team how you can learn more about managing diabetes.
  • Ask your loved one about coping with diabetes and how you can help.

Here are sample questions:

  • Do you ever feel down or overwhelmed about all you have to do to manage your diabetes?
  • Have you set goals to manage your diabetes?
  • What things seem to get in the way of reaching your goals?
  • What can I do to help? (Example: Are there things I can do to make it easier for you to live with diabetes? If you want to be more active, will it help if we take walks together?)
  • Have you talked to your health care team about your diabetes care and how you want to reach your goals?

How you can help.

Try some of these tips to help your loved one.

  • Find ways to help your loved one manage the stress of living with diabetes. Being a good listener is often the most important thing you can do to help.
  • Ask your loved one if he or she would like reminders about doctor visits, when to check blood sugar, and when to take medicine.
  • Help your loved one write a list of questions for the health care team.
  • Eat well. Help your loved one make meals that include foods such as fruits, vegetables, and whole grains.
  • Find things you can do together such as walking, dancing, or gardening. Being active is a great way to handle stress.
  • Walking together daily gives you time to talk and stay active.
  • Cut back on sweets by serving fresh fruit for dessert.
https://www.niddk.nih.gov/health-information/health-communication-programs/ndep/ndep-health-topics/help-cope-diabetes/Pages/publicationdetail.aspx

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Diabetes symptoms

Individuals can experience different signs and symptoms of diabetes, and sometimes there may be no signs. Some of the signs commonly experienced include:

  • Frequent urination
  • Excessive thirst
  • Increased hunger
  • Weight loss
  • Tiredness
  • Lack of interest and concentration
  • A tingling sensation or numbness in the hands or feet
  • Blurred vision
  • Frequent infections
  • Slow-healing wounds
  • Vomiting and stomach pain (often mistaken as the flu)

The development of type 1 diabetes is usually sudden and dramatic while the symptoms can often be mild or absent in people with type 2 diabetes, making this type of diabetes hard to detect.

http://www.idf.org/signs-and-symptoms-diabetes

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Who is at risk of developing diabetes?

Type 1 diabetes risk factors: The risk factors for type 1 diabetes are still being researched. However, having a family member with type 1 diabetes slightly increases the risk of developing the disease. Environmental factors and exposure to some viral infections have also been linked to the risk of developing type 1 diabetes.

Type 2 diabetes risk factors: Several risk factors have been associated with type 2 diabetes and include:

  • Family history of diabetes
  • Overweight
  • Unhealthy diet
  • Physical inactivity
  • Increasing age
  • Having high blood pressure measuring 140/90 or higher
  • Having abnormal cholesterol with HDL (“good”) cholesterol is 35 or lower, or triglyceride level is 250 or higher.
  • Ethnicity (Being African American, American Indian, Asian American, Pacific Islander, or Hispanic American/Latino heritage.)
  • Impaired glucose tolerance (IGT)*
  • History of gestational diabetes
  • Poor nutrition during pregnancy

Impaired glucose tolerance (IGT) risks factors. This is a category of higher than normal blood glucose, but below the threshold for diagnosing diabetes. Changes in diet and physical activity related to rapid development and urbanization have led to sharp increases in the numbers of people developing diabetes.

Gestational diabetes risk factors. Pregnant women who are overweight, have been diagnosed with IGT, or have a family history of diabetes are all at increased risk of developing gestational diabetes mellitus. In addition, having been previously diagnosed with gestational diabetes or being of certain ethnic groups puts women at increased risk of developing GDM.

http://www.idf.org/about-diabetes/risk-factors

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What is diabetes? 

 

Diabetes is the condition in which the body does not properly process food for use as energy. Most of the food we eat turns into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn’t make insulin or not enough, or can’t use its own insulin as well as it should. This causes sugars to build up in your blood. If the Diabetes management is not the correct one, it can cause serious health complications including heart disease, blindness, kidney failure, others.1

Types of diabetes 

Type 1 diabetes: It is usually diagnosed in children and young adults. Only 5% of people with diabetes have this form of the disease. In type 1 diabetes, the body does not produce insulin. The body breaks down the sugars and starches you eat into a simple sugar called glucose, which it uses for energy. Insulin is a hormone that the body needs to get glucose from the bloodstream into the cells of the body. With the help of insulin therapy and other treatments, even young children can learn to manage their condition and live healthy.2

Type 2 diabetes: If you have type 2 diabetes your body does not use insulin properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for it. But, over time it isn’t able to keep up and can’t make enough insulin to keep your blood glucose at normal levels.3

Gestational diabetes: Gestational diabetes develops in 2 percent to 5 percent of all pregnancies but usually disappears when a pregnancy is over. Gestational diabetes occurs more frequently in African Americans, Hispanic/Latino Americans, American Indians, and people with a family history of diabetes than in other groups. Obesity is also associated with higher risk. Women who have had gestational diabetes are at increased risk of later developing Type 2 diabetes. In some studies, nearly 40 percent of women with a history of gestational diabetes developed diabetes in the future.4

LADA: LADA tends to develop more slowly than type 1 diabetes in childhood and, because LADA can sometimes appear similar to type 2 diabetes, doctors may mistakenly diagnose LADA as type 2 diabetes. It shows many of the genetic, immune, and metabolic features of Type 1 diabetes, and carries a high risk of progression to insulin dependency. This form of the condition is known as ‘latent autoimmune diabetes in adults’ (LADA). It is found in about 10% of initially non-insulin-requiring people with diabetes, and is therefore probably more prevalent than Type 1 diabetes.5

