A Better Way to Manage Diabetes

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Not one-size-fits-all

Diabetes is a complex condition, particularly in older adults, who need to be extra careful about their blood sugar dropping too low. In 2015 the American Diabetes Association revised its standards of treatment. Here’s what you should know.

Set a goal for blood sugar control

If you’re in relatively good health, your goal for hemoglobin A1C (the protein that binds with glucose in the blood) should be 7.5. If you have additional chronic or complex illnesses that might make self-care difficult, your goal should be 8.0. Your doctor may set a different goal based on your own health and preferences.

Lower blood pressure

Blood pressure goals have been raised to 140 mm Hg/90 mm Hg from 130/80. Some people should still strive for the lower numbers, but for others, too tight control may do more harm than good. Ask your doctor what your goal should be.

Consider a statin

The ADA says almost everyone 40 and older with diabetes—a major heart disease risk factor—should be taking a statin. Your doctor may not recommend a statin if the risk of side effects, such as interactions with other drugs you’re taking, are too great.

Avoid e-cigarettes

The ADA makes clear that e-cigarettes aren’t recommended as an alternative to smoking or as an aid to help quit smoking.

Keep moving

Sitting for more than 90 minutes at a time increases your risk for heart disease. The ADA encourages people to get up and move around intermittently. Moreover, get at least 30 minutes of aerobic exercise at least five days a week and regular resistance training, such as with hand weights or resistance bands.

Examine your feet

Diabetes makes your feet prone to nerve damage (neuropathy), infections and poor circulation. Get your feet examined at every doctor’s visit and check your feet every night for skin lesions that aren’t healing.

Asian Americans and screening

If you’re Asian American, you should be screened for diabetes if your body mass index (BMI)—a calculation of height and weight—is 23 or higher. Asian Americans tend to have more visceral fat (fat stored deep within the abdomen) that’s associated with increased diabetes risk. (The recommendation remains at a BMI of 25 for the rest of the population.)