Live Well with Diabetes

HbA1c is made when the glucose (sugar) in your body sticks to your red blood cells. Your body can’t use the sugar properly, so more of it sticks to your blood cells and builds up in your blood.

Diabetes is diagnosed if you have 2 or more HbA1c readings of 48 or above.

If you have diabetes, an ideal HbA1c level is 48 or below.

If you're at risk of developing type 2 diabetes, your target HbA1c level should be below 42 or below. Find out if you're at risk of type 2 diabetes

Some people with type 2 diabetes are able to put their diabetes into remission. This means your blood sugar levels are in the healthy range without taking any medication.

This can be achieved through making lifestyle changes to support your health. For many people, diabetes remission can be life-changing. 

Learn more about Type 2 Diabetes Remission

There are two main types – HDL or high-density lipoprotein (good cholesterol) and LDL or low-density lipoprotein (bad cholesterol).

Healthy levels of each type of cholesterol are important for our cells to function. We need balanced levels of cholesterol to make vitamin D and some hormones.

If the levels of your LDL Cholesterol become too high and the HDL Cholesterol become too low, you are at higher risk of developing cardiovascular disease (also known as CVD or heart disease).

For many people, eating a healthy, balanced diet and being physically active is enough to keep cholesterol levels healthy. But, if your LDL cholesterol is high, most people need medication to lower it.

Find out what is a healthy, balanced diet for diabetes?

Your cardiovascular disease (CVD) risk is an attempt to measure what your risk is of having a heart attack or a stroke over the next 10 years. The figure below illustrates what CVD scores mean.

• A 20% CVD Risk Score means that of 100 people with this score, 20 people will have a heart attack or stroke in the next 10 years.

The good news is that this risk can be reduced by lowering diabetes markers like your blood sugar levels, blood pressure, BMI, and LDL cholesterol.

Your creatinine level and other information (such as age, sex and ethnicity) are used to estimate how well your kidneys are working. This is also known as your glomerular filtration rate (eGFR).

Your eGFR number tells you how much kidney function you have. As kidney disease gets worse your eGFR number goes down. Your eGFR results is given as a stage from 1 of 5. 

The figure below shows each of the stages and what they mean:

• Stage 1 G1: 90ml/min or more - Kidney function within normal range, but other tests have found signs of kidney damage
• Stage 2 G2: 60 to 89 ml/min - Slightly reduced kidney function with other signs of kidney damage
• Stage 3a and 3b: 30 to 59 ml/min - Moderately reduced kidney function. Suggests signs of chronic kidney disease
• Stage 4: 15 to 29 ml/min - Severely reduced kidney function. Suggests signs of chronic kidney disease
• Stage 5: Less than 15 ml/min - Kidney failure

It’s helpful to think of blood pressure like the force of water flowing through a hose.

Blood pressure is measured using two numbers:

• Systolic pressure: this is the higher of the two numbers. It’s the pressure against your arteries when your heart is pumping blood around your body.
• Diastolic pressure: this is the lower of the two numbers. It shows how much pressure is in your arteries when your heart relaxes between beats. 

Both systolic and diastolic pressure are measured in millimetres of mercury (mmHg).

Keeping your blood pressure within a healthy range reduces your chances of developing further health complications from Diabetes.

• For people with diabetes the blood pressure target is usually below 140/90.
• If you are aged 80 years or above the target is usually below 150/90.
• For some people with kidney disease the target may be below 130/80. 

These are just general guidelines, so it is important to speak to your healthcare team about your individual target.

BMI is just an indicator and should be considered along with other health indicators, like muscle mass, blood pressure, and cholesterol.

Working towards a healthier BMI is often important if you have diabetes. Higher BMIs are linked with insulin resistance, which means your body’s cells don’t respond to insulin as effectively. This can make it harder to manage blood glucose levels. This also increases the likelihood of long-term complications, such as cardiovascular disease and kidney problems. 

Even small drops in BMI can lead to meaningful improvements in blood sugar control, insulin sensitivity, and overall wellbeing. 

• The NHS recommends a target BMI between 18.5 and 24.9 for most adults
• Working toward a healthier BMI with balanced eating and regular physical activity can improve your long-term health
• For people with diabetes aiming for a BMI in this range can help manage the condition and prevent further health issues

This can worsen insulin resistance, as the insulin may struggle to get through the excess fat. This means the insulin your body produces doesn’t work as effectively, which can lead to higher blood sugar levels.

Managing your waist size can help improve how well your body responds to insulin. This can make it easier to control your blood glucose and reduce your risk of further complications from diabetes.

What is a healthy waist size?

A healthy waist measurement varies based on your gender and ethnicity. This is because you have a higher risk of type 2 diabetes if you are of a Black or South Asian background.

To reduce your risk of complications and support diabetes management, aim for a waist size less than:

• 80cm (31.5in) for all women
• 94cm (37in) for most men
• 90cm (35in) for South Asian men.

Follow the pages below to find out how to do the following while living with diabetes:

• NHS Diabetes Prevention Programme
• Better Living
• Diabetes UK

You can join the Habits for Health programme here at the medical practice for hands-on support with lifestyle changes.

Habits for Health is a six-week rolling drop-in programme. It was designed by our healthcare professionals to help you better manage your long-term condition. Our patients have successfully improved both their physical and mental health through the programme.

Visit the Health Connections website for more information

You can find out when the next session will be by visiting our events page

In our Education Session recording, Dr Rob Taylor and Jo Fordham, from the Health Connections Team, share some simple tips to help patients manage Type 2 Diabetes. 

The aim of this session is to help you move towards a healthier lifestyle, reduce medication use, and move towards diabetes remission.

Learn more about Diabetes Remission

The session covers the following: 

• How diabetes affects your body. 
• How lifestyle changes, such as food choices and movement, can help you manage your condition.
• How we manage our sleep, stress and general health and wellbeing to support good health.

We also encourage you to watch the recording of the education session if you have Prediabetes or are at high risk for Diabetes.