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To manage diabetes, look at the big picture
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Diabetes affects several parts of the body, but when it comes to managing their disease, people sometimes focus too closely on controlling their blood sugar without looking at their health as a whole. Having diabetes means putting extra effort into preventing heart disease, strokes, circulation problems, kidney disease, nerve damage, blindness, and even Alzheimer’s disease.
Increased heart disease risk
Heart disease is one of the top complications of diabetes. Among people over age 65 with diabetes, the Centers for Disease Control and Prevention found that heart disease was noted on almost 70% of their death certificates.
“No matter how well your blood glucose is controlled, if you have diabetes, you are at a high risk of developing heart disease—even if you have no other risk factors,” says Vrinda Suneja, M.D., medical director at Fox Run, an Erickson Living community in Novi, Mich.
Blood pressure readings and cholesterol levels should be closely monitored. “Goals vary depending on someone’s health, but most seniors without diabetes should have a blood pressure no higher than 150/90; whereas, those with diabetes should keep theirs below 140/90,” Suneja says. “With regard to cholesterol, we look very closely at the risk of heart disease and other individual factors to determine the safest levels for each person.”
Heart disease risk also factors in when determining your blood sugar parameters. The A1c, also called glycated hemoglobin, is a number that reflects how well your blood sugar has been controlled over a period of six to twelve weeks. For most people over age 65, it should be about 7%, but when determining your ideal A1c, day-to-day glucometer readings, and diabetes treatments, your doctor evaluates your overall health. “We look at patients as a whole person,” says Joel Zonszein, M.D., director of the Clinical Diabetes Center at Montefiore Medical Center in the Bronx, NY. “We take into account factors such as life expectancy and the presence of other health conditions.”
What you might not be doing
You know, of course, to keep away from sugary treats, but making other food choices can help protect your heart while keeping your blood sugar in a good range. “People with diabetes need to eat a lot more vegetables, fruits, and whole grains,” Suneja says. “They need to limit their intake of fat and sodium.”
And get more exercise. “This is one of the most important changes people can make, yet I find for many of them, it’s hard to get started or maintain an activity program,” Suneja says.
A healthier diet and a little exercise can go a long way, no matter how old you are. “One study showed that older people who made modest improvements in their lifestyle were able to prevent or delay the onset of diabetes better than younger people,” Zonszein says. “That’s an important message.”
Adding heart-healthy behaviors to your daily routine can help prevent other diabetes complications such as vascular disease, nerve damage, and problems with your kidneys and eyes. You can also protect the rest of your body by having yearly eye exams, getting flu shots, and seeing the dentist and podiatrist regularly.
Get involved in your treatment
“Everyone has an individual balance of treatment modalities that works best for them,” Zonszein says. “Being an active participant in your treatment plan can help you and your doctor make adjustments that will keep you in your best health.”
If you have diabetes, you probably take medication for it, and a major part of being engaged in your treatment is keeping your doctor up to date with the rest of your medicine list. Along with prescriptions, bring to your appointments a list of over-the-counter drugs, supplements, herbal preparations, and even topical ointments and creams. “We need to know what else you’re taking in order to prescribe a medication that will not interact with others or have unpleasant side effects,” Zonszein explains.
Ask for support when you need it. If you’re having trouble with your eating plan, ask your doctor if you can see a dietitian. If you can’t start or stick to an exercise plan, ask if a referral to a physical therapist might help you be more active.
“Adhering to a treatment plan that you helped develop enables you to be more active and live well,” Zonszein says. And a little incentive once in a while is nice. “People with diabetes should keep in mind that if their disease and any complications are controlled,” he says, “it won’t hurt to have a slice of pie every now and then.”
A free program to help you live better
The American Diabetes Association offers a free program called Living with Type 2 Diabetes. It gives you access to resources and tips about how to live well. By enrolling in the program, you’ll receive:
•Three issues of Diabetes Forecast magazine
•A monthly newsletter
•Personalized text messages with medication and appointment reminders
•Information about local events
For more information, contact the American Diabetes Association.
At least once or twice a month I like to post real information: good for your health. We also have health tips and quizzes you can take at www.ehsecrets.com. This begins a series on the Endocrine system, starting with the Pancreas since it has been in the...