How Can Diabetes Be Controlled?

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How Can Diabetes Be Controlled?

Overweight Increases the Risk of Diabetes in Older Adults

People with diabetes can take action to lower their chances of developing heart disease, stroke, and other diabetes-related problems by:

Controlling the ABCs of diabetes
Following an individualized meal plan
Engaging in physical activity
Using self-management techniques, such as foot checks and self-monitoring of blood glucose, as instructed by healthcare providers
Reporting any new symptoms, such as vision problems or falls, to their healthcare provider in a timely manner
Avoiding tobacco use
Taking medications as prescribed
A multidisciplinary team approach is critical to success in diabetes care and prevention. All health care providers can help by discussing how self-management and diabetes control relate to preventing complications.

Controlling the ABCs of Diabetes

About 2 out of 3 (65 percent) people with diabetes die of some form of heart or blood vessel disease (e.g., heart "attack" or stroke).23 People who have diabetes often have high blood pressure and high cholesterol as well. To address this, a healthcare provider who encounters a person with diabetes will develop individual goals for blood glucose, blood pressure, and cholesterol.

Healthcare providers use the A1C blood test to measure "average" blood glucose levels over a two to three month period. Healthcare providers also use blood pressure and cholesterol to check the health of someone who has diabetes. These are referred to as the "ABCs of diabetes." (For more information, see "Comprehensive Treatment of Diabetes")

The ABCs of Diabetes (A1C, Blood Pressure, and Cholesterol)

Using the A1C, good blood glucose levels are less than 7 percent
Good blood pressure levels are less than 130/80
Good cholesterol levels (LDL) are less than 100 mg/dl
The figures above are considered "target values" for the general population, and are meant to be tailored to individual needs by a healthcare provider. Among frail older adults, in particular, these rules do not always apply (see glossary for definition of “frail”). To find out more, see "How Is Diabetes Different for Older Adults Than Younger Adults?"

Many people with diabetes, including older adults, are not aware of the link between cardiovascular disease (e.g., heart disease and stroke) and diabetes.

In one survey, nearly 7 in 10 (68 percent) people with diabetes reported that they do not consider cardiovascular disease to be a serious complication of diabetes
In the same survey, 3 in 5 (60 percent) people with diabetes reported that they do not feel at risk for either high blood pressure or cholesterol problems
Healthcare providers also need to be educated in this area. A survey of healthcare providers worldwide (called the AUDIT Study) showed that the targets that diabetes specialists set for their patients are frequently not as low as their professional organizations recommend. Specifically, many diabetes specialists still do not recognize that diabetes is a "coronary equivalent." The term "coronary equivalent" refers to the fact that people with diabetes are at high risk for suffering a cardiovascular event, such as a stroke or heart attack, and should be considered in the same category as others who are at high risk for suffering a cardiovascular event.

Table 2 demonstrates some of the types of services used by providers and people with diabetes to control the disease. Table 2 also shows the percentage of people who receive services, in comparison with the objectives set by the U.S. Department of Health and Human Services for 2010 (called Healthy People 2010).