7 Principles for Good Diabetes Care
These principles, or steps, will help you manage your diabetes and live a long and active life. Every person who has diabetes has different needs. Talk to your health care team about a treatment plan that is best for you. Diabetes affects almost every part of the body and good diabetes care requires a team of health care providers. They include doctors, diabetes educators, nurses, dietitians, pharmacists, mental health workers, eye specialists, foot specialists, dentists, and social workers. Print out and take this information with you when you visit your doctor or other members of your team to talk about your treatment plan.
It Is Important to Control Diabetes
Taking good care of diabetes can lower the chances of getting:
- heart disease
- eye disease that can lead to a loss of vision or even blindness
- nerve damage that may cause a loss of feeling or pain in the hands, feet, legs, or other parts of the body and lead to problems such as lower limb amputation or erectile dysfunction
- kidney failure
- gum disease and loss of teeth
As you read through this information, look for things with a to help you take action to control your diabetes.
Principle 1: Learn as Much as You Can About Diabetes
The more you know about diabetes, the better you can work with your health care team to manage your disease and reduce your risk for problems. You should know what type of diabetes you have. If you do not know, ask your doctor whether you have type 1 or type 2 diabetes.
- Type 1 diabetes. People who have this type of diabetes need to take insulin every day. This type of diabetes used to be called juvenile diabetes.
- Type 2 diabetes. Diet and daily physical activity help to control type 2 diabetes. Most people also need to take diabetes pills or insulin. Type 2 diabetes is very common and used to be called adult onset diabetes.
Diabetes is always a serious disease. Terms that suggest that diabetes is not serious, such as "a touch of diabetes," "mild diabetes," and "sugar's a little high," are not correct and should no longer be used.
Many People Who Have Diabetes Do Not Know It
Finding and treating diabetes early can prevent health problems later on. Many people with type 2 diabetes have no symptoms and do not know they have diabetes. Some people are at higher risk for diabetes than others. People at high risk include those who:
- are older than 45
- are overweight
- have a close family member such as a parent, a brother, or a sister who has or had diabetes
- had diabetes during pregnancy
- had a baby that weight more than 9 pounds
- are African American, Hispanic or Latino, Asian American or Pacific Islander, or Native American
- have high blood pressure
- have high cholesterol or other abnormal blood fats
- are inactive
Ask your doctor if you have type 1 or type 2 diabetes.
If you know someone who has any of the risk factors for diabetes, suggest they talk to their doctor about getting tested.
Principle 2: Get Regular Care for Your DiabetesIf you have diabetes, it is important to:
- see your health care team regularly
- make sure your treatment plan is working. If it is not, ask your health care team to help you change it
- ask your family, friends, and co-workers for help and support when you need it
Work with your health care team to get the best help to control your diabetes.
Ask your health care
team how often you need to see them for check-ups.
Write down the date and time for your next visit:
- Date of my next visit is:____________________
Ask your doctor, clinic or office staff, or pharmacist to help you find
resources if you have problems paying for food, medicines, and medical supplies.
You should be able to get Medicare or other insurance to help you pay for
Make a list of questions and concerns you want to talk about at your next visit to your health care team.
Principle 3: Learn How to Control Your DiabetesDiabetes affects many parts of the body. To stay healthy, it is important to know how to eat the right foods, how to be physically active, and how to look after yourself. Using the following checklist will help you learn how to control your diabetes.
How Active Are You in Controlling Your Diabetes?
Look at the list below. Check all of the statements that describe you.
I talk to my health care team about:
- my special needs to help control my diabetes
- ways to improve my ABC numbers: A1C,* Blood pressure, and Cholesterol
- aspirin therapy to prevent heart problems
- getting regular physical activity
- quitting smoking, if needed
I learn from my doctor, diabetes educator, podiatrist, pharmacist, or dietitian how to
- follow a meal plan to control my diabetes
- check my feet every day
- take my medicines as prescribed
- check my blood glucose levels
*A1C (pronounced A-one-C) is a measure of your average blood glucose over the last three months. You should get this test at least twice a year.
- I visit my
- doctor at least twice a year
- eye doctor each year and report any changes in vision
- dentist twice a year
- specialists as my doctor advises
Go over any items you did not check with your health care team. Learning how to control your diabetes can help you stay healthy.
Ask your health care team to help you learn more about diabetes and how to control it.
Principle 4: Take Care of Your Diabetes ABC'sA major goal of treatment is to control the ABCs of diabetes: A1C (blood glucose average), Blood pressure, and Cholesterol. You can do this in many ways.
- Follow a meal plan that was made for you.
- Be active every day.
- Take your medicine as prescribed.
- Before taking any non-prescription medicines, vitamins, or herbal products, ask your pharmacist how they may affect your diabetes or prescription medicines.
- Test your blood glucose on a routine basis.
Talk to your health care team about the best ways to control your A1C, blood pressure, and cholesterol and know your target numbers.
Get involved in setting goals and making a treatment plan for your diabetes.
Principle 5: Monitor Your Diabetes ABCs
To reduce your risk for diabetes problems such as blindness, kidney disease, losing a foot or leg, and early death from heart attack or stroke, you and your health care team need to monitor the diabetes ABCs: A1C, Blood pressure, and Cholesterol. Talk to your health care team about how to reach your target numbers.
Get the A1C Test
The A1C test is usually done by your doctor. It measures how well your blood glucose has been controlled over the last three months. This test is very important because it tells how well you are taking care of your diabetes over the long term. It should be done at least twice a year.
