Articles, Blog

Know Your Key Diabetes Numbers: Learn From a Physician

September 11, 2019


Hi, I’m Rich Jackson, I’m a long time endocrinologist
and a diabetes specialist, and I’ve been working diabetes and people with diabetes for over
thirty years. When you have diabetes you wonder: what’s
the most important thing I can do? I feel the most important thing you can do
is find out where you are today, and you can find out where you are by knowing your personal
results for these five numbers. Your blood pressure, your LDL Cholesterol,
the A1c, the eGFR, the results of your eye exam. Knowing those numbers tells you where you’re
starting and what direction you need to go. Blood pressure, probably the most important
single number for people with diabetes. And what should your blood pressure goal be? Well, though that may vary between individuals,
in general 130/80 is a good target. To control your blood pressure, you’d like
each of your numbers the top and the bottom to be below the goal. You’d like your top number to be below 130
and your bottom number to be below 80. The LDL Cholesterol should be in most people
with diabetes, under 100, but the most important thing is that if the LDL Cholesterol is not
in the target range, that you do something about it, which is almost always taking a
statin medication. LDL and blood pressure are probably the two
numbers that have the biggest impact on your diabetes related complications. The A1c is an amazing test that absolutely
accurately averages every single glucose you’ve had for the last 2 to 3 months. Now where should your A1c be? All of the guidelines tell us that should
be below 7% but we know that that can’t be achieved by everybody with diabetes. It’s easier to reach that goal early in the
course of your type 2 diabetes, and as your diabetes progresses, it may both become harder
to reach that goal, and less necessary to reach that goal in order to avoid complications. That’s why you need to have a healthcare provider
that you can talk to about where you A1c goal should be at this particular time. The eGFR reflects your kidney function and
we all know that people with diabetes can be at risk for future kidney problems. The eGFR can be measured with a simple blood
test that should be done every year, and the number should be above 60. If it’s below 60, that doesn’t mean that problems
will happen, but it should alert you and your doctor to pay a little more attention to that. There’s some medications that are very useful
in that situation and you may want to look a little more closely at your blood pressure
and your A1c control. I think eye exams are one of the most unappreciated
areas of diabetes. When you have your yearly eye exam the doctor
is able to look very closely at the back of your eye, at the area called the retina. and
before people develop visual problems from diabetes, in fact years before they develop
visual problems there’s very early changes they can see in the back of your eye that
you can’t appreciate, that don’t affect your vision. The only way to discover these is by having
an eye doctor look at your eye. The other really good news is not only can
they see these early changes, but that we already have very, very effective treatments
for them, so that in today’s world if someone has a regular eye exam, even if their blood
pressure, their LDL, their A1c are not where they want them to be, their chances of having
eye problems almost go to zero. What is your goal if you have diabetes? We’ve talked about the five numbers that you
should track but really your goal is to lead a long and healthy life, and it’s knowing
these numbers that will help you. You need to know where you are now in order
to know where you want to go. So knowing your blood pressure, your LDL Cholesterol,
the A1c, your eGFR, the results of your eye exam give you a starting point. They tell you where you need to take action,
and they can tell you the areas in which you are already doing better, maybe better than
you think. Know these numbers now, check them regularly,
once a year, sometimes more often for the rest of your life, and you’ll always be able
to track where you are with your diabetes.

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1 Comment

  • Reply Barbra April 12, 2019 at 8:32 pm

    Can someone tell me where
    I can find up to date information on the latest guidelines and numbers for
    glucose & A1c for non-diabetics as well as diabetics (2019). I am finding
    conflicting information. What organization(s) or council(s) set the standards.
    If you have a link, I would appreciate it. The numbers I am finding are all
    over the place and accuracy is needed. Thanks so much.

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