07337 PDP_DiabetesControl1.indd i 07337 PDP_DiabetesControl1.indd i 

Keep your diabete

under control 

Keep your diabete

under control

U.S. Department 

of Health and 

Human Services 

NATIONAL INSTITUTES OF HEALTH National Diabetes I

Prevent diabetes problems: 

Keep your diabetes 

under control 

NATIONAL INSTITUTES OF HEALTH 

National Diabetes Information Clearinghouse 

Contents
 

What are diabetes problems?................................. 1 

Will I have diabetes problems?.............................. 1 

What should my blood glucose numbers be? ....... 2 

How can I find out what my average blood 

glucose is? ................................................................ 3
 

What should my blood pressure be? ..................... 5
 

What should my cholesterol be?............................ 6
 

What does smoking have to do with diabetes 


problems?................................................................. 7
 

What else can I do to prevent diabetes 


problems?................................................................. 8
 

Things to Check for Good Diabetes Care ............ 9
 

How to Use the Daily Diabetes Record Page..... 14
 

Pronunciation Guide............................................. 19
 

For More Information .......................................... 20
 

More in the Series................................................. 22
 

Acknowledgments ................................................. 23
 

What are diabetes problems? 

Too much glucose* in the blood for a long time can 

cause diabetes problems. This high blood glucose, 

also called blood sugar, can damage many parts of 

the body, such as the heart, blood vessels, eyes, and 

kidneys. Heart and blood vessel disease can lead 

to heart attacks and strokes. You can do a lot to 

prevent or slow down diabetes problems. 

Will I have diabetes problems? 

Maybe. You may have one or more diabetes 

problems or none at all. If you get diabetes 

when you are young, you may not have diabetes 

problems for many years. If you find out you have 

diabetes as an adult, you may already have diabetes 

problems. Either way, keeping your 

blood glucose, blood pressure, and 

cholesterol under control can 

prevent diabetes problems. 

*See page 19 for tips 

on how to say the 

words in bold type. 

Be active to prevent 

diabetes problems. 


 
What should my blood glucose 


numbers be?
 

Keeping your blood glucose on target can prevent 

or delay diabetes problems. The chart below 

shows target blood glucose levels for most people 

with diabetes. 

Target Blood Glucose Levels 

for People with Diabetes 

Before meals 70 to 130 

1 to 2 hours after 


the start of a meal less than 180
 

Talk with your health care provider about what 

your blood glucose numbers should be and write 

them here: 

My Target Blood Glucose Levels 

Before meals ______ to ______ 

1 to 2 hours after 


the start of a meal less than _______
 

Talk with your health care provider about when 

you need to check your blood glucose using a blood 

glucose meter. You will do the checks yourself. 

Your health care provider can teach you how to use 

your meter. 


 
Keep track of your blood glucose checks using 

the record page in this booklet on pages 16 and 

17. Make copies yourself or ask your health care 

provider for a blood glucose record book. Your 

blood glucose check results will help you and your 

health care provider make a plan for keeping your 

blood glucose under control. Always bring your 

record book to your doctor visits so you can talk 

about reaching your glucose goals. 

How can I find out what my average 

blood glucose is? 

Ask your health care provider for the A1C test. 

This blood test shows the average amount of 

glucose in your blood during the past 2 to 3 

months. Have this test done at least twice a year. 

If your A1C result is not on target, your health 

care provider may do this test more often to see if 

your result is improving as your treatment changes. 

Your A1C result plus your blood glucose meter 

results can show whether your blood glucose is 

under control. 


 
The A1C target for most people with diabetes is 

below 7 percent. Ask your health care provider if 

this target is right for you. Then write your A1C 

target here: 

My A1C target is ____________ percent. 

If your A1C test result is on target, then your blood 

glucose is in a desirable range and your diabetes 

treatment plan is working. The lower your A1C is, 

the lower your chance of having health problems. 

