Reducing Risks

The goal in managing your diabetes is to enable you to enjoy a long healthy life in spite of having diabetes. In order to reduce the risk of diabetes complications, there are a number of preventative care actions for you to take.

 

Reducing Risks through Preventative medical care:

 

Tests/checks to Have Once a Year:

Dilated eye exam- This important eye exam will help to detect signs of diabetic retinopathy. Retinopathy can lead to blindness if not treated. Early detection through this dilated eye exam can lead to successful treatment.

 

Microalbumin test- This is a urine test that your doctor will do annually to check the health of your kidneys.

 

Cholesterol Test- Your doctor should do a yearly fasting blood test to check your cholesterol levels. If you are taking medication for your cholesterol you may have this test done more often. It is important that YOU know what your cholesterol numbers are and what they mean. This can help you to make different choices to reduce your risk for heart disease. Cholesterol is a fat-like substance that is produced and stored in your liver.  Cholesterol is also found in your diet but only in animal products.  While some cholesterol in the blood is essential, too much of it can be harmful.  When it travels through the bloodstream, cholesterol is wrapped in protein and called lipoprotein.  Over time, excess cholesterol can build up on the walls of your arteries.  This buildup, known as “plaque,” can narrow your arteries and reduce blood flow to your heart, causing serious cardiovascular risk.

 

“Bad Cholesterol” LDL (low-density lipoprotein) – Easily sticks to the walls of the arteries to form blockages or plaque.

 

“Good Cholesterol” HDL (high-density lipoprotein)- Helps to remove excess cholesterol from the bloodstream by taking it back to the liver where it can be processed or removed from the body.

 

Healthy eating and physical activity are the first-line therapies to combat high cholesterol.  Sometimes medication may be necessary.  Be sure your doctor monitors your cholesterol levels and be sure you know your numbers.

 

DESIRED CHOLESTEROL LEVELS

 

Tests/Checks to Have Several Times a year:

Blood Pressure Checks:

Your blood pressure is the force that pushes blood from your heart through the arteries and veins in your body. Blood pressure is always listed as two numbers. The first or top number is your systolic pressure.  This number is the pressure when your heart is pumping and your blood pressure is in full force.  The bottom or second number is your diastolic pressure.  This is the pressure when your heart is relaxing between beats and your blood pressure drops.  If you have diabetes, your blood pressure should be below 130/80.

 

High blood pressure, also called hypertension, is often called the “silent killer” because it frequently has no symptoms.  That’s why it is very important to get regular medical check-ups and have your blood pressure checked often even if you feel well.

 

High blood pressure damages the coronary arteries, making the heart work harder than it should.  It also increases the risk of stroke.

 

You can decrease your risk for high blood pressure by eating a low-salt, low-fat diet, exercising regularly, and keeping your weight under control.  Also limit alcohol intake, don’t smoke, and reduce your stress.

 

DESIRED BLOOD PRESSURE FOR PEOPLE WITH DIABETES

Systolic           130 or less

Diastolic          80 or less

 

Hemoglobin A1c: This is a blood test that your doctor will order every 3-6 months to monitory your blood sugar.

What does A1C tell you? The A1C% represents the level of glucose control you have had over the last 2-3 months. If your daily blood sugars have been high over the last several months, then your A1C% will also be high.

 

 

When should I have an A1C test?

You should always have an A1C test when you are first diagnosed with diabetes and then every 6 months thereafter. Some people need an A1C test done more often than others. You should have an A1C test done every 3 months, if ¨ you are on insulin, ¨ you have blood sugars that are out of control, or ¨ your A1C is > 8%. If you are pregnant and have diabetes, you need an A1C test every month.

An A1C test can be done at any time – before or after you have eaten. Be sure to ask your health care provider if it is time for you to have an A1C test done!

 

What is the difference in A1C and daily blood sugar testing?

Self-monitoring blood glucose (SMBG) testing is what you do every day at home with your blood sugar machine. These values are what you write in your logbook and take to your doctor. The A1C test is a test usually done in your physician’s office or lab but it can also be done at home with a kit you can buy at your local pharmacy. Both tests are very important in managing your diabetes!

