Setting Goals for Diabetes Care: What Matters Most?
Living with type 2 diabetes means having a lot of things to think about. Rather than trying to do everything perfectly, many physicians suggest focusing on a few main things. The question is though– what are the goals that are really worth working towards? Here’s what the studies show matters most…
Top Priority: Blood Sugar
A1C (also called hemoglobin A1C) measures the average amount of glucose in the blood over the past 2-3 months. It indicates how well a person’s treatment plan (diabetes medicines, food, activity) is working, and if changes need to be made. Your A1C will be measured in your doctor’s office and is usually checked 2-4 times a year. An A1C that runs 6.5 or above indicates a person has diabetes. The goal is to keep the A1C at 7 or lower. When the A1C runs above target for long periods of time – there is a greater risk for other health problems (complications) such as damage to the blood vessels of the heart, eye and kidneys.
Also Important: Blood Pressure and Cholesterol
Blood Pressure is also a very important measure. Since complications related to heart disease and stroke are the most common complications of high blood sugar, keeping blood pressure in target helps to reduce that risk. Blood pressure should be checked at every medical appointment. The goal for most people with diabetes is below 130 / 80, with both numbers below the target.
Cholesterol management is also important to reduce risks of heart disease and stroke. Every year, your healthcare provider should review the results of blood tests for LDL and HDL cholesterol as well as triglycerides to make sure they are in target. The LDL cholesterol goal for most people with diabetes is below 70.
Talk to your doctor about what’s right for you on all three of these important numbers.
Your Personal Goals:
In addition to keeping your medical goals in mind, your personal goals are very important. Think about why all the effort is worth it. Your personal goals may change over time – but think of a few and write them down. Personal goals are often the best motivation towards good health! Some sample personal goals you might consider include:
- Be able to see my grandchildren grow up.
- Take a trip to Europe and be able to walk everywhere I want.
- Play pickleball more often
Action Steps to Achieve Goals:
The good news about each of these goals is that they require similar action steps to help achieve them. Blood sugar, blood pressure, and cholesterol are more likely to move into target range when the following things are done:
- Take medicines as prescribed
- Follow a meal plan – putting priority on eating more whole foods that are high in fiber and less processed, refined foods.
- Engage in regular physical activity – aiming for 150 minutes a week as a goal
- Lose weight, if you carry excess weight. Significant improvements can usually be seen with a goal of losing between 5 – 15% body weight (so for a 250 pound person, that would be a weight loss of between 12 – 37 pounds.)
Added Benefits:
When you focus on these top priority goals (and take the action steps that help achieve them, such as eating well, exercising more, and losing weight),you’ll have some added benefits.
You’ll feel less stress and worry. You’ll feel pride in your accomplishments. You may be able to take less medicines over time. And most importantly, you’ll know that you are preventing future health problems with diabetes. Remember– well-controlled diabetes is the leading cause of nothing!
Extra Credit Goal!
Time in Range (TIR) is also a measure of glucose control over time. It is available for people who wear a continuous glucose monitor (CGM). (If you don’t wear one, your A1C gives similar information). The TIR number tells the percent of time that glucose levels are in the target range. The range can be individualized for each person – but a general goal is to keep glucose between 70-180 mg/dl at least 70% of the time. This information comes from the data reports that are created from CGM data and is most accurate when it’s based on 14 days of data. The higher the TIR number – the better.
The medical information on Diabetes – What To Know’s website is provided as an information resource only. The content is not in any way intended to be nor should you rely on it as a substitute for professional medical evaluation, diagnosis, advice and treatment.
