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What are the ABCs of diabetes control?

William Lee Dubois
Endocrinology Diabetes & Metabolism
The ABCs are a catchy way of remembering the three common cornerstones of good diabetes control. A is for Average blood sugar, B is for Blood pressure, and C is for Cholesterol.

Average blood sugar can be estimated using a home glucose meter, but your doctor will order a special test called an A1C four times a year to see what your night and day average is. In some ABC lists you’ll see that A = A1C, rather than Average blood sugar, but they are one in the same. Your average target may vary with your age and other medical conditions but a typical goal is between 6.0 and 6.9, which roughly works out to night and day average range of 126 to 151 mg/dL. If you are elderly and have a heart condition, your doctor may give you a higher target.

Blood pressure is vitally important for both cardiovascular risk and because high blood pressure is hard on the kidneys, which are also at risk from elevated blood sugars. The normal target blood pressure for people with diabetes is less than 130/80 mmHg.

Cholesterol has been shown to be a major risk factor for heart attacks and strokes, so it is important for people with diabetes to control their cholesterol, especially the “bad” cholesterol, called LDL, to a much greater degree than is needed for non-diabetic people. The LDL target is between 70 and 100 (lower if other risk factors for heart disease are present). The target for your “good” cholesterol is 40-50.
Diabetes and cardiovascular disease are closely linked. The best way to prevent cardiovascular disease is to take good care of yourself and keep your diabetes under control. Start with the ABCs of diabetes management:
A is for A1C. The A1C test gives your doctor important insight into your blood glucose levels over the previous two to three months. It's a good idea to check your A1C level twice a year. For most people who have diabetes, the goal is an A1C of less than 7 percent. Your physician will advise you on your target A1C.  
B is for blood pressure. When a person with diabetes also has high blood pressure, the risk for cardiovascular disease doubles. High blood pressure forces the heart to work harder to circulate blood, and can lead to a heart attack, stroke, and kidney damage. Studies have also shown that there is a link between high blood pressure and resistance to insulin by the body's cells. For people with diabetes, the goal is a blood pressure of less than 130/80 mmHg.
C is for cholesterol. In people with diabetes, LDL (or "bad") cholesterol, tends to build up and clog the arteries. Triglycerides, another form of fat that can cause atherosclerosis (narrowing of the arteries), also tend to be abnormally high in diabetes. HDL (or "good") cholesterol helps keep the arteries healthy by removing cholesterol from the body. In diabetes, HDL levels tend to be lower than normal. This combination of abnormal lipid levels is often seen in people with premature heart disease.
For most people, target blood levels of these lipids are:
  • Total cholesterol, less than 200 mg/dL
  • LDL cholesterol, less than 100 mg/dL (below 70 mg/dL for those who already have, or are at high risk for, heart disease)
  • Triglycerides, less than 150 mg/dL
  • HDL cholesterol, greater than 40 mg/dL for men and greater than 50 mg/dL for women
Constance Brown-Riggs
Nutrition & Dietetics

The ABCs of diabetes are an abbreviation for A1C, blood pressure and cholesterol. Understanding the ABCs of diabetes control will help you live well with diabetes.

  • A1C – The A1C test tells you what your blood glucose level has been every day for the past 90 days. The goal is to achieve and maintain normal blood glucose levels as safely as possible. The American Diabetes Association recommends an A1C less than 7. Keeping your blood glucose under control can protect your heart and blood vessels, kidneys, feet, and eyes.
  • Bp - Achieve and maintain blood pressure in an ideal range to reduce the risk of uncontrolled hypertension. For most people with diabetes the goal is 130/80. High blood pressure can cause heart attack, stroke, and kidney disease.
  • C - Achieve and maintain cholesterol levels that reduce the risk for cardiovascular disease. The goal for LDL – so called “bad” cholesterol, is less than 100 for most people with diabetes. LDL cholesterol can build up and clog your blood vessels, causing heart attack and stroke. The goal for HDL – so called “good” cholesterol, is 40 or higher. HDL cholesterol helps to remove cholesterol from your blood vessels.

Diabetes is unique to each individual, so your individual goals should be set with your diabetes health care provider, and you should work closely with them to adjust your care plan if you aren't meeting your goals.

Be well…

 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.