Managing Diabetes
Diabetes can be a scary disease mainly because of the long-term complications it can cause. Diabetes is the main cause of blindness and kidney failure and the second cause of amputations in the United States. It is also strongly associated with heart attacks and strokes.
As scary as those statistics can be, it isn’t inevitable that complications will occur.
There are a number of ways to decrease the risk of complications. The first and most important one is keeping blood sugars well controlled.
Blood sugars should be monitored at home as well as the lab test, hemoglobin A1c (Hgb A1c) The Hbg A1C can be drawn at the doctor’s office every three to six months. The Hgb A1c is a three month average of blood sugars. Each individual should have their own blood sugar and Hgb A1c goals set by a health care provider, however, in general an average blood sugar of less than 140 or an A1c of 7.0 is the goal for those diagnosed with diabetes.
Two large landmark studies proved that in both Type 1 and Type 2 diabetes, the risk of complications decease dramatically when the A1c is below 7.0.
To achieve good control and maintain control it is essential to have education about diabetes. Visiting a health care provider, dietitian and diabetes nurse educator is the best way to get individualized, reliable education. Eating well, exercising and taking the necessary medications as directed make more sense if the right education is provided. Diabetes education is covered by Medicare, Medicaid and most private insurances.
Good control of blood pressure is essential. Blood pressure should be below 130/85. Many people know that high blood pressure increases the risk of stroke but high blood pressure also increases the risk of kidney failure. The kidneys are mainly made up of blood and if pressures are high, the kidneys can be easily damaged. Blood pressure should be checked at every doctor’s visit.
Cholesterol levels should be checked on a yearly basis unless otherwise advised. The three numbers to look at are HDL, LDL and triglycerides. HDL is the good or “healthy” cholesterol. Desired levels are over 40 for men and over 50 for women. LDL is the bad or “lousy” cholesterol. Desired levels are under 100. Triglycerides are another type of fat in the blood. A goal of 150 or less is recommended for triglycerides. Not only a high intake of fat can increase triglycerides but high, uncontrolled blood sugars and a high sugar intake can cause an increase.
A urine test called microalbumin should be checked yearly. Microalbumin tests for signs of protein in the urine, which if detected at higher than normal amounts, indicates early problems with the kidneys. At this point, certain medications can improve or reverse such problems but with no intervention, the kidneys will continue to deteriorate. Blood tests are also taken to check for the health of the kidneys but microalbumin detects kidney problems earlier than these blood tests.
Diabetes can be hard on the teeth and poorly cared for teeth tend to increase risks of infection. Brushing teeth and flossing daily is highly recommended. Also avoiding high sugar foods, like soda, will keep teeth healthier. Dental exams are encouraged every six months.
A dilated eye exam is recommended once a year. As mentioned previously, diabetes is the leading cause of blindness but with good diabetes control and eye problems caught early by an eye doctor, the risk of eyesight loss is greatly decreased. Eye exams are usually covered by Medicare, Medicaid or private insurance for diabetes.
Finally, don’t forget about your feet. Diabetes can cause a decrease in feeling and blood flow in the body and the feet are often the first place these symptoms show up. Whenever attending a doctor’s appointment, those with diabetes should take their shoes and socks off as soon as they get to the exam room. This allows the health care provider to easily check feet for adequate feeling and blood flow. Some essential foot care rules at home are: wear comfortable shoes that fit properly, don’t go barefoot, keep skin soft, don’t let feet get dry and cracked, don’t wear socks that are too tight, check feet daily for any cuts, open sores or color changes and cut toenails straight across. Finally, see a podiatrist, a specialist in the care of feet, if needed.
Taking care of diabetes can mean living a healthy and vibrant life!