- The target A1C for most people with diabetes is less than 7.
Ask your health care team what your A1C is and keep a dated record of the results.
Discuss your A1C target with your health care team and write it down.
Discuss what you need to do to reach your target.
Check Your Own Blood Glucose
You may need to check your own blood glucose on a regular basis to help control your diabetes. It will tell you what your blood glucose is at the time you test. Keep a record of your results and show it to your health care team. Some meters and test strips report blood glucose results as plasma glucose values which are 10 to 15 percent higher than whole blood glucose values. Ask your doctor or pharmacist whether your meter and strips provide whole blood or plasma results.
- The target glucose range for most people using whole blood is 80 to 120 before meals and 100 to 140 at bedtime.
- The target glucose range for most people using plasma is 90 to 130 before meals and 110 to 150 at bedtime.
Talk to your health care team about the best ways to check your own blood glucose.
Ask your health care team what your blood glucose targets are before meals, after meals, and at bedtime and write them down.
Ask what to do if your blood glucose is often higher or lower than it should be.
Ask how to get the supplies you need to do the tests. Most insurance companies, including Medicare, now pay for diabetes supplies.
Know Your Blood Pressure
High blood pressure makes your heart work too hard. This leads to strokes and other problems such as kidney disease. Your blood pressure should be checked at every visit. You may need to check it yourself.
- The target blood pressure for most people with diabetes is less than 130/80.
Ask your health care team what your blood pressure is and keep a dated record of the results.
Discuss your blood pressure target with your health care team and write it down.
Discuss what you need to do to reach your target.
Ask if you need to test your blood pressure yourself. If so, find out how, when, and what supplies you need.
Know Your Cholesterol
LDL is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year.
- The target LDL cholesterol for most people with diabetes is less than 100.
Discuss your LDL cholesterol target with your health care team and keep a record of the results.
Discuss what you need to do to reach your target.
Keep a Record of Your Results
Keeping a record of your results helps you reach your targets. It helps you know when you and your health care team need to take extra action.
Use the record card to keep track of your ABC numbers.
Principle 6: Prevent Long-Term Diabetes ProblemsPeople with diabetes must control their blood glucose, blood pressure, and cholesterol to prevent the problems of diabetes: heart attack, stroke, eye and kidney problems, nerve damage, impotence, foot or leg amputation, gum disease, and loss of teeth. Here are the key self-care activities to help you manage your diabetes and live a long and healthy life.
- Follow your diabetes meal plan with the correct portion sizes. Eat a variety of foods that are high in fiber and low in fat and salt.
- Be active every day.
- Take medicines as prescribed. If you have questions, talk to your pharmacist or doctor about your medicines.
- Look at your feet and wash and dry them well each day. Tell your podiatrist or health care team about any changes with your feet.
- Check your mouth daily for gum or tooth problems. Call your dentist right away if you have problems with your teeth or gums.
- Test your blood glucose as prescribed by your doctor.
- Check your blood pressure as prescribed by your doctor.
- Reach and stay at a healthy weight.
- Stop smoking.
- Make sure your eyeglasses or contact lens prescription is up to date so you can see clearly. Report any changes in your vision to your health care team.
Work with your health care team to prevent diabetes problems.
Principle 7: Get Checked for Long-Term Problems and Treat Them
See your health care team regularly to check for problems that diabetes can cause. Regular check-ups help to prevent problems or find them early when they can be treated and managed well. Along with the checks of your A1C, blood pressure, and cholesterol (see Principle 5), here are some tests that you will need:
|Triglycerides (a type of blood fat)||Get yearly|
|Dilated eye exam to check for eye problems||Get yearly|
|Foot check||Get every visit|
|Complete foot exam to check for circulation, loss of feeling, sores, or changes in shape||Get yearly|
|Urine test to check for kidney problems||Get yearly|
|Dental exams to prevent gum disease and loss of teeth||Get twice a year|
Ask your doctor about these and other tests you may need to have.
Ask your doctor or nurse educator what your last hemoglobin A1c test result was. Write it below. Diabetes Care Record
A1C (blood glucose average) My target _______
A1C target suggested for most people with diabetes is below 7
BLOOD PRESSURE My target _______
BP target for most people with diabetes is below 130/80
CHOLESTEROL (LDL) My target _______
LDL target for most people with diabetes is below 100
TRIGLYCERIDES My target _______
Triglycerides target for most people with diabetes is below 150
WEIGHT My target _______
For most people, good blood sugar levels are:
|On waking up (before breakfast)||80 to 120|
|Before meals||80 to 120|
|2 hours after meals||160 or less|
|At bedtime||100 to 140|
Ask your healthcare provider what your blood sugar levels should be. If you have diabetes, print out this chart and record the blood sugar ranges that your doctor believes optimal for you.
|On waking up (before breakfast)||_______ to _______|
|Before meals||_______ to _______|
|2 hours after meals||_______ or less|
|At bedtime||_______ or _______|
You and your health care provider will agree on when to check blood sugar using a blood glucose meter. You will do the tests yourself. Be sure to ask your health care provider or diabetes assistant to teach you how to use the meter.
IMAGES PROVIDED BY:
Medically reviewed by Robert Bargar, MD; Board Certification in Public Health & General Preventive Medicine August 18, 2017
The above information has ben provided with the kind permission of the National Diabetes Educational Program (ndep.nih.gov/).