# ![](media/image1.png){width="0.8625in" height="1.4in"}*National Diabetes Education Program (NDEP)*

# *Guiding Principles for Diabetes Care:*

#### *For People with Diabetes*

## *Introduction*

The Guiding Principles for Diabetes Care are written for people with
diabetes, their families, health care providers, and those who pay for
health care. The principles describe the key points of good diabetes
care and are based upon current research, guidelines, and standards of
care. But because each person with diabetes has different needs, he or
she should talk with a health care provider about the treatment plan
that works best for him or her and why.

Taking proper care of diabetes can lower the chances of getting eye
disease, kidney disease, nerve damage, and other problems linked to
diabetes. With proper education and good self-care, people with diabetes
should expect to lead long and active lives at work, home and during
leisure time.

### *Principle 1: Screening High-Risk People and Diagnosing Diabetes*

*One-third of people with diabetes remain undiagnosed. Finding and
treating diabetes early can improve health outcomes for people with
diabetes. Therefore, routine screening and correct diagnosis are
essential.*

Diabetes is more common among people who are older, overweight, have a
family history of diabetes, have had gestational diabetes (diabetes
during pregnancy), and are of certain ethnic backgrounds. People at high
risk for diabetes should have frequent, routine testing for diabetes.
Finding and treating diabetes early can lower a person's chances of
getting diabetes problems such as eye disease, kidney disease, nerve
disease, and heart disease. You should be told right away that you have
diabetes and the type of diabetes you have. Terms such as "a touch of
diabetes," \"borderline diabetes,\" or "sugar's a little high" are not
correct and are no longer used.

### *Principle 2: On-Going Care*

People with diabetes should always receive high-quality care on an
ongoing basis to ensure that they are taking good care of their
diabetes, and to make changes to their treatment plan when needed to
achieve control of the disease.

People with diabetes should always expect to receive care and support
that is positive and helpful. You should not have trouble getting care,
and you should be able to see your health care provider on a regular
basis. In addition to your physician, you should be able to see other
types of health care providers who can help you manage your disease such
as a diabetes educator or a nutritionist. People of certain ethnic
backgrounds, children, teenagers, pregnant women and older adults have
very special needs that need special treatment. People with diabetes
also need support from their family, friends, and co-workers. You should
not be prevented from getting the proper education, equipment, supplies
and medicine because of lack of money. You should not be discriminated
against in your work, getting insurance, and obtaining licenses.

### *Principle 3: Diabetes Education*

*People with diabetes and their family members have the right to
accurate information and education needed for diabetes self-care*.

People with diabetes should be able to get the education they need to
become active in treating and managing their disease. Taking an active
role in managing your diabetes will help you stay healthier. This
education should be ongoing and should address your unique needs and the
needs of your family.

***Principle 4: Treating Hyperglycemia (High Blood Sugar)***

Blood sugar levels should be kept as near to normal levels as is safely
possible. The target range should be based on an overall assessment of
the person's health.

The number one goal of diabetes treatment is to control high blood sugar
levels. Over time, high blood sugar has been shown to cause eye disease,
kidney disease and nerve damage, and may also be linked to heart disease
and stroke.

There are many methods to control high blood sugar. These methods will
vary from person to person and will depend on your unique needs. In type
1 diabetes, the treatment plan includes a healthy diet and regular
physical activity coordinated with an insulin schedule. Treatment for
type 2 diabetes often includes a healthy diet, physical activity, and in
some cases, pills and/or insulin. You should be involved in creating
your treatment plan and making decisions about your diabetes care.

***Principle 5: Self-Monitoring of Blood Glucose and Hemoglobin A1c
(HbA1c)***

*Blood sugar levels and hemoglobin A1c values should be measured on a
routine basis using current, reliable methods.*

Diabetes is sometimes called the "silent disease" because it can cause
serious damage to the body without showing any signs or symptoms. You
may need to self-test your blood sugar on a regular basis to measure
your blood sugar levels and help you manage your diabetes. You should
work with your health care provider to decide how often to test, the
type of test to use, and how often to report the test results. You
should talk to your health care provider about getting the supplies you
need to self-test.

Hemoglobin A1c (pronounced he'-me-glo'-bin ay-wun-see, or H-b-A-one-c,)
is a test that gives the average amount of sugar in the blood over the
last 2 to 3 months. This test is very important because it tells how
well you are managing your diabetes. Lowering the HbA1c number by any
amount improves your chances of staying healthy and lowers your chances
of having diabetes problems. You should talk to your health care
provider about your HbA1c number and your own target goal.

### *Principle 6: Preventing and Diagnosing Long-term Diabetes Problems*

Excellent diabetes care can greatly lower the chances of developing
long-term diabetes problems.

People with diabetes must control their blood sugar levels to prevent
diabetes problems such as eye disease, kidney disease, nerve damage,
heart disease and stroke. People with diabetes should also ask their
health care provider for regular blood pressure checks, cholesterol
tests, and other blood fat tests (HDL or "good cholesterol" and LDL or
"bad cholesterol"). Routine testing of these factors is also part of
good diabetes care.

You should work with your health care provider to make healthy lifestyle
choices to help control and manage your diabetes. Eating to control
blood sugar and blood fat levels, taking prescribed diabetes medicine,
getting regular physical activity, and getting regular foot and eye
exams are all important for good health and to help control diabetes.

### *Principle 7: Screening For and Treating Long-Term Diabetes Problems*

People with diabetes should have regular exams to help find and treat
long-term diabetes problems. All long-term diabetes problems have
effective treatments.

All people with diabetes should be examined by their health care
providers for the problems that can occur with diabetes. Regular exams
by a health care provider can help find problems at a time when they can
be treated and managed successfully. You should have your feet, eyes and
kidneys checked on a regular basis. Other tests may also be needed.

The long-term problems that occur in people with diabetes can usually be
prevented or delayed if they are found and treated at an early stage.
For example, kidney disease can be slowed or prevented by controlling
high blood pressure and high blood sugar and by taking special
medicines. Severe eye disease can be managed by laser surgery. Problems
of circulation in the legs, heart or brain can be improved by treatments
that may or may not involve surgery. These examples show that it is
important for people with diabetes to be treated for diabetes problems
at any stage of the disease to prevent the problems from getting worse.