What to Know and What to Do Next

By Nelius W.K, AGACNP-BC, Nurse Practitioner and Founder of Suilen Health. Health education only; this does not replace advice from your own clinician.

Most people leave a diabetes diagnosis with more questions than answers. If that was you, or if you are worried about your numbers, this is a good place to start. Type 2 diabetes is common in our community, but it is also one of the conditions where everyday steps make a real difference.

How common is it?

According to the CDC’s national health survey, about 18 out of every 100 Black adults in the United States have diabetes. Roughly 14 of those 18 have been diagnosed, and about 4 do not know they have it yet. That last group matters. Diabetes can sit quietly for years, and the damage to the eyes, kidneys, nerves and heart can begin before anything feels wrong.

Why get checked?

You can feel completely fine and still have high blood sugar. If you are over 35, have a parent or sibling with diabetes, carry extra weight around your middle, or have high blood pressure, ask your clinician for a blood sugar test at your next visit. Finding it early gives you more options.

What your A1C means

The A1C is a blood test that shows your average blood sugar over about three months. The American Diabetes Association’s general goal for many adults is below 7%, but your own goal may be different depending on your age, other conditions and medicines. Ask your clinician: “What should my A1C goal be?”

One thing worth knowing: A1C can read a little differently in some Black adults. Research shows that Black adults, on average, can have a slightly higher A1C than white adults with the same average blood sugar. And about 7 in 100 Black babies in the U.S. are born with sickle cell trait, which can make some A1C lab tests read falsely high. If your A1C does not match what your home readings show, ask whether another test or a continuous glucose monitor would help. This is not a reason to skip the test. It is a reason to ask good questions.

Five steps to take this month

1. Know your numbers. Ask for your most recent A1C and write it down. If you do not have one from the past year, ask for it.

2. Check your kidneys every year. The ADA recommends most people with diabetes have a urine test for protein and a blood test of kidney function at least once a year. Kidney damage from diabetes often shows no symptoms until it is advanced, so these tests are how you catch it early.

3. Keep your blood pressure under control. For most people with diabetes, the goal is below 130/80. High blood pressure and diabetes together raise the risk of heart disease, stroke and kidney problems, and treating one helps the other.

4. Aim for steady, not perfect. If you carry extra weight, losing 5 to 7 percent of your starting weight can improve blood sugar and lower heart risk. For someone who weighs 220 pounds, that is about 11 to 15 pounds. You do not need to give up the foods you love. Try smaller portions of starchy sides, swapping sweet drinks for water or unsweetened tea, and walking for 10 minutes after meals.

5. Ask about all your options. Newer medicines, including GLP-1 and SGLT2 medicines, are now recommended by the ADA for many people with type 2 diabetes. They can protect the heart and kidneys, not just lower blood sugar. Cost and side effects matter, so ask your clinician or pharmacist what is covered for you.

Questions to bring to your next visit

  • What is my A1C, and what should my goal be?
  • Have my kidneys been checked this year?
  • Is my medicine the right one for me, and is there a lower-cost option?
  • Would a glucose monitor help me?
  • How often should I check my blood sugar at home?

Know the signs of low blood sugar

If you take insulin or certain diabetes pills, low blood sugar can happen. Shakiness, sweating, confusion, a pounding heart or sudden hunger are warning signs. If you feel these, check your sugar if you can, and have fast-acting sugar such as juice or glucose tablets. Call 911 for fainting, a seizure, or if someone cannot swallow safely.

Related reading: Kidney and hypertension

Want more support?

Our Diabetes Type II: Take Control Care Kit includes a daily blood sugar tracker, medication and insulin education, a meal planning guide built around steady blood sugar, an A1C and lab result guide, and a guide to recognizing low blood sugar: Get the kit.

Prefer to learn with others? Join our monthly membership for live Saturday sessions at 10:00 AM, where we take one health topic at a time: Join Suilen Health.

Sources

  • Centers for Disease Control and Prevention, National Center for Health Statistics. Data Brief No. 319: Prevalence of Diabetes in Adults, 2013 to 2016.
  • American Diabetes Association. Standards of Care in Diabetes, 2026.
  • Klonoff DC. Hemoglobinopathies and Hemoglobin A1c in Diabetes Mellitus. Journal of Diabetes Science and Technology, 2019.