The American Diabetes Association and the American College of Cardiology have teamed up to raise public awareness of the “ABCs of diabetes,” namely A1C, blood pressure, and cholesterol. To have a good sense of your risk of cardiovascular disease and other diabetes complications, you need to “know your numbers.”
The A1C, or HbA1c, test is a measure of blood glucose control over the previous 2–3 months. Your doctor will likely recommend that you have an A1C test at least twice a year. It is usually done in a laboratory setting, which may or may not be located within your health-care provider’s office. Small changes in A1C can make a big difference in your risk for diabetes-related complications. For example, lowering your A1C level by just one percentage point can reduce your risk for all complications by 30% to 35% and cut your risk of heart attack by 18%. Each A1C percentage point above 7.0% doubles your risk of complications.
For most people with diabetes, the A1C target is below 7%. However, even lower levels reduce the risk for complications even more, so each person with diabetes and his diabetes care team should set individualized A1C goals. Certain populations (including children, pregnant women, and elderly people) require special considerations.
Monitoring your blood glucose levels at home between doctor visits helps you know if what you are doing is working to keep your blood glucose levels controlled. The blood glucose targets for most people using a standard, plasma-calibrated blood glucose meter are as follows:
• Before meals, 70–130 mg/dl
• 1 to 2 hours after the start of a meal, less than 180 mg/dl
Your blood pressure should be checked at every medical appointment. For most people with diabetes, the recommended blood pressure target is blood pressure below 140/80 mm Hg.
People with diabetes are advised to have a blood test to measure triglycerides, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol at least once a year. The goals for most people are as follows, but these numbers may be modified based on your individual risk profile:
• LDL (“bad”) cholesterol, under 100 mg/dl
• Triglycerides, under 150 mg/dl
• HDL (“good”) cholesterol for men, above 40 mg/dl
• HDL (“good”) cholesterol for women, above 50 mg/dl