Managing diabetes is more than managing blood glucose; it’s also about managing your overall health. And the heart and cardiovascular systems are special considerations.

High blood pressure (hypertension)
Like glucose, blood pressure can fluctuate in a day. Some things make it go up naturally—when you’re exercising and your heart is pumping blood, or if you’re stressed, or even if you drink a stimulant like caffeine. These periodic jumps in themselves aren’t so bad, just as long as your pressure settles back into a healthy level (just as with glucose). The problem is when your average blood pressure stays above a healthy range.

To help with healthy blood pressure, keep your weight under control, and also watch what you put into your body. Avoid too much fat and pass on the salt shaker and very salty foods; don’t drink too much alcohol, and if you smoke, quit.

Good glucose control helps too, as does the more efficient use of insulin if you have insulin resistance. Excess glucose and insulin in the blood can aggravate hypertension, which is another reason why poorly controlled diabetes is often accompanied by high blood pressure. The American Diabetes Association recommends a blood pressure target goal of less than 130/80 mm Hg.

The American Diabetes Association, the National Institutes of Health, and other organizations are working hard to spread the message that people with diabetes and their physicians need to focus on controlling blood pressure, just as they focus on controlling blood glucose. In both cases, your diet and activity are important. And, as with diabetes, when diet and exercise aren’t enough, you may also need medications to help get your blood pressure under control.

Triglycerides and cholesterol
You’ll hear a lot about triglycerides and cholesterol in the blood, and that high levels are not healthy. Conditions where the “lipids,” or fats, in the blood are not at a healthy range are also called dyslipidemia.

Triglycerides: When your body digests fats, triglycerides are created, and this is the main form in which our bodies store fat for energy. If you have elevated levels in your blood, it’s a sign that your body is not processing fats properly. This is also a warning sign of risk for heart disease.

Cholesterol: Cholesterol is, strictly speaking, not a fat—but a substance that travels in our bodies with fats, so it is often spoken of together with triglycerides. There are actually two kinds of cholesterol: LDL and HDL. Of particular concern is LDL, or “bad,” cholesterol. High LDL cholesterol contributes significantly to the risk of heart disease. On the other hand, HDL or “good” cholesterol can help to protect you against heart disease. Exercise has been shown to help increase HDL and lower triglycerides, and it may even help to lower LDLs. A healthy diet helps as well, especially avoiding foods high in saturated fat (found in meats and dairy products, as well as some other foods) and “trans” fats (hydrogenated vegetable oils, such as vegetable shortenings, which are also found in many processed foods and baked goods).

Generally, it’s recommended that people with diabetes have an HDL over 40 mg/dL (for a man) or over 50 (for a woman), and an LDL level below 100 mg/dL. Triglycerides should be at 150 or lower. If these numbers are out of range, diet and exercise can help; but for many people, diet and exercise alone may not be able to bring them down enough. In such cases, medications may be appropriate.

Want to read hundreds more FREE articles like this? Join today!