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3 Diabetes Numbers That Are as Important as A1C

Even if your A1C is under control, these other numbers may signal that your health is at risk.

Medically reviewed in November 2021

Knowing your numbers is an important part of diabetes management. At the top of the list of numbers you need to know is your A1C, a blood test that shows how stable your blood glucose levels have been over the past 90 days.

A1C is used to set treatment goals, decide what type of treatment you need, and determine how well a treatment plan is working.

While different people will have different A1C goals, most will want to maintain an A1C below 7 percent. This can help avoid complications from diabetes, such as nerve damage and eye problems that can result in vision loss.

But A1C is not the only number important to diabetes management. People with type 2 diabetes are at an increased risk of cardiovascular disease and kidney disease—and the following tests can help monitor for these complications.

Blood pressure
Blood pressure is the force that circulating blood exerts on the walls of the blood vessels. When blood pressure is too high, it can damage the arteries and the heart.

High blood pressure (called hypertension) can also damage the blood vessels in the kidneys and eyes, contributing to diabetic kidney disease and macular degeneration, two possible complications of diabetes.

Ideally, blood pressure should be below 120/80. Your goal may be different based on individual factors. If your blood pressure is elevated, your healthcare provider can recommend ways to lower it. This may include changes to diet and lifestyle, as well as medications.

Cholesterol and triglycerides
Cholesterols are fats (or lipids) that circulate in the blood. Your body uses cholesterols to build cell membranes and a variety of other important substances—hormones, digestive acids, vitamins. There are two main types of cholesterol:

  • LDL, or low-density lipoprotein, is called the “bad cholesterol” because elevated levels contribute to the buildup of arterial plaque. The recommended levels are below 100mg for most men and women, but may be different based on cardiac risk factors.
  • HDL, or high-density lipoprotein, is called the “good cholesterol” because having higher levels of it reduces the risk of cardiovascular disease. HDL helps move LDL out of the blood. The desirable level is 60 mg or above.
  • Triglycerides are another type of blood fat, and levels should be below 150 mg.

If your cholesterol levels are not where they need to be, you may need to make additional lifestyle changes. Most people with type 2 diabetes will take a medication to control cholesterol.

Microalbuminuria test
This test checks for a protein (called albumin) in the urine and helps gauge your risk for kidney disease. Ideally there should be no protein in the urine—protein should stay in the bloodstream, and protein in the urine can be a sign of kidney damage.

Diabetic kidney disease may be treated with medications to lower blood pressure, cholesterol, and blood glucose, and medications to improve kidney function.

What you can do
Communicating with your healthcare provider and staying up to date on screening tests will help spot early warning signs of these serious diabetes complications.

In addition to the tests mentioned here, people with type 2 diabetes should see an eye doctor and have their feet checked by a healthcare provider. Eye problems and problems with the feet (such as ulcers and loss of feeling) are possible complications of type 2 diabetes.

Article sources open article sources

MedlinePlus. "A1C test."
National Institute of Diabetes and Digestive and Kidney Diseases. "The A1C Test & Diabetes."
American Heart Association. "Diabetes Complications and Risks."
Muhammad Abdul-Ghani, Ralph A. DeFronzo, et al. "Cardiovascular Disease and Type 2 Diabetes: Has the Dawn of a New Era Arrived?" Diabetes Care, 2017. Vol. 40, No. 7.
UpToDate. "Patient education: Diabetic kidney disease (Beyond the Basics)."
National Institute of Diabetes and Digestive and Kidney Diseases. "Diabetic Kidney Disease."
American Diabetes Association. "Diabetes and High Blood Pressure."
MedlinePlus. "High Blood Pressure."
UpToDate. "Patient education: High blood pressure in adults (Beyond the Basics)."
American Diabetes Association. "Introduction: Standards of Medical Care in Diabetes—2022." Diabetes Care, 2022. Vol. 45, Suppl. 1.
MedlinePlus. "Cholesterol Levels: What You Need to Know."
National Lipid Association. "2018 Guideline on the Management of Blood Cholesterol - NLA Perspective."
MedlinePlus. "Microalbuminuria test."
Mayo Clinic. "Diabetic nephropathy (kidney disease)."
MedlinePlus. "Diabetes tests and checkups."

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