If your result is too high, you may need a change 

in your diabetes plan. Your health care team can 

help you decide what part of your plan to change. 

You may need to change your meal plan, your 

diabetes medicines, or your physical activity plan. 

What Your A1C Result Means 

My A1C Result My Average Blood Glucose 

6% . . . . . . . . . . . . . . . . . 135 

7% . . . . . . . . . . . . . . . . . 170 

8% . . . . . . . . . . . . . . . . . 205 

9% . . . . . . . . . . . . . . . . . 240 

10% . . . . . . . . . . . . . . . . . 275 

11% . . . . . . . . . . . . . . . . . 310 

12% . . . . . . . . . . . . . . . . . 345


 
What should my blood pressure be? 

Normal blood pressure will help prevent damage to 

your eyes, kidneys, heart, and blood vessels. Blood 

pressure is written with two numbers separated by 

a slash. For example, 120/70 is said as “120 over 

70.” The first number should be below 130 and 

the second number should be below 80. Keep your 

blood pressure as close to these numbers as you 

can. If you already have kidney disease, ask your 

doctor what numbers are best for you. 

Meal planning, medicines, and physical activity can 

help you reach your blood pressure target. 

Have your blood 

pressure checked 

at every visit. 


 
What should my cholesterol be? 

Normal cholesterol and blood fat levels will help 

prevent heart disease and stroke, the biggest 

health problems for people with diabetes. Keeping 

cholesterol levels under control can also help with 

blood flow. Have your blood fat levels checked at 

least once a year. Meal planning, physical activity, 

and medicines can help you reach your blood fat 

targets: 

Target Blood Fat Levels 

for People with Diabetes 

Total cholesterol	 below 200
 

LDL cholesterol	 below 100
 

HDL cholesterol	 above 40 (men) 

above 50 (women) 

Triglycerides	 below 150
 


 
What does smoking have to do with 

diabetes problems? 

Smoking and diabetes are a dangerous combination. 

Smoking raises your risk for diabetes problems. If 

you quit smoking, you’ll lower your risk for heart 

attack, stroke, nerve disease, and kidney disease. 

Your cholesterol and your blood pressure levels 

may improve. Your blood circulation will also 

improve. 

If you smoke, ask your health care provider for 

help in quitting. 


 
Check your feet each day 

to keep them healthy. 

What else can I do to prevent 


diabetes problems?
 

You can do many things to prevent diabetes 

problems. For example, to keep your feet healthy, 

check them each day. Ask your health care team 

whether you should take a low-dose aspirin every 

day to lower your risk for heart disease. To keep 

your eyes healthy, visit an eye care professional 

once a year for a complete eye examination that 

includes using drops in your eyes to dilate the 

pupils. 

Make sure your doctor 

checks your urine for 

protein every year. At least 

once a year, your blood 

creatinine level should be 

checked. Also once a year, 

your health care provider 

should do a complete 

foot exam. See page 10 

for what you can do each 

day to stay healthy with 

diabetes. See pages 11 

to 13 for other things for 

your health care provider 

to check for good diabetes 

care. 


 
Things to Check for Good 


Diabetes Care
 

Taking care of diabetes is a team effort between 

you and your health care team—doctor, diabetes 

nurse educator, diabetes dietitian educator, 

pharmacist, and others. You are the most 

important member of the team. 

Take charge of your diabetes by learning what to 

do for good diabetes care: 

● things to do every day for good diabetes care 

(see page 10) 

● things for your health care provider to look 

at every time you have a checkup (see pages 

11 and 12) 

● things for you or your health care provider 

to do at least once or twice a year (see pages 

12 and 13) 

Keep a daily record of blood glucose check results. 

Make copies of the Daily Diabetes Record on 

pages 16 and 17 in this booklet. This information 

will help you see whether you are reaching your 

blood glucose goals. 

You can prevent or slow down diabetes problems 

by reaching your blood glucose, blood pressure, 

and cholesterol goals most of the time. 


