Number 

1 

in a 

Series 

of 7 

Large-print version 

Prevent diabetes problems:
 

Keep your diabetes 

under control 

U.S. Department 


of Health and
 

Human Services
 

NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse

Prevent diabetes problems:

Keep your diabetes 

under control

U.S. Department 

of Health and 

Human Services

NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse

Contents 

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

How can I find out what my average blood
 

What does smoking have to do with
 

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

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

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

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

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

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.
 

1 
 

 

 

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. 

2 
 

 

 

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. 

3 
 

 

 

 

...................

...................

...................

...................

...................

...................

...................

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. 

4 

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. 

5 
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 

6 
 

 

 

 

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. 

7 
 

 

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. 

Check your feet each day 

to keep them healthy. 

8 
 

 

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. 

9 
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. 

10 
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. 

11 
 

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. 

12 
 

 

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. 

13 
 

 

 

________________________________________________ 

________________________________________________ 

________________________________________________ 

________________________________________________ 

________________________________________________ 

________________________________________________ 

________________________________________________ 

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: 

14 
 

 

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 

15 
16 17

Daily Diabetes Record* Week Starting __________________

Other Breakfast Medicine Lunch Medicine Dinner Medicine Bedtime Medicine Notes: 

blood blood blood blood blood (Special events, sick days, exercise)

glucose glucose glucose glucose glucose

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

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

18 
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) 

19 
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, contact the American Dietetic 

Association at www.eatright.org and click on “Find a 

Nutrition Professional.” 

20 
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
 

TTY: 1–866–569–1162
 

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 20814–9692
 

Phone: 1–888–693–NDEP (6337)
 

TTY: 1–866–569–1162
 

Fax: 703–738–4929
 

Email: ndep@mail.nih.gov
 

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
 

21 
More in the Series 

The “Prevent Diabetes Problems” Series has 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
 

TTY: 1–866–569–1162
 

Fax: 703–738–4929
 

Email: ndic@info.niddk.nih.gov
 

These booklets are also available at 

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

22 
 

 

 

 

 

 

 

 

 

Acknowledgments 

The National Diabetes Information Clearinghouse thanks the 

people who helped review or field-test 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 Grady Health 

System Diabetes Clinic 

Atlanta, GA
 

Ernestine Baker, R.N.,
 

F.N.P., C.D.E. 

Kris Ernst, R.N., C.D.E. 

Margaret Fowke, R.D., L.D. 

Kay Mann, R.N., C.D.E. 

For the Indian Health 

Service 

Albuquerque, NM
 

Ruth Bear, R.D., C.D.E.
 

Dorinda Bradley, R.N.,
 

C.D.E. 

Terry Fisher, R.N. 

Lorraine Valdez, R.N., 

C.D.E. 

Red Lake, MN 

Charmaine Branchaud, 

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

For the Medlantic 

Research Center 

Washington, DC 

Resa Levetan, M.D. 

For the Texas Diabetes 

Council 

Texas Department of 

Health 

Austin, TX 

Luby Garza-Abijaoude, 

M.S., R.D., L.D. 

23 

 

 

 

 

 

 

 

 

National Diabetes 

Information Clearinghouse 

1 Information Way
 

Bethesda, MD 20892–3560
 

Phone: 1–800–860–8747
 

TTY: 1–866–569–1162
 

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. When 

prepared, this publication included the most current information available. 

For updates or for questions about any medications, contact the U.S. Food 

and Drug Administration toll-free at 1–888–INFO–FDA (463–6332) or visit 

www.fda.gov. Consult your doctor for more information. 
U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

NIH Publication No. 08–4349L 

February 2008