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Being in the “Know”: The Diabetes Numbers Game

Amy Campbell

December 27, 2011

Having diabetes is a lot of work. I don’t have diabetes myself, but I’ve been around and worked with a lot of people who do, and what they do for themselves every day, 365 days a year, is amazing. They don’t call diabetes a “self-management” condition for nothing!

One major aspect of diabetes management is “knowing your numbers.” Part of knowing your numbers means knowing what your blood glucose results are, and then knowing what to do about them. But a bigger-picture part of this concept is knowing your other diabetes numbers. Diabetes isn’t just about blood glucose; it’s about other factors, too, like blood pressure, cholesterol, and kidney health.

Below are the numbers that you need to have checked regularly. Some numbers you’ll have measured at every visit, like blood pressure, while others may only need to be checked once a year. These numbers are what drive (or should drive) your diabetes treatment plan, so if you don’t know what they mean, what they are, or what to do about them, your homework for the new year is outlined for you. Don’t leave it up to your doctor, nurse practitioner, or diabetes educator to inform you. These are YOUR numbers, so ask about them. Here’s what being in the “know” means:

• Know what your diabetes numbers are (the results)
• Know what the results mean
• Know what to do about them

Key Diabetes Numbers and Exams
A1C. This number gives you an indication of your average blood glucose control over the past 2–3 months. Your blood glucose checks with your meter tell you what’s happening on a daily basis; your A1C gives you the bigger picture. Lowering your A1C by one percentage point can lower your risk of complications by up to 40%. For most people, the A1C goal is less than 7%, although your goal may be different. Get this checked 2–4 times a year.

Blood pressure. Some may argue that blood pressure is the most important number in diabetes care. High blood pressure raises your risk of heart attack, stroke, kidney damage, and eye problems. If your blood pressure is high, get a home monitor, check it daily, and keep a record of your results to bring to your provider. Otherwise, have your blood pressure checked at every office visit and ask what your result is (don’t just accept the answer that it’s “good”). For most people with diabetes, the goal is less than 130/80.

Cholesterol. The “cholesterol” test often encompasses what is called a lipid profile, which takes into account your total cholesterol, HDL (“good”) cholesterol, LDL (“bad”) cholesterol, and triglycerides (blood fats). Make sure you at least know your LDL number, which should be under 100, or under 70 if you already have heart disease. LDL is typically checked once a year, but may be checked more often if it’s high and/or if you’re on cholesterol-lowering medicine.

Eye exam. Diabetic retinopathy is the most common type of diabetic eye disease and is a leading cause of blindness. Retinopathy happens when blood vessels in the eye swell and leak, or when abnormal, new blood vessels form. Other eye problems can occur too, such as macular edema, glaucoma, and cataracts. Controlling blood glucose, blood pressure, and cholesterol are key ways to prevent eye disease. Have a dilated eye exam at least once a year (eye checks at your local eye glass store don’t count). The goal? No eye disease.

Foot exam. You (or a family member or friend) should be checking your feet every day for cuts, sores, redness, or swelling. But you also need a more thorough foot exam by your health-care provider at least once a year. Your provider will examine your skin, check for any structural changes in your feet, measure your sensation, and check your pulses for any circulation issues. If you have or have had foot problems, such as a foot ulcer, calluses, amputation, etc., you should have a foot exam at every office visit. Remind your provider to check your feet by taking off your shoes and socks when you’re in the exam room.

eGFR. Here’s a test that you might not be familiar with: eGFR stands for “estimated glomerular filtration rate” and it’s another way, along with the microalbumin test, for your provider to see how well your kidneys are working. The eGFR is determined by several factors, including your blood creatinine level (a waste product that comes from muscle metabolism), your age, your sex, and your race. A number lower than 60 ml/minute may indicate signs of kidney disease. This test may not be accurate if you are older than age 70, under the age of 18, very malnourished, a vegetarian, taking creatine supplements for bodybuilding, pregnant, very muscular, or very overweight, so ask your provider if you should have this measured. You might need to have your eGFR tested every few months, depending on the result.

Microalbumin. The microalbumin test is a urine test that checks for tiny amounts of protein in your urine. When your kidneys are working as they should, there is no protein in your urine (for the most part). “Spilling” protein in your urine can indicate kidney damage. Fortunately, there are things that can be done to prevent damage from worsening if caught early on. The microalbumin test goal is less than 30. You can lessen your chances of kidney damage by — surprise — controlling your blood glucose, keeping your A1C under 7%, and controlling your blood pressure.

Your provider may order other tests or exams for you, in addition to these. But these seven tests and exams make up the core set. It’s a lot to remember, so it may help you to ask your provider or educator for a sheet on which to keep track of your results and the dates when you had them done. Knowledge is power, and remember, this is your diabetes. Stay in the game!



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