 
Things to Do Every Day for Good Diabetes Care
 

Follow the healthy eating plan that 

you and your doctor or dietitian have 

worked out. 

Be active a total of 30 minutes most 

days. Ask your doctor what activities 

are best for you. 

Take your medicines as directed. 

Check your blood glucose every day. 

Each time you check your blood 

glucose, write the number in your 

record book. 

Check your feet every day for cuts, 

blisters, sores, swelling, redness, or 

sore toenails. 

Brush and floss your teeth every day. 

Control your blood pressure and 

cholesterol. 

Don’t smoke. 

0
 
Things for Your Health Care Provider to Look 

at Every Time You Have a Checkup 

Your blood 

glucose records 

Show your records to your 

health care provider. 

Tell your health care provider 

if you often have low blood 

glucose or high blood glucose. 

Your weight Talk with your health care 

provider about how much you 

should weigh. 

Talk about ways to reach your 

goal that will work for you. 

Your blood 

pressure 

The goal for most people with 

diabetes is less than 130/80. 

Ask your health care provider 

about ways to reach your goal. 

Your 

medicines 

Talk with your health care 

provider about any problems 

you have had with your 

medicines. 

Your feet Ask your health care provider 

to check your feet for problems. 


 
Your physical 

activity plan 

Talk with your health care 

provider about what you do 

to stay active. 

Your meal 

plan 

Talk about what you eat, 

how much you eat, and 

when you eat. 

Your feelings Ask your health care provider 

about ways to handle stress. 

If you are feeling sad or 

unable to cope with problems, 

ask about how to get help. 

Your smoking If you smoke, talk with your 

health care provider about 

how you can quit. 

Things for You or Your Health Care Provider 

to Do at Least Once or Twice a Year 

A1C test Have this blood test at least 

twice a year (see pages 3 and 

4). Your result will tell you 

what your average blood 

glucose level was for the past 

2 to 3 months. 


 
Blood lipid 

(fats) lab tests 

Get a blood test to check your 

• total cholesterol—aim for 

below 200 

• LDL—aim for below 100 

• HDL—men: aim for above 40; 

women: aim for above 50 

• triglycerides—aim for 

below 150 

These test results will help you plan 

how to prevent heart attack and stroke. 

Kidney 

function tests 

Once a year, get a urine test to 

check for protein. At least 

once a year, get a blood test 

to check for creatinine. The 

results will tell you how well 

your kidneys are working. 

Dilated eye 

exam 

See an eye care professional 

once a year for a complete 

eye exam. 

Dental exam See your dentist twice a year 

for a cleaning and checkup. 

Foot exam Ask your health care provider 

to check your feet to make 

sure your foot nerves and your 

blood circulation are OK. 

Flu shot Get a flu shot each year. 

Pneumonia 

vaccine 

Get one; if you’re over 64 and 

your shot was more than 5 

years ago, get one more. 


 
___________________________________________ 

___________________________________________ 

___________________________________________ 

___________________________________________ 

___________________________________________ 

___________________________________________ 

___________________________________________ 

How to Use the Daily Diabetes 


Record Page
 

Use copies of the record page on pages 16 and 17 

to keep track of blood glucose checks, medicines, 

and notes about things that affect your blood 

glucose. Make one copy of the record page for 

each week. This record will help you see whether 

your diabetes plan is working. Review your record 

with your health care provider. 

Blood Glucose Checks 

Talk with your health care provider and decide on 

the best times to check blood glucose. You may be 

checking blood glucose before meals, after meals, 

or at bedtime. Write when to check here: 


 
If needed, draw a line in the boxes 

under “Breakfast,” “Lunch,” and 

“Dinner” to make room for blood 

glucose check results before and after 

a meal, like this example: 

See page 2 for information about target blood 

glucose levels. 

Medicines 

Under the heading marked “Medicine,” write the 

names of your diabetes medicines and the amounts 

taken. 

