Beyond Blood Glucose

By Martha Funnell, MS, RN, CDE

One of the hardest things about living with diabetes is thinking about the possibility of long-term complications: eye, kidney and nerve damage, as well as heart attacks and strokes. You may already know that keeping your blood glucose as close to normal as is safe for you is the best way to lower your risk. The target for most people with diabetes is to keep their A1C levels at less than 7%. But here are some other steps you can take to lower your risk for these complications.

HIGH BLOOD PRESSURE

Having high blood pressure along with diabetes increases your risk of complications. High blood pressure increases the force of the blood through your blood vessels. Over time, that can damage both the small blood vessels and the large blood vessels. Damage to the small blood vessels in your eyes and kidneys increases your risk of eye disease and kidney damage. Damage to the large blood vessels increases your risk of heart attacks and strokes.

Two blood pressure medicines commonly used for people with diabetes are ACE inhibitors, or ARBs. These medicines not only lower your blood pressure but also help protect your kidneys. Even when your blood pressure reaches the target range, taking your medicines helps to keep it there. That
is why it is important for you to continue taking your medicines for high blood pressure, even if your blood pressure is within your target range.

130/80

The recommended target for blood pressure among people with diabetes is 130/80 mmHg or lower.

STRESS

Stress can raise both your blood glucose and your blood pressure. You cannot always control the amount of stress in your life, but you can learn to handle it differently. Physical activity, meditation, prayer, yoga and relaxation exercises are all positive ways to deal with stress. Another idea is to avoid, as much as you can, events that cause you to feel stressed. Or try a support group for people with diabetes.

SMOKING

Smoking is not good for anyone, but it is more harmful for people with diabetes. When you smoke and have diabetes, you increase your risk for kidney and nerve damage. Smoking also damages the heart and blood vessels and adds greatly to your risk for heart attack and strokes.

Wanting to prevent complications from diabetes is another good reason to stop smoking. If you do smoke, try to cut down on the amount you smoke. Talk with your healthcare team about ways to stop smoking. Medicines, nicotine patches or gum and/or stop-smoking programs or help lines can all help.

IMPROVE BLOOD GLUCOSE AND BLOOD PRESSURE

Fortunately, many of the things you do to lower your blood glucose also help to lower your blood pressure. These include weight loss, physical activity and eating more vegetables, fruits and whole grains. Less salt in your diet may also help lower your blood pressure.

ALCOHOL

Drinking too much is especially unhealthy for people with diabetes. Alcohol is high in calories, low in food value and can get in the way of your exercise and weight loss goals. Too much alcohol can damage your heart, blood vessels and liver. Talk with your healthcare provider if you believe you are drinking too much or if you want to stop. He or she can tell you about resources in your area.

Lowering your risk for complications is the main goal of managing diabetes. Going beyond blood glucose gives you the greatest chance for living a longer, healthier life. It is a lot to do and it isn’t always easy, but most people find that it is worth the effort.