Maxy sez : Diabetes by the Numbers

By Jennifer Acosta Scott Reviewed by Farrokh Sohrabi, MD

Staying healthy with type 2 diabetes is a numbers game. Get the scoop on the health indicators you should be measuring and why.
When you have type 2 diabetes, you’ve got to know your numbers. It’s not just about blood sugar. To successfully manage diabetes, there are several measurements that you should take, or have taken, on a regular basis. Keeping track of the following numbers can help you live well with type 2 diabetes and lower your risk of complications.

Blood sugar levels. This is probably the type 2 diabetes measure you’re most familiar with. Testing your blood sugar regularly allows you to see how certain foods, exercise, and other activities affect your blood sugar levels on a day-to-day basis. Many people with type 2 diabetes need to test once or twice a day to make sure blood sugar levels are in target range. If your blood sugar is very well controlled, you may only need to check a few times a week, according to the National Institutes of Health.

The American Diabetes Association recommends aiming for a blood sugar level between 70 to 130 mg/dl before meals and less than 180 mg/dl one to two hours after a meal. To keep your blood sugar within this range, follow a healthy, well-rounded diet and eat meals and snacks on a consistent schedule. If your blood sugar is not well controlled, talk to your doctor about adjusting your diabetes management plan.

A1C level. This is a blood test, typically given at doctor's appointments, that measures your average blood sugar levels over a longer period. “It gives you a picture of what’s been going on over the past two to three months,” says Dawn Sherr, RD, a certified diabetes educator and spokesperson for the American Association of Diabetes Educators. Essentially, your A1C result shows how well your diabetes treatment plan is working.

Depending on your results, you may need to have the test from two to four times a year. For most people, an A1C level of 7 percent or less is ideal. If your A1C level is higher, you and your doctor may discuss making changes to your diabetes treatment plan. Healthy lifestyle practices, like consistent blood sugar control and regular physical activity, can help keep your A1C levels low.

Blood pressure. Monitoring your blood pressure is another important way to maintain your health. “People with diabetes are more likely to develop heart disease, and blood pressure is a big factor in that,” Sherr says.

Your blood pressure should be checked several times a year — ideally, every time you see the doctor who is treating your diabetes, Sherr says. Most people with diabetes should aim for a blood pressure of less than 140/80. To prevent high blood pressure, cut back on salt in your diet, exercise regularly, and quit smoking. Some people with type 2 diabetes may need to take medications to lower their blood pressure.

Cholesterol. This is a substance in your body with two components. Low-density lipoprotein (LDL) is known as bad cholesterol; it can build up in your arteries and contribute to heart disease. High-density lipoprotein (HDL) is called the good cholesterol and has a protective effect on your arteries. Your doctor will perform a blood test once a year to check your cholesterol levels, though you may have it checked more often if your numbers are high, Sherr says.

A test result of less than 100 mg/dl of LDL cholesterol is ideal, while HDL cholesterol should be above 40 mg/dl for men and 50 mg/dl for women. Triglycerides, a type of blood fat that can increase your risk of heart disease, should be less than 150 mg/dl for both men and women. If your cholesterol levels are outside these ranges, you can improve them by losing excess weight, exercising, and eating a healthy diet that’s rich in fresh produce and low in fat.

BMI. Short for body mass index, this is a measure that uses your height and weight to estimate how much body fat you have. Since managing weight plays a role in controlling type 2 diabetes, a healthy BMI is important.

Your doctor will probably review your BMI annually, but you can also calculate it yourself by dividing your weight in pounds by your height in inches squared, and then multiplying that number by 703. Online calculators are also available to do the math for you. A healthy BMI ranges from 18.5 to 24.9 — anything over that is considered overweight, and a BMI over 30 is considered obese.

However, the measurement may not be accurate for some people, such as those with a large amount of muscle. “The BMI score can sometimes be deceiving and not the best way to look at the health effects of someone’s weight,” says Fernando Ovalle, MD, an endocrinologist and professor of medicine at University of Alabama at Birmingham College of Medicine. In these cases, other measurements may be used, such as waist-to-hip ratio and abdominal circumference.

Microalbumin. This test measures the amount of protein, or albumin, in your urine, which helps your doctor know how well your kidneys are working. Your doctor should administer this test at least once a year.

The test compares the level of albumin with the level of creatinine, a waste product. Your albumin-to-creatinine ratio should be less than 30, according to the National Institute of Diabetes and Digestive and Kidney Diseases. To keep your microalbumin results within a healthy range, it’s important to keep your kidneys healthy. High blood pressure and high blood sugar can both damage your kidneys, so controlling those factors will go a long way toward preventing kidney problems — and many other health problems — in the future.