Notes 

Write down things that affect your blood glucose 

level. Some examples are 

● eating more or less than usual 

● forgetting to take your diabetes medicine 

● exercising—write down what kind and for 

how long 

● being sick or upset about something—being 

under stress 

● going to a social event or other special event, or 

being on vacation 


 
Daily Diabetes Record* Week Starting ___________

	 

	 

	 

Other	 

blood	 

glucose	 

Breakfast	 

blood	 

glucose	 

Medicine	 

	 

	 

Lunch	 

blood	 

glucose	 

Medicine	 

	 

	 

Dinner	 

blood	 

glucose	 

Medicine	 

	 

	 

Bedtime	 

blood	 

glucose 

Medicine	 

	 

Notes:			 

(Special events, sick days, exercise)	 

Monday 

Tuesday 

Wednesday 

Thursday 

Friday 

Saturday 

Sunday 

*Keep	this	copy	clean.		Make	photocopies	and	write	on	the	copies. 

16 17 
My Health Care Team Members
 

Name and Address Phone Number 

Doctor 

Diabetes 

dietitian 

educator 

Diabetes 

nurse 

educator 

Eye care 

professional 

Dentist 

Foot doctor 

Pharmacist 

Counselor 


 
Pronunciation Guide 

A1C (AY-WUHN-SEE) 

cholesterol (koh-LESS-tur-ol) 

circulation (SUR-kyoo-LAY-shuhn) 

creatinine (kree-AT-ih-neen) 

glucose (GLOO-kohss) 

triglycerides (try-GLISS-ur-eyedz)


 
For More Information 

Diabetes Teachers (nurses, dietitians, pharmacists, 

and other health professionals) 

To find a diabetes teacher near you, call the 

American Association of Diabetes Educators 

toll-free at 1–800–TEAMUP4 (832–6874), 

or look on the Internet at 

www.diabeteseducator.org 

and click on “Find a 

Diabetes Educator.” 

Dietitians 

To find a dietitian near you, 

call the American Dietetic 

Association toll-free at 

1–800–877–1600, or look on the Internet at 

www.eatright.org and click on “Find a Nutrition 

Professional.” 

0
 
To get more information about taking care of 

diabetes, contact 

National Diabetes Information Clearinghouse 

1 Information Way
 

Bethesda, MD 20892–3560
 

Phone: 1–800–860–8747
 

Fax: 703–738–4929
 

Email: ndic@info.niddk.nih.gov
 

Internet: www.diabetes.niddk.nih.gov
 

National Diabetes Education Program 

1 Diabetes Way
 

Bethesda, MD 20892–3560
 

Phone: 1–800–438–5383
 

Fax: 703–738–4929
 

Internet: www.ndep.nih.gov
 

American Diabetes Association 

1701 North Beauregard Street
 

Alexandria, VA 22311
 

Phone: 1–800–DIABETES (342–2383)
 

Internet: www.diabetes.org
 

Juvenile Diabetes Research Foundation
 

International
 

120 Wall Street
 

New York, NY 10005–4001
 

Phone: 1–800–533–CURE (2873)
 

Internet: www.jdrf.org
 


 
More in the Series 

The “Prevent Diabetes Problems” Series includes 

seven booklets that can help you learn more about 

how to prevent diabetes problems. 

For free single copies of these booklets, write, call, 

fax, or email the 

National Diabetes Information Clearinghouse 

1 Information Way 

Bethesda, MD 20892–3560 

Phone: 1–800–860–8747 

Fax: 703–738–4929 

Email: ndic@info.niddk.nih.gov 

These booklets are also available at 

www.diabetes.niddk.nih.gov on the Internet. 


 
07337 PDP_DiabetesControl1.indd Sec1:23 07337 PDP_DiabetesControl1.indd Sec1:23 

The National Diabetes Information Clea

thanks the people who helped review or fi 

this publication: 

For the American 

Association of Diabetes 

Educators 

Lynn Grieger, R.D.,

 C.D.E. 