The difference in these two tests is the time period the test results are based on. When you do SMBG testing, it tells you what your blood sugar is right now. These results will be different every time you test depending on the time of day, when and what you have eaten, what medication(s) you have taken, and how much exercise you have done. The A1C test shows what your blood sugar levels have been over the past 2 or 3 months. The A1C results
are reported as a percent (%).

The A1C test gives you the BIG picture of your overall glucose control.

 

How do my A1C results compare to my blood sugar results?

Experts suggest that your A1C goal should be less than 7%. Any A1C greater than 8% means that your diabetes is starting to get out of control and you need to adjust your diabetes management plan to get better results. It is important to contact your doctor when you are exhibiting poor glucose (sugar) control. Set your A1C goal with your healthcare provider.

 

How should I use the results of the A1C test?

 

The A1C test results can help you manage your diabetes in many ways. Use these results to:

  • Look back and review your glucose control over the past 2-3 months.
  • See if your diabetes treatment plan is working for you – are your medication(s), diet and exercise in the right proportions?
  • Review the last several months to see if a change in your treatment plan has helped to improve your blood sugar control.

 

How does lowering my A1C help me?

A lower A1C value means a lower risk of developing complications such as heart disease
(cardiovascular), nerve disease (neuropathy), kidney disease (nephropathy), and eye
disease (retinopathy). Research studies have shown that the risks of developing these diseases are muchlower when blood sugars are in control and A1C is less than 7%.

 

How much do I need to reduce my A1C for it to be beneficial?

Any reduction is beneficial. A larger reduction is more beneficial than a small one. Even if you have to take small steps to get there, set a goal for yourself to reduce your A1C.  Lowering your A1C just 1% can reduce your risk of developing eye, kidney, and nerve disease by 40%.

 

How can I lower my A1C?

 

  • Check your blood sugar more often. Test several times a day and
    at different times from one day to the next. That way you will get a better
    overall picture of your blood sugar levels. Keep a log and show it to your doctor.
  • With your healthcare team, identify high blood sugar patterns and
    adjust your management plan to help control those high levels.
  • Increase your exercise. Ask your doctor before starting or changing
    your exercise routine. Walking as little as 30 minutes a day can help.
  • Attend diabetes self-management education classes and learn more
    about how you can take control and manage your diabetes!
  • Control depression. If you are feeling depressed, seek medical assistance. You are not in this alone.

 

 

Foot Checks: It is important for you, and your doctor to pay close attention to your feet.

Over time high blood glucose, blood pressure and cholesterol affect the nerves and blood vessels of the feet. As a result, you may not be aware of when you have injured your foot or have an infection.  You should check your feet every day for any changes and your doctor should check your feet every time you have an appointment.  Here are some foot care tips:

  • Check your feet every day for cracks, calluses, sores, swelling, redness or any changes. If you have a cut or sore that is slow to heal or looks infected, contact your doctor right away.
  • If you have trouble looking at your own feet, have a loved one hold up a mirror to help you to inspect your feet
  • Wash your feet in warm but not hot water and dry thoroughly.  Do not soak your feet.
  • Apply lotion to dry areas of your feet, but avoid putting lotion between your toes.
  • Cut or file your toenails straight across.
  • Report any problems or changes with your feet or toes to your doctor right away!

 

Dental Exam: Every person should visit the dentist twice a year for a tooth cleaning and check up. Your diabetes puts you at greater risk for developing gum disease, or periodontal disease. This type of infection destroys the gums and the bones that hold the teeth. Infections in your teeth and gums can also cause problems with your heart and can make your blood glucose hard to control. You should see your dentist twice a year and brush and floss your teeth every day.

Reducing your risk for diabetes complications involves both your every day choices and your regular preventative care with your health care team. Learn as much as you can about diabetes management so that you can feel confident you are doing everything possible to live long and healthy with diabetes!