• What are diabetes problems?
• Will I have diabetes problems?
• What should my blood sugar numbers be?
• How can I find out what my average blood sugar is?
• What should I do about blood pressure?
• What should I know and do about smoking?
• What else can I do to prevent diabetes problems?
• Things to check for good diabetes care
• How to use the daily diabetes record page
• For more information
• More in the series
• Acknowledgments

What are
diabetes
problems?

Too much sugar in the blood for a long time causes diabetes problems. This high blood sugar can damage many parts of the body, such as the heart, blood vessels, and kidneys. Diabetes problems can be scary, but there is a lot you can do to prevent them or slow them down.

Will I have
diabetes
problems?

What should
my blood sugar numbers be?

For most people, good blood sugar levels are

Ask your health care provider what your blood sugar numbers should be.
Print out this chart and record them.

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 to teach you how to use the meter.

Keep track of your blood sugar using the record page. Print out the record page or ask your health care provider for a blood sugar record book. Your blood sugar check results will help you and your health care provider make a plan for keeping your blood sugar under control.

How can I
find out what
my average
blood sugar is?

Ask your health care provider to do a hemoglobin A-1-c (HE-moh-glow-bin A-1-c) test. This blood test shows the average amount of sugar in your blood during the past 3 months. Have this test done at least twice a year. Your health care provider uses this test plus your blood glucose meter test results to tell if your blood sugar is under control.

Aim for a score of less than 7 percent. If your test result is less than 7 percent, then your blood sugar is in a good range and your diabetes treatment plan is working. You are doing all you can to prevent diabetes problems.

A test result of more than 8 percent is too high. At more than 8 percent, you have a greater chance of getting diabetes problems, like kidney damage, and you need a change in your diabetes plan. Your health care provider can help you decide what part of your plan to change. You may need to change your meal plan, your diabetes medicines, or your exercise plan.

Keep your hemoglobin A-1-c below 7 percent.

What should I do about blood pressure?

Normal blood pressure will help prevent damage to your eyes, kidneys, heart, and blood vessels. Blood pressure is written with two numbers separated by a slash. For example: 120/70. The first number should be below 130 and the second number should be below 85. Keep your blood pressure as close to these numbers as you can.

If your blood pressure is too high, your doctor might ask you to take a blood pressure medicine called an ACE inhibitor (in-HIB-it-ur). This type of blood pressure medicine is best for people with diabetes.

Keep your blood pressure below 130/85.

What should I
know and do
about smoking?

Do not smoke. Smoking slows down the blood flow and can make heart and blood vessel problems worse. Smoking can slow blood flow to your feet and legs and make sores and infections harder to heal.

If you smoke, ask your health care provider for help in quitting.

What else can
I do to prevent
diabetes
problems?

Things to check
for good
diabetes care

Taking care of diabetes is a team effort between you and your health care provider team (doctor, diabetes nurse educator, diabetes dietitian educator, pharmacist, and others). You are the most important member of the team.

Take charge of your diabetes care by learning what to do for good diabetes care:

• Things to do every day for good diabetes care.
• Things for your health care provider to look at every time you have a checkup.
• Things for you or your health care provider to do at least once or twice a year.

Keep a daily record of blood sugar test results. (Print out the daily diabetes record page.) This information will help you see if you are reaching your blood sugar goals. You can prevent or slow down diabetes problems by reaching your blood sugar goals most of the time.

Things to do every day for good diabetes care:

	Follow the healthy eating plan that you and your doctor or dietitian have worked out. Eat your meals and snacks at around the same times each day.
	Be active a total of 30 minutes most days. Ask your doctor what activities are best for you.
	Take your diabetes medicine at the same times each day.
	Check your blood sugar every day. Each time you check your blood sugar, write the number in your record book. Call your doctor if your numbers are too high or too low for 2 to 3 days.
	Check your feet every day for cuts, blisters, sores, swelling, redness, or sore toenails.
	Brush and floss your teeth and gums every day.
	Don't smoke.

Things for your health care provider to look at every time you have a checkup:

Your blood sugar records	Show your records to your health care provider. Tell your health care provider if you have low blood sugar or high blood sugar often.
Your weight	Ask your health care provider how much you should weigh. Talk about ways to reach your goal that will work for you
Your blood pressure	A good goal for most people is less than 130/85. Ask your health care provider about ways to reach your goal.
Your diabetes medicines plan	Talk to your health care provider about any problems you have had with your diabetes medicines.
Your feet	Ask your health care provider to check your feet to make sure your foot nerves and your blood circulation are OK.
Your plan for exercise	Tell your health care provider what you do to stay active.
Your meal plan	Ask questions about what to eat, how much to eat, or when to eat.
Your feelings (Are you tense or depressed?)	Ask your health care provider about ways to handle stress. If you are feeling sad or unable to cope with problems, ask about how to get help.
Your smoking	If you smoke, quitting may be very hard to do. But your health care provider may be able to help.

