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Managing Diabetes

What is Diabetes and Hemoglobin A1c Good Control?

Diabetes is a problem with your body that causes blood glucose (also called blood sugar) levels to rise higher than normal. This is also called hyperglycemia. When you eat, your body breaks food down into glucose and sends it into the blood. Insulin then helps move the glucose from the blood into your cells. When glucose enters your cells, it is either used as fuel for energy right away or stored for later use. In a person with diabetes, there is a problem with insulin. But, not everyone with diabetes has the same problem.

There are different types of diabetes—type 1, type 2, and a condition called gestational diabetes. If you have diabetes, your body either doesn’t make insulin, can’t use insulin it does make well, or both.

Diabetes may be treated with insulin, oral medications, exercise, and meal planning. If left untreated, diabetes can lead to several complications, such as nerve damage, kidney or eye problems, heart disease, and stroke. But, if managed well, you can live a long, healthy life with diabetes.

Type 1
In type 1 diabetes, your immune system mistakenly destroys the beta cells in your pancreas that make insulin. Your body treats beta cells as foreign invaders and destroys them. This can happen over a few weeks, months, or years. When enough beta cells are gone, your pancreas stops making insulin, or makes so little insulin that you need to take insulin to live. Type 1 diabetes develops most often in young people but can appear in adults.

Type 2
If you have type 2 diabetes your body does not use insulin properly. This is called insulin resistance. At first, the beta cells make extra insulin to make up for it. But, over time, your pancreas can’t make enough insulin to keep blood glucose at normal levels. Type 2 diabetes develops most often in middle aged and older adults but can appear in young people. Some people with type 2 diabetes can manage their diabetes with healthy eating and exercise. However, your doctor may need to also prescribe oral medications (pills) and/or insulin to help you meet your target blood glucose levels. Diabetes is a progressive disease. Even if you don’t need to treat your diabetes with medications at first, you may need to over time.

Diabetes Management
You will work with your health care team to make a plan that helps you reach your goals. Together, you’ll keep track of the ABCs of diabetes:

  • A is for A1C: Your A1C check tells you your average blood glucose for the past 2 to 3 months.
  • B is for blood pressure: Your blood pressure numbers tell you the force of blood inside your blood vessels. When your blood pressure is high, your heart has to work harder.
  • C is for cholesterol: Your cholesterol numbers tell you about the amount of fat in your blood. Some kinds, like HDL cholesterol, help protect you heart. Others, like LDL cholesterol, can clog your blood vessels and lead to heart disease. Triglycerides are another kind of blood fat that raises your risk for a heart attack or stroke.

What is the A1C test?
The A1C is a blood test that tells you what your average blood sugar (blood glucose) levels have been for the past two to three months. It measures how much sugar is attached to your red blood cells. If your blood sugar is frequently high, more will be attached to your blood cells. Because you are always making new red blood cells to replace old ones, your A1C changes over time as your blood sugar levels change.

How often should I have an A1C?
Usually your doctor will measure your A1C at least twice a year. If your medication is changing, you are making other changes in how you take care of yourself, or other things might be affecting your blood sugar, you may have it checked more often.

What is a good target for A1C?
The American Diabetes Association® (ADA) recommends a target for A1C of less than 7% for most adults. You and your doctor may decide on a higher or lower target depending on your treatment goals and other factors. The closer you get to your target, the better your chances of preventing or delaying problems from diabetes that can develop over time. Studies have shown that for every one-point decrease in A1C levels, you reduce your risk of long-term diabetes complications by up to 40%.

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