Amy Tenderich was diagnosed with type 1 diabetes in May of 2003. She is the founder and editor-in-chief of Diabetes Mine and co-authored the book Know Your Numbers, Outlive Your Diabetes. You will frequently find her speaking at diabetes, health, and social media events across the country.

Although diabetes-related complications may seem to appear suddenly, they are actually the outcome of long periods—years and sometimes decades—of “suboptimal metabolic control.” That is, when the balance of your body’s physical and chemical processes is not right.

Practically, this means that when the amounts of sugar (glucose), fats (lipids), and other substances in your blood remain off-balance for long periods of time, it does gradual damage to your body. You may not feel it, but when your blood glucose levels (BG) run too high for too long, parts of your body are quietly deteriorating.

The good news here is that “nothing happens fast with diabetes,” as my co-author Dr. Richard Jackson of Joslin Diabetes Center likes to say.

So you don’t need to panic if you have an occasional high BG result. Everyone has a few bad days now and then. However, if your levels consistently remain out of range, you are actively increasing your chance of future health problems.

This is important to know, and again: it’s why the A1c test is so important. This blood test gives you a measure of your average BG levels over the past three months. If you have a few high BG readings here and there, you might be just fine. But if your A1c and blood pressure levels are not in good control over time, then you ARE in danger of developing complications. Things like eye damage or kidney disease may be quietly sneaking up on you.

According to the American Diabetes Association and other national organizations, good control is defined as:

A1c of 7.0 or less

Blood pressure of 130/80 or lower

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