Monday, June 13, 2011

Managing Diabetes and Preventing Complications

If you have diabetes, you know how important it is to maintain good blood glucose control. Not only will this lessen the symptoms of diabetes, you’ll also have more energy. Keeping your blood glucose level as close to normal as possible can also help delay and possibly prevent serious or deadly complications of diabetes.

Uncontrolled diabetes can increase your risk for:

  • heart disease and stroke
  • blindness
  • nerve damage (called diabetic neuropathy)
  • kidney damage (called nephropathy)
  • complicated pregnancy
  • amputation (removal of a limb)

If unaddressed, these problems can significantly affect your quality of life, leading to disability and even death.

Steering Clear of Complications

The good news is that you can cut your risk of developing many of these complications by sticking with an intensive glucose management plan. This includes:

  • frequently checking blood glucose levels (either in the lab and at home with a glucose meter to give you immediate feedback on your blood glucose level)
  • taking your medication regularly, if needed
  • following a proper diet and exercise plan
  • working with your health team

If lifestyle changes alone aren’t enough to keep your blood sugar (glucose) levels in check, your doctor may prescribe medications. These medications help to make your cells more receptive to insulin or to improve the ability of your pancreas to make insulin. Be sure to take your medication as directed, and talk with your health care professional if you experience any side effects.

It’s also important to stay on top of follow-up appointments so your health care professional can keep tabs on your condition. A diabetes educator is a health care professional who can teach you how to best manage your diabetes. The educator will be an important part of your care team. He or she will review blood sugar records, ask about lifestyle choices and suggest any needed changes to your therapy. Diabetes educators are found in hospitals, physician offices, and managed care organizations, home health care and other settings.

Your health care professional will also advise you to see other health care providers, such as a podiatrist (foot specialist), nutritionist and ophthalmologist (eye specialist). They can address some of the health problems that might result from having diabetes.

Tips to Prevent Health Problems Caused by Diabetes

It’s important to take good care of your body. Talk with your health team about what you can do to stay healthy. Here are some things to keep in mind:

  • Adopt healthy lifestyle habits. Physical activity, losing weight and eating a low saturated-fat, reduced-calorie diet can help prevent or delay diabetes and its complications. If you have diabetes, talk with your health care provider about your intake of carbohydrates. Foods high in dietary carbohydrates include sugar, starchy foods like potatoes and pasta, grains, rice, breads, and cereals.
  • Don’t skip out on home blood glucose monitoring. Very high glucose levels (hyperglycemia) or very low glucose levels (hypoglycemia) are both dangerous health emergencies. Be sure to monitor your blood glucose at whatever intervals your health care professional recommends, usually one to four times a day (for example, before and after meals, before and after exercise, before bedtime).
  • Find out your average blood glucose level. At least twice a year, get a blood test called the A1C test. The result will tell you your average glucose level for the past two to three months.
  • Consult a nutritionist. Talk to a nutritionist about how to best plan your meals. Learn how different foods affect your glucose levels and ask about healthy and tasty food options, as well as portion control.
  • Get yearly eye exams. Finding and treating eye problems early may keep your eyes healthy.
  • Watch your blood pressure and cholesterol levels. Get both checked regularly. High levels may increase your risk for heart problems.
  • Care for your feet. Get a complete foot exam at least twice a year. Wear shoes that fit well and give support. Check your feet daily for cuts, sores, bumps, blisters or red spots. Contact your doctor if you notice swelling or infections or feel numbness or tingling or unusual cold sensation in either foot.
  • Check your kidneys yearly. Diabetes can be hard on your kidneys. A urine and blood test will show if your kidneys are OK.
  • Care for your teeth and gums. See your dentist twice a year to have your teeth cleaned and gums checked.
  • Pay attention to signs of nerve damage. Contact your health care provider if you have trouble digesting food or if you notice tingling, numbness or other strange sensations in your feet, legs, arms or hands. This could be a sign of nerve damage. Men should also report any difficulty getting or maintaining an erection.
  • Protect your skin. Keep your skin clean and use skin softeners for dryness. Take care of minor cuts and bruises to prevent infections.
  • Ask for a flu shot every year. This will help keep you healthy.
  • Monitor your mood. People with diabetes have a higher rate of depression.

Heart Disease & Diabetes

Two-thirds of people with diabetes die from cardiovascular disease, typically at far younger ages than those without the disease. That’s why it’s important to know your ABCs to reduce your risk, according to the National Diabetes Education Program and the American Diabetes Association.

ABC's of diabetes

Target numbers

A is for the A1C test (hemoglobin A1C) , which measures average blood glucose over the previous three months

Below 7 (an average blood glucose of 150)

B is for blood pressure

Below 130/80

C is for cholesterol

LDL less than 100 mg/dL; less than 70 mg/dL for people with diabetes and heart disease


If you have questions and would like more information please call our office to setup an appointment to talk to Anthony Cannon, MD at (609) 587-9944.

© 2011. National Women's Health Resource Center, Inc. All rights reserved. All content provided in this guide is for information purposes only. Any information herein relating to specific medical conditions, preventive care and/or healthy lifestyles does not suggest individual diagnosis or treatment and is not a substitute for medical attention.

Thursday, June 2, 2011

Higher fracture Risk for Diabetes Patients

It’s a known fact that there are certain risks associated with diabetes. But now a study from the University of California has found that people with type 2 diabetes may be at a greater risk of fractures.

A new study found in the Journal of the American Medical Association, reveals that diabetes patients who are receiving bone mineral density testing should or should not keep getting the testing after all.

Researchers found that femoral neck bone mineral density (BMD) T scores and World Health Organization Fracture Risk Algorithm (FRAX) scores do predict fracture risk in older patients with diabetes. But doctors must also consider a possible further increase in risk due to diabetes when interpreting these scores.

Bone mineral density is most often determined using dual energy X-ray absorptiometry, or DEXA, scanning, which measures the amount of low-energy and high-energy beams that pass through the bone during the X-ray.

A BMD T score measures the density of a patient's bone compared to a normal, healthy 30-year-old. A T score that is within 1 standard deviation of a healthy young adult is considered normal, while a BMD greater than 2.5 standard deviations from normal (-2.5) is the threshold for osteoporosis.

The University analyzed data from three prospective observational studies which followed 18,000 older people for an average of around 12 years, including 770 women and close to 1,200 men with type 2 diabetes.

During the follow-up, 84 women with diabetes and 32 men with diabetes experienced hip fractures; 262 women with diabetes and 133 men with diabetes experienced other non-spinal fractures.

Bone mineral density T scores and FRAX scores were both associated with hip and non-spine fracture risk in the diabetes patients.

The new findings confirm that a diabetes patient with a FRAX score of 3% has a higher fracture risk than a non-diabetes patient with the same score. If you have questions and would like more information please call our office to setup an appointment to talk to Anthony Cannon, MD at (609) 587-9944.