Things for you or your health care provider to do at least once or twice a year:

How to use the daily diabetes record page

Use copies of the record page to keep track of blood sugar checks, medicines, and notes about things that affect your blood sugar. Print one copy of the record page for each week. This record will help you see if your diabetes plan is working. Review your record with your health care providers.

Blood sugar checks

If needed, draw a line in the boxes under "Breakfast," "Lunch," and "Dinner" to make room for blood sugar check results before and after a meal, like this example:

See "What should my blood sugar numbers be?" for information about good blood sugar levels.

Medicines

Under the heading marked "Medicine," write the name of your diabetes medicine and the amount taken.

Notes

Write down things that affect your blood sugar level. Some examples are

• Eating more or less than usual.
• Forgetting to take your diabetes medicine.
• Exercising (write down what kind and for how long).
• Being sick or upset about something (being under stress).
• Going to a social event or other special event, or being on vacation.

Daily diabetes record page

My health care provider team members

Print out this chart and record names, addresses, and phone numbers.

For more information

Diabetes Teachers (nurses, dietitians, pharmacists, and other health professionals)

To find a diabetes teacher near you,
call the American Association of Diabetes Educators
toll-free at 1-800-TEAMUP4 (1-800-832-6874),
or look on the Internet at http://www.aadenet.org/ and
click on "Find an Educator."

To find a program near you, call toll-free at
1-800-DIABETES (1-800-342-2383), or
see www.diabetes.org/education/edustate2.asp
on the Internet.

To find a dietitian near you,
call the American Dietetic Association's National Center for Nutrition and
Dietetics toll-free at 1-800-366-1655,
or look on the Internet at
http://www.eatright.org/ and click on
"Find a Dietitian."

More in the series

Acknowledgments

The National Diabetes Information Clearinghouse thanks the people who helped review or field-test this booklet.

For American Association of Diabetes Educators Lynn Grieger, R.D., C.D.E. Arlington, VT Celia Levesque, R.N., C.D.E. Montgomery, AL Teresa McMahon, Pharm.D., C.D.E. Seattle, WA Barbara Schreiner, R.N., M.N., C.D.E. Galveston, TX For American Diabetes Association Phyllis Barrier, M.S., R.D., C.D.E. Alexandria, VA Linda Haas, Ph.C., R.N., C.D.E. Seattle, WA Kathleen Mahoney, M.S.N., R.N., C.D.E. Drexel Hill, PA Randi Kington, M.S., R.N., C.S., C.D.E. Hartford, CT Diabetes Research and Training Center Albert Einstein School of Medicine Norwalk Hospital Norwalk, CT Jill Ely, R.N., C.D.E. Sam Engel, M.D. Pam Howard, A.P.R.N., C.D.E.

Diabetes Research and Training Center Indiana University School of Medicine Indianapolis, IN Madelyn Wheeler, M.S., R.D., F.A.D.A., C.D.E. Diabetes Research and Training Center VA/JDF Diabetes Research Center Vanderbilt School of Medicine Nashville, TN Ok Chon Allison, M.S.N., R.N.C.S., A.N.P., C.D.E. Barbara Backer, B.S. James W. Pichert, Ph.D. Alvin Powers, M.D. Melissa E. Schweikhart Michael B. Smith Kathleen Wolffe, R.N. Grady Health System Diabetes Clinic Atlanta, GA Ernestine Baker, R.N., F.N.P., C.D.E. Kris Ernst, R.N., C.D.E. Margaret Fowke, R.D., L.D. Kay Mann, R.N., C.D.E. Health Care Financing Administration Baltimore, MD Jan Drass, R.N., C.D.E.

Indian Health Service Albuquerque, NM Ruth Bear, R.D., C.D.E. Dorinda Bradley, R.N., C.D.E. Terry Fisher, R.N. Lorraine Valdez, R.N., C.D.E. Indian Health Service Red Lake, MN Charmaine Branchaud, B.S.N., R.N., C.D.E. Medlantic Research Center Washington, DC Resa Levetan, M.D. Texas Diabetes Council Texas Department of Health Austin, TX Luby Garza-Abijaoude, M.S., R.D., L.D.