Arlington, VT 

Celia Levesque, R.N., 

C.D.E. 

Montgomery, AL 

Teresa McMahon, 

 Pharm.D., C.D.E. 

Seattle, WA 

Barbara Schreiner, R.N., 

 M.N., C.D.E. 

Galveston, TX 

For the American 

 Diabetes Association 

Phyllis Barrier, M.S., 

 R.D., C.D.E. 

Alexandria, VA 

Linda Haas, Ph.C., R.N.,

 C.D.E. 

Seattle, WA 

Kathleen Mahoney, 

M.S.N., R.N., C.D.E. 

Drexel Hill, PA 

Randi Kington, M.S., 

R.N., C.S., C.D.E. 

Hartford, CT 

For the Centers for 

Medicare & Medicaid 

Services 

Baltimore, MD
 

Jan Drass, R.N., C.D.E.
 

For the Diabetes Research 

and Training Centers 

Albert Einstein School 

 of Medicine 

Norwalk Hospital 

Norwalk, CT 

Jill Ely, R.N., C.D.E. 

Sam Engel, M.D. 

Pam Howard, A.P.R.N.,

 C.D.E. 

Indiana University 

School of Medicine 

Indianapolis, IN 

Madelyn Wheeler, M.S., 

R.D., F.A.D.A., C.D.E. 

VA/JDF Diabetes

 Research Center 

Vanderbilt School of

 Medicine 

Nashville, TN 

Ok Chon Allison, 

 M.S.N., R.N.C.S., 

 A.N.P., C.D.E. 

Barbara Backer, B.S. 

James W. Pichert, Ph.D. 

Alvin Powers, M.D. 

Melissa E. Schweikhart 

Michael B. Smith 

Kathleen Wolffe, R.N. 

For the G

System 

Atlanta, G

Ernestine 

 F.N.P., 

Kris Erns

Margaret 

 L.D. 

Kay Man

For the In

Service 

Albuquer

Ruth Bea

Dorinda 

 C.D.E

Terry Fish

Lorraine 

C.D.E

Red Lake

Charmain

B.S.N.

For the M

 Resear

Washingt

Resa Lev

For the Te

Counc

Texas De

 Health 

Austin, T

Luby Gar

M.S., R

National Diabetes 

Information Clearinghouse
 

1 Information Way 

Bethesda, MD 20892–3560 

Phone: 1–800–860–8747 

Fax: 703–738–4929
 

Email: ndic@info.niddk.nih.gov
 

Internet: www.diabetes.niddk.nih.gov
 

The National Diabetes Information Clearinghouse (NDIC) 

is a service of the National Institute of Diabetes and Digestive 

and Kidney Diseases (NIDDK). The NIDDK is part of 

the National Institutes of Health of the U.S. Department 

of Health and Human Services. Established in 1978, the 

Clearinghouse provides information about diabetes to people 

with diabetes and to their families, health care professionals, 

and the public. The NDIC answers inquiries, develops and 

distributes publications, and works closely with professional 

and patient organizations and Government agencies to 

coordinate resources about diabetes. 

Publications produced by the Clearinghouse are carefully 

reviewed by both NIDDK scientists and outside experts. 

This publication is not copyrighted. The Clearinghouse encourages users of 

this booklet to duplicate and distribute as many copies as desired. 

This booklet is also available at www.diabetes.niddk.nih.gov. 

This publication may contain information about medications used to treat a health 

condition. When this publication was prepared, the NIDDK included the most 

current information available. Occasionally, new information about medication is 

released. For updates or for questions about any medications, please contact the 

U.S. Food and Drug Administration at 1–888–INFO–FDA (463–6332), a toll-free 

call, or visit their website at www.fda.gov. Consult your doctor for more information.
U.S. DEPArTmENT OF HEALTH 

AND HUmAN SErvICES 

National Institutes of Health 

NIH Publication No. 08–4349 

February 2008