MODY: MODY is a rare form of diabetes which is different from both Type 1 and Type 2 diabetes, and runs strongly in families. MODY is caused by a mutation (or change) in a single gene. If a parent has this gene mutation, any child they have, has a 50% chance of inheriting it from them. If a child does inherit the mutation they will generally go on to develop MODY before they’re 25, whatever their weight, lifestyle, ethnic group, etc.6

1. https://www.cdc.gov/media/presskits/aahd/diabetes.pdf
2. http://www.diabetes.org/diabetes-basics/type-1/#sthash.nyczemvd.dpuf
3. http://www.diabetes.org/diabetes-basics/type-2/#sthash.kUsjZUuD.dpuf
4. cdc.gov
5. https://www.idf.org/sites/default/files/attachments/article_5_en.pdf
6. https://www.diabetes.org.uk/Diabetes-the-basics/Other-types-of-diabetes/MODY/

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Food Safety

If you have questions about food safety topics, call the USDA Meat & Poultry Hotline at 1-888MPHotline or chat live with a food safety specialist at AskKaren.gov. These services are available from 10:00 a.m. to 4:00 p.m. Eastern Time, Monday through Friday, in English and Spanish.

Basics for Handling Food Safely

Safe steps in food handling, cooking, and storage are essential to prevent foodborne illness. You can’t see, smell, or taste harmful bacteria that may cause illness. In every step of food preparation, follow the four steps of the Food Safe Families campaign to keep food safe:

  • Clean — Wash hands and surfaces often.
  • Separate — Don’t cross-contaminate.
  • Cook — Cook to the right temperature.
  • Chill — Refrigerate promptly.

Shopping

  • Purchase refrigerated or frozen items after selecting your non-perishables.
  • Never choose meat or poultry in packaging that is torn or leaking.
  • Do not buy food past “Sell-By,” “Use-By,” or other expiration dates.

Storage

  • Always refrigerate perishable food within 2 hours—1 hour when the temperature is above 90 °F (32.2 ºC).
  • Check the temperature of your refrigerator and freezer with an appliance thermometer. The refrigerator should be at 40 °F (4.4 ºC) or below and the freezer at 0 °F (-17.7 ºC) or below.
  • Cook or freeze fresh poultry, fish, ground meats, and variety meats within 2 days; other beef, veal, lamb, or pork, within 3 to 5 days.
  • Perishable food such as meat and poultry should be wrapped securely to maintain quality and to prevent meat juices from getting onto other food.
  • To maintain quality when freezing meat and poultry in its original package, wrap the package again with foil or plastic wrap that is recommended for the freezer.
  • Canned foods are safe indefinitely as long as they are not exposed to freezing temperatures, or temperatures above 90 °F. If the cans look ok, they are safe to use. Discard cans that are dented, rusted, or swollen. High-acid canned food (tomatoes, fruits) will keep their best quality for 12 to 18 months; low-acid canned food (meats, vegetables) for 2 to 5 years.

Preparation

  • Always wash hands with warm water and soap for 20 seconds before and after handling food.
  • Don’t cross-contaminate. Keep raw meat, poultry, fish, and their juices away from other food. After cutting raw meats, wash cutting board, utensils, and countertops with hot, soapy water.
  • Cutting boards, utensils, and countertops can be sanitized by using a solution of 1 tablespoon of unscented, liquid chlorine bleach in 1 gallon of water.
  • Marinate meat and poultry in a covered dish in the refrigerator.

Thawing

  • Refrigerator: The refrigerator allows slow, safe thawing. Make sure thawing meat and poultry juices do not drip onto other food.
  • Cold Water: For faster thawing, place food in a leak-proof plastic bag. Submerge in cold tap water. Change the water every 30 minutes. Cook immediately after thawing.
  • Microwave: Cook meat and poultry immediately after microwave thawing.

Cooking
Cook all raw beef, pork, lamb and veal steaks, chops, and roasts to a minimum internal temperature of 145 °F (62.8 ºC) as measured with a food thermometer before removing meat from the heat source. For safety and quality, allow meat to rest for at least three minutes before carving or consuming. For reasons of personal preference, consumers may choose to cook meat to higher temperatures.

Ground meats: Cook all raw ground beef, pork, lamb, and veal to an internal temperature of 160 °F (71.1 ºC) as measured with a food thermometer.

Poultry: Cook all poultry to an internal temperature of 165 °F (73.9 °C) as measured with a food thermometer.

Serving

  • Hot food should be held at 140 °F (60 °C) or warmer.
  • Cold food should be held at 40 °F (4.4 ºC) or colder.
  • When serving food at a buffet, keep food hot with chafing dishes, slow cookers, and warming trays. Keep food cold by nesting dishes in bowls of ice or use small serving trays and replace them often.
  • Perishable food should not be left out more than 2 hours at room temperature—1 hour when the temperature is above 90 °F (32.2 ºC).

Leftovers

  • Discard any food left out at room temperature for more than 2 hours—1 hour if the temperature was above 90 °F (32.2 ºC).
  • Place food into shallow containers and immediately put in the refrigerator or freezer for rapid cooling.
  • Use cooked leftovers within 4 days.
  • Reheat leftovers to 165 °F (73.9 °C).

Refreezing
Meat and poultry defrosted in the refrigerator may be refrozen before or after cooking. If thawed by other methods, cook before refreezing.

Cold Storage Chart

These short, but safe, time limits will help keep refrigerated food from spoiling or becoming dangerous to eat. Because freezing keeps food safe indefinitely, recommended storage times are for quality only.

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