Updated October 11, 2007

Avoiding Complications:
Nurturing Your “Health Bank”

by Amy Tenderich, M.A.

Most people who are diagnosed with diabetes or prediabetes are told at some point about the long-term damage diabetes can do, such as causing heart attack and stroke, blindness, kidney disease, and limb amputations. Unfortunately, too few are also told that all of these complications are largely preventable—through a combination of healthy lifestyle practices, frequent checkups and laboratory tests for screening and monitoring, and medication when necessary.

This may sound like a long list of things to do, but it may be simpler than you think—if you focus your efforts on the areas that will have the most impact for you.

Understanding and monitoring the big picture of your overall health with diabetes can be achieved by keeping tabs on five simple medical tests: HbA1c, blood pressure, blood lipids (cholesterol and triglycerides), microalbumin, and a dilated eye exam.

These tests are currently the best measures available to indicate each person's individual health risks with regard to diabetes. Yet despite these tests being widely accessible and easy to administer, fewer than 42% of adults with diabetes have either had them or understand what the results mean, according to an April 2006 report by USA Today.

Why aren't more people with diabetes aware of these critical tests or their own personal results? There are lots of possible reasons, ranging from not being informed, to not understanding the information or its importance, to feeling too overwhelmed by other concerns to act on the information.

"So often people with diabetes focus on the stuff they feel guilty about (usually weight or food), when that may not even be their most critical health issue. What they don't usually do is get the hard facts on where they stand in terms of their own diabetes health risks. But this is what’s really going to improve the quality and length of their life,” says Dr. Richard Jackson, Director of Outreach at the Joslin Diabetes Center in Boston.

Dr. Jackson’s long-standing notion is that everyone with diabetes should track their lab test results just as carefully as they track their money in the bank. In our new book Know Your Numbers, Outlive Your Diabetes, Dr. Jackson and I describe how to create a simple “balance sheet” that can help people see clearly where they have the most “health dollars” in the bank and where their most urgent “health debts” lie. (For a sample sheet, click here.) By taking action where it’s most needed, readers can achieve the long, healthy, complication-free lives they want.

Collect your numbers
The first step in creating your health balance sheet is to gather your test results. Most people have had at least some of these tests conducted at some point, but they may not know exactly how long ago, what the tests measured, or what the results were. For clarity, here’s what each one does:

HbA1c. The HbA1c test (also called the glycosylated hemoglobin test or the A1C test) is a measure of the amount of glucose in your blood over the previous 2–3 months. This test complements daily blood glucose monitoring by providing a broader picture than the “snapshots” provided by your meter. Keeping your HbA1c test results in the recommended range lowers your risk of all diabetes-related complications.

Amy Tenderich is the author of the blog Diabetes Mine, which can be read at www.diabetesmine.com, and coauthor, along with Richard Jackson, M.D., of Know Your Numbers, Outlive Your Diabetes, published in 2007 by Marlowe & Company. Dr. Jackson is Director of Outreach at the Joslin Diabetes Center in Boston and an Assistant Professor of Medicine at Harvard Medical School.

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