Your Heart, Blood Pressure and Cholesterol

Eyes, kidneys and feet get most of the attention, but heart disease and stroke are the largest long-term risks that come with diabetes.

This is why good diabetes care is never only about blood sugar. Managing your blood glucose, your blood pressure and your cholesterol together is what reduces cardiovascular risk — and blood pressure and cholesterol contribute independently, which is why treating them is not a distraction from your diabetes.

There is a specific reason to take this seriously if you are Indian. South Asians develop diabetes and its cardiovascular consequences at lower levels of body weight and waist size than white Europeans, which is why India uses lower cut-offs — overweight from a BMI of 23, and abdominal obesity from a waist of 90 cm in men and 80 cm in women.

So a waist measurement is worth taking, and worth tracking, even when your weight looks acceptable.

What actually helps: getting blood pressure to target, treating cholesterol if advised, not smoking, regular activity, and losing some weight if you are carrying extra around the middle. Not smoking is the single largest item on that list.

Ask what your blood pressure and cholesterol targets are, and whether you are meeting them. Many people know their HbA1c and not those two numbers.