The Top Ten Targets You Should Remember
Roberto C. Mirasoi, MD, FPCp, FPSEM
1. HgbA1c < 7 or HgbA1c <6.5.
Hemoglobin A1c is the retrospective control of your blood sugar for the past three months. The American Diabetes Association recommends an HgbA 1c goal of less than 7.0%, while other groups such as the International Diabetes Federation and the American Association of Clinical Endocrinologists recommend a goal of less than 6.5%. Studies have shown that there is a 10% decrease in relative risk for every 1% reduction in HgbA 1c. So, if you have an HgbA 1c of 10.7 and you drop it to 8.5, not yet at goal, you have managed to decrease your risk of microvascular complications by about 20%. The closer to normal the HgbA 1c, the lower the absolute risk for microvascular complications.
2. Fasting Blood Sugar < 120 mg/dl.
A blood sample taken after an overnight fast of about 8 hours is called Fasting blood sugar or FBS. Your FBS should not go beyond 120 mg/dl. Levels below this value have been associated with fewer complications.
3. Post prandial sugar <140.
Normally, your blood glucose levels increase slightly after you eat. This increase causes your pancreas to release insulin so that your blood glucose levels do not get too high. Blood glucose levels that remain high over time can damage your eyes, kidneys, nerves, and blood vessels. It should not go beyond 140 mg/dl.
4. Blood Pressure < 130/80.
Blood pressures should be measured frequently and should target 130/80. A single drug or most commonly a combination of anti-hypertensive drugs are used to achieve the target BP.
5. Total Cholesterol<200 mg/dl and LDL < 100 mg/dl.
Total blood cholesterol below 200 mg/dL puts you at relatively low risk of coronary heart disease. The lower your LDL cholesterol, the lower your risk of heart attack and stroke. In fact, it’s a better gauge of risk than total blood cholesterol. If you are not at target a low fat diet and a statin maybe prescribed.
6. Triglyceride <150 mg/dl.
Triglyceride is a form of fat. Many people have high triglyceride levels due to being overweight/obese, physical inactivity, cigarette smoking, excess alcohol consumption and/or a diet very high in carbohydrates (60 percent of more of calories). High triglycerides are a lifestyle-related risk factor but may be due to genetics as well. Lifestyle changes are essential and if elevated a drug will be added to your regimen.
7. Micro albumin negative.
Micro albumin measures small amounts of protein in the urine. This is the hallmark of Diabetes nephropathy or diabetes kidney disease. At the micro albumin stage, it is still reversible. If elevated, an ace inhibitor or an angiotensin receptor blocker is used to prevent further progression of proteinuria. Several studies have shown that these drugs are helpful in the early stages of OM nephropathy.
8. If overweight lose 10%.
Losing 10% of your weight has been shown to improve metabolic profile. Blood pressures are lower, cholesterol is down, and blood sugars improve and could decrease your risk of heart disease. This 10% is most often difficult target to achieve. You should follow your health professional’s advice. Seek help if you have difficulty shedding off that 10% of excess weight.
9. Fats should constitute only <20% of diet.
Your diet is the cornerstone of diabetes therapy. Remember to decrease your fat intake especially saturated fats. Avoid animal sourced fats. Refrain from eating junk food. Fried foods should be limited. Remove cholesterol from your diet. Hidden fats should be avoided.
10. Exercise 30 minutes, moderate intensity 5-7 days a week.
The effect of exercise cannot be overemphasized. Exercise maintains weight, improves circulation and does wonders to your general well-being. Simple exercises could be used e.g. walking 30 minutes daily. Walk more. If you are using a pedometer- you need 10,000 steps.
Knowing all of these will help you keep your diabetes in control. Knowing these numbers will absolutely add more years.
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