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Reviewed by Professor Ian Campbell, consultant physician
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| Your weight is just one of your essential health numbers. |
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Everyone should know certain things about their health - such as height, weight, blood pressure and cholesterol levels.
Knowing this information is all the more important in diabetes, because:
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Type 2 diabetes (non-insulin dependent diabetes) is strongly related to being overweight
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these figures affect your cardiovascular health and everyone with diabetes has an increased risk of cardiovascular disease (heart attack, stroke).
Your vital statistics
| Essential health numbers |
| Your
age | ……years |
| Height (no
shoes) | ……m |
| Weight
(unclothed) | ……kg |
| Waist
circumference | ……cm |
| Blood
pressure | ……/……mmHg |
| Blood
glucose | ……mmol/l |
| Blood
cholesterol | ……mmol/l |
Combined with other factors such as your gender and smoking history, these figures help determine your chances of developing an event like a heart attack or stroke in the next few years.
If you can complete all these boxes now, you're in the minority. Not sure why these figures are important? Read on…
Fat estimation: waist measurement
Your waist measurement indicates how much extra fat you are carrying around.
The increase in girth that comes with being overweight is associated with an increase in risk of cardiovascular disease and diabetes.
This pattern of weight gain indicates a change in the body's metabolism called ‘insulin resistance’, which is associated with the acceleration of hardening of the arteries.
If the arteries narrow too much, they can become blocked, leading to stroke or heart attack.
How do I get my number?
All you need is a tape measure:
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put the tape measure round your stomach at the level of your belly button (navel).
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stand up straight, but make sure your tummy muscles are completely relaxed. In other words, let it all hang out.
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if you draw in your spare tyre, you won’t get an accurate reading.
What does it mean?
Men
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If the circumference of your waist is 94-102cm, your cardiovascular risk increases 1.5 to 2 times.
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If your waist measures more than 102cm, your cardiovascular risk increases 4.6 times.
Women
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If the circumference of your waist is 80-88cm, your cardiovascular risk increases 1.5 to 2 times.
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If your waist measures more than 88cm, your cardiovascular risk increases 2.6 times.
Weight assessment: body mass index
Excess body weight is associated with high blood pressure, increased risk of cardiovascular disease, diabetes, a shorter lifespan and some cancers.
The body mass index (BMI) is used to judge weight according to height. Only when both are taken into account is it possible to say if a person is overweight.
How do I get my number?
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BMI example
If you weigh 80kg and are 1.7m:
1. Take your weight 80
2. Multiply your height by itself 1.7x1.7=2.89
3. Divide your weight by this figure.
4. 80 ÷ 2.89= 27.7.
27.7 is the BMI
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To calculate your BMI, you'll need to know your weight in kilograms and your height in metres.
Then take your weight and divide it by the square of your height.
What does it mean?
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A BMI of 20-24.9 is normal weight.
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A BMI of 25-30 is overweight.
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A BMI of more than 30 is obese.
Being overweight literally takes years off your life. For non-smoking 40 year olds:
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if you're overweight, you lose over three years of life.
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if you're male and obese, you lose over six years of life.
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if you're female and obese, you lose over seven years of life.
If you add smoking to obesity, both sexes lose over 13 years of life compared to non-smokers with a normal BMI.
Asian people in the UK are particularly prone to developing cardiovascular disease and diabetes. The reasons for this are not well understood, but the effect is substantial.
As a result, the World Health Organisation has recently proposed that the BMI threshold for being overweight should be lowered to 23 for Asian people.
Blood pressure
Everyone with diabetes should know their blood pressure because, like diabetes, high blood pressure increases your risk of heart disease.
How do I get my number?
Your GP usually takes this measurement - it should be a regular part of your diabetes checkups.
Blood pressure can also be measured at home using an electronic meter. Electronic meters are now quite accurate and affordable.
What does it mean?
For people with diabetes, the goals are:
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systolic pressure of less than 130mmHg
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diastolic pressure of less than 80mmHg.
Blood glucose
When high levels of blood glucose are present for years, it leads to damage of the small blood vessels.
This increases your risk of developing complications such as eye disease, kidney
disease, nerve
disease and cardiovascular disease.
How do I get my number?
If you have diabetes, you will probably have your own blood glucose meter to use at home. It can also be tested by your GP or at your local diabetes clinic.
What does it mean?
The ideal values for the blood sugar levels are:
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4 to 7mmol/l before meals
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less than 10mmol/l 90 minutes after a meal
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around 8mmol/l at bedtime.
By keeping the blood sugar level within these limits, you significantly reduce your risk of these complications.
Cholesterol
Blood cholesterol is another essential ‘number’, because in diabetes even a slightly higher level of cholesterol can increase your risk of heart disease.
How do I get my number?
Although you can now buy kits that let you check your own cholesterol level, they only give a rough guide.
Instead, get your cholesterol measured accurately by your GP or nurse.
What does it mean?
The ideal cholesterol level for people who have diabetes is less than 4mmol/l.
Recent studies have shown that most people with diabetes (especially Type 2) would benefit from lowering their cholesterol by taking a medicine called a statin.
How do these numbers calculate risk?
Doctors use charts to match your cholesterol level against other factors such as:
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age
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sex
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blood pressure
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smoking history
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presence of diabetes.
These charts give a figure called the 10-year coronary risk.
This gives a percentage likelihood of heart attack in the next 10 years for someone who hasn’t yet got any evidence of heart disease or damage from high blood pressure or diabetes.
The risks are usually thought of in three bands:
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high risk – more than 30 per cent chance of a heart attack or stroke in the next 10 years
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medium risk – 15-30 per cent
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low risk – less than 15 per cent.
These charts only give a broad idea of coronary risk, and are far from perfect predictors of who will have a heart attack
or stroke.
They are widely used to determine those at highest risk of developing serious cardiovascular complications, who need the most vigorous approach to treatment.
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References
Home P, Mant J, Turner C, et al. Management of Type 2 diabetes:
summary of updated NICE guidance. BMJ 2008; 336: 1306-8.
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Based on a text by Dr Dan Rutherford, GP
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Last updated 22.09.2008
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