Keeping control of your “ABCs" -- A1c, blood pressure, and cholesterol -- can go a long way to help prevent heart disease, stroke, and other heart problems when you have type 1 or type 2 diabetes. And your heart health is very important: You are two to four times more likely to have strokes and heart disease if you have diabetes. Follow these guidelines for heart-healthy living to meet your ABC goals. Your doctor may tailor your goals based on your age, blood sugar (also called glucose) levels, and heart or other diabetes-linked problems you may have.
A is for A1c Testing for Diabetes
Why Does A1c Matter?
Keeping control of your blood sugar over time helps lower your risk of problems such as kidney, nerve, and eye disease. It may also make you less likely to have a heart attack, stroke, and death from heart disease. Each percentage point you drop in your A1c test result (from 8% to 7%, for example) can drop your risk of kidney, eye, and nerve disease by a whopping 40%.
If you have diabetes, you should check your blood sugar often to make sure your levels are in check. A hemoglobin A1c test is a blood test that measures your average blood sugar level over the past 2 to 3 months. It's a way to check how well you control your blood sugar over time. A1c measures how much glucose has been "sticking" to your red blood cells. If your treatment changes or your blood sugar control is not on target, then you should repeat the test every 3 months.
What's Your A1c Goal?
Aim for an A1c of around 7% or less.
How Can You Improve Your Score?
If you think of daily blood sugar testing like a pop quiz, the A1c test is a midterm. Steady daily blood sugar control improves your A1c score, which shows your past efforts. Take your diabetes drugs and make sure you eat healthy, get exercise, and follow the other heart-healthy guidelines below. This will help you reach your A1c goal.
B is for Blood Pressure and Diabetes
About 70% of people with diabetes either have high blood pressure -- a score of at least 140/90 (read as "140 over 90") -- or use prescription drugs to keep their blood pressure down. High blood pressure raises your chance of having other health problems that diabetes can cause, like eye disease and kidney damage. It also makes you more likely to have heart disease and stroke.
Why Does Blood Pressure Matter?
Keeping your blood pressure at a healthy level lowers your chances of having heart disease by 33% to 50% -- a big benefit. It can also help prevent or delay kidney disease, another common problem with diabetes.
What's Your Blood Pressure Goal?
Aim for a blood pressure score below 140/80 most of the time. Get your blood pressure checked at least four times a year or at each diabetes checkup. You could also use a blood pressure monitor at home to check your blood pressure more often.
How Can You Improve Your Blood Pressure?
All the things that are good for your heart will help you control your blood pressure: eat a low-salt diet, eat more foods high in potassium, get regular exercise, limit alcohol, quit smoking, and stay at a healthy weight. When lifestyle changes aren't enough to control high blood pressure, drugs can help lower it.
C is for Cholesterol and Diabetes
The wrong kinds of fats in your blood can build up in your arteries. This raises your chance of heart disease and stroke. The biggest problem is "bad" cholesterol -- called LDL cholesterol. Other things that raise your risk of heart disease and stroke are included in a calculation to find out if you will need medication to lower your cholesterol.
Why Does Cholesterol Matter?
Keeping your LDL cholesterol at a healthy level can bring down your chances of having heart disease. Your doctor will let you know by how much your cholesterol should be lowered.
What's Your Cholesterol Goal?
Have your cholesterol checked at least once a year. Aim for these scores:
- LDL below 100 for most people with diabetes under the age of 40 or those without heart disease. Experts advise a goal below 70 if you have had a heart attack or other heart problem.
- HDL above 50 for women, and above 40 for men.
- Triglycerides lower than 150.
How Can You Improve Your Cholesterol?
You can lower your cholesterol and your chance of heart disease by making changes in what you eat and how active you are. Eat a mix of colorful fruits and vegetables. Make other foods that are low in saturated and trans fat and cholesterol, and high in whole-grain fiber, a big part of your diet. Adding omega-3 fatty acids and plant stanols/sterols helps. Lose weight if you need to, and get regular exercise. If that's not enough to get your cholesterol to healthy levels and your doctor determines you are at a high risk of future heart attacks or heart disease, your doctor may prescribe a drug to help you reach your goal.
Improve Your ABCs With Heart-Healthy Living
Your doctor will likely advise you to eat well and exercise most days to help manage your ABCs. These tips can help you get there:
- Watch Your Blood Sugar: Keep clear records of your blood sugar levels. Write down anything that may have affected your blood sugar. Then you can see how diet, exercise, and any drugs you take affect your readings. Talk to your doctor or diabetes team about what you can do to improve your blood sugar control.
- Control Your Weight: If you're overweight, lose weight by eating healthier. Get more exercise to help control your A1c, blood pressure, and cholesterol levels.
- Get Moving: Do 30 to 60 minutes of combined aerobic and strength training exercises, such as brisk walking or lifting weights, on most days. Even without weight loss, being active helps your diabetes control.
- Eat Healthy: Fill your plate with lots of fruits and vegetables. Choose foods low in salt and sugar. Eat plenty of fiber from fruits, vegetables, and whole grains like brown rice and oatmeal. Choose heart-healthy fats such as olive and canola oil, fatty fish, nuts, and avocados. If you drink alcohol, do it in moderation.
- Take Drugs as Prescribed: Take your diabetes drugs exactly as your doctor advises, even when you feel healthy.
- Quit Smoking: If you're a smoker, get help to quit. Try a smoking cessation program to boost your chance of success.
- Get Support: Ask your family and friends to help you stick to a heart-healthy lifestyle.