How can I stay as healthy as possible if I have diabetes?

If you have diabetes, you have an increased risk of heart disease and stroke. But there are things you can do to help lower this risk.

One way to remember how to stay healthy is to think of your "ABCs":

• "A" is for "A1C" – A1C is a blood test. It shows what your average blood sugar level has been during the last few months.

• "B" is for "blood pressure" – Managing your blood pressure is just as important as managing your blood sugar. High blood pressure puts you at risk for heart attack, stroke, and kidney disease.

• "C" is for "cholesterol" – Cholesterol is a waxy substance in blood. High cholesterol also increases your risk of heart attack, stroke, and other serious problems.

Why are my ABCs so important?

Compared with people who do not have diabetes:

• People with diabetes are 2 to 3 times more likely to have a heart attack or a stroke.

• People with diabetes can have heart attacks at a younger age. When this happens, heart attacks can be more severe and more deadly.

• People with diabetes are also much more likely to get kidney disease.

By managing your ABCs, you can lower your risk of these problems by a lot.

Isn't my blood sugar the most important thing?

Keeping blood sugar low is important in preventing some problems caused by diabetes. These include:

• Eye diseases that lead to vision loss or blindness

• Kidney disease

• Nerve damage (called "neuropathy") that can cause numbness or pain in the hands and feet

• Needing to have toes, fingers, or other body parts removed (amputated)

Even so, blood sugar is just 1 of the things you need to think about. That's because the problems caused by high blood pressure and high cholesterol are often more serious than the ones caused by high blood sugar.

What should my ABC levels be?

This depends on how severe your diabetes is, how old you are, and what other health problems you have. Ask your doctor or nurse what your target levels should be.

Many people with diabetes aim for:

• A1C levels below 7 percent

• Blood pressure below 130/80 (for most people)

• LDL cholesterol level below 100 – LDL is 1 type of cholesterol. It is often called the "bad cholesterol."

How can I manage my ABCs?

You and your doctor will work together to make a plan. This might include:

• Medicines – Most people with diabetes take medicine every day to manage their blood sugar. Some of these medicines can also help prevent heart attack or stroke and help protect the kidneys.

  Plus, many people with diabetes need other medicines every day. These are used to treat high blood pressure or high cholesterol, or to prevent future health problems. If you have any problems with your medicines, or are having trouble paying for them, talk to your doctor or nurse.

• Lifestyle changes – Choices you make every day can have a big impact on your ABCs and your general health. Some things you can do to help manage your ABCs or lower your health risks include:

  • Eat a healthy diet – Eat lots of fruits, vegetables, whole grains, and low-fat dairy products. Limit meat and fried or fatty foods.

  • Be active – Try to do something active for 30 minutes or more on most days of the week. Even gentle forms of exercise, like walking, are good for your health.

  • Quit smoking – Smoking increases the chance you will have a heart attack or stroke, or get cancer. Your doctor or nurse can help you quit.

  • Lose weight, if you have excess body weight – This can help lower the risk of many health problems.

  • Avoid alcohol – Alcohol can increase blood sugar and blood pressure.

Luckily, many of the lifestyle changes above can improve all 3 of the ABCs. For instance, being active and losing weight can help improve blood sugar, blood pressure, and cholesterol levels (table 1).

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