Do Your Diabetes Homework

Keeping complications from turning into major concerns is about more than just glucose testing. Learn to control the disease by doing your homework. In school, you probably dreaded homework. But what if your well-being—even your life—had depended on it? Perhaps you would’ve rushed home from the bus to get started rather than dragging your feet by watching TV, playing outside or (gasp!) cleaning your room.

Doing your diabetes homework can, in fact, affect your health and quality of life. Think of daily glucose monitoring as part of your course load; it’s mandatory if you want a healthy grade, but there’s still some homework to be done. And a big part of this homework is managing your ABCs: “A” relates to your A1c levels (average glucose over the past two to three months), “B” refers to your blood pressure, and “C” to cholesterol levels.

To help you ace your diabetes management, we’re assigning some worthwhile homework—making note of things you should be doing daily beyond managing your blood glucose levels—to help keep diabetes complications from becoming major health problems.



ASSIGNMENT: PROTECT YOUR EYES.
When it comes to caring for your eyes, glucose isn’t your only concern. Along with high blood sugar levels, high blood pressure can damage the tiny blood vessels in your retina, which is the lining at the back of your eye. This is known as diabetic retinopathy, and it’s the most common eye problem among people with diabetes. Individuals with diabetes are also more likely to develop glaucoma and cataracts. “The best thing you can do day in and day out to prevent eye problems beyond keeping your blood glucose in control is to get and keep your blood pressure under control,” says Hope Warshaw, a dietitian, certified diabetes educator and author of several books, including Real-Life Guide to Diabetes: Practical Answers to Your Diabetes Problems. “I don’t think that’s always an obvious connection for people with diabetes, but it needs to become one.”
EXTRA CREDIT: Get an annual eye test, including a dilated retinal exam, which allows your eye doctor to see the back of your eye and check for problems, recommends the American Diabetes Association (ADA).

ASSIGNMENT: SHOW YOUR FEET SOME LOVE.
Feet are a major concern in diabetes care. Foot problems such as calluses are more common and develop more quickly in people who have type 2 diabetes, according to the ADA. And because diabetic neuropathy (or nerve damage) may cause you to lose feeling in your feet over time, you might not notice a callus until it’s already broken down and developed into an ulcer. With daily foot care, you can keep calluses from building. Most experts recommend using a pumice stone right after showering and a good moisturizer to keep your feet soft, as well as keeping your toenails neatly clipped straight across to help prevent them from becoming ingrown. But be sure to consult with your healthcare provider before performing any foot care—especially if you have little or no sensation in your feet.
EXTRA CREDIT: Increase the blood flow in your feet, and improve your health, by taking daily walks.

ASSIGNMENT: BE GOOD TO YOUR TEETH AND GUMS.
Good dental hygiene is important for everyone, but when you have diabetes, it becomes even more critical. “You’re more likely to experience problems with your teeth and gums than people without diabetes, especially if your blood sugar isn’t controlled,” Warshaw says. “And dental problems like a tooth infection or mouth sores can actually cause your glucose to become elevated, so it’s important to take good care of your teeth and gums.” Use a soft toothbrush at least twice daily, floss, and keep your mouth moist to avoid dry mouth, which increases your cavity risk. Try sugar-free gum or candies or simply drinking more water.
EXTRA CREDIT: Be sure to see your dentist at least twice a year, and tell him or her that you have diabetes.

ASSIGNMENT: KEEP YOUR SKIN MOISTURIZED.
Dry skin doesn’t get as much attention as other complications, but it’s another unwanted side effect of high blood sugar. Resist the urge to scratch, Warshaw says. “Scratching that itch can cause sores and lead to infection, which individuals with diabetes are more prone to anyway,” she says. The ADA recommends applying a moisturizer to your skin while it’s still damp from your shower or bath to help seal in moisture, paying special attention to your elbows, legs and heels.
EXTRA CREDIT: Your lifestyle has an impact on your skin’s moisture, so eat a healthy diet, drink plenty of water and exercise to keep your skin healthy.

ASSIGNMENT: GET TO OR STAY AT A HEALTHY WEIGHT.
We know there’s a connection between type 2 diabetes, heart disease and being overweight or obese, but that’s only part of the picture, according to Lee Kaplan, M.D., Ph.D., spokesman for The Obesity Society. “While obesity can be a cause of diabetes in people who are genetically susceptible to it, only about 20 percent of people who are obese have type 2 diabetes,” Kaplan says. That said, if you are overweight or obese, dropping just a few pounds goes a long way to managing your ABCs. It lowers cholesterol, glucose and blood pressure in one fell swoop, according to the ADA.
EXTRA CREDIT: Get serious about weight loss by setting a reasonable goal. A loss of just 5 to 10 percent of your total body weight can yield measurable health benefits.

ASSIGNMENT: DEFEND AGAINST THE FLU
Having the flu isn’t pleasant for anyone, but individuals who have even well-controlled diabetes are at greater risk for flu complications, including hospitalization and death. This makes vaccination mandatory. “The flu shot is an annual preventive measure and a CDC [Centers for Disease Control and Prevention] recommendation,” Warshaw says. The CDC also recommends a pneumonia vaccine for people with diabetes.
EXTRA CREDIT: To further decrease your risk, the ADA recommends that your friends and loved ones also get a flu shot.

ASSIGNMENT: TAKE YOUR GLUCOSE MEDICINE
We all want to be healthy, but for some, taking medications feels like a daily reminder that all is not well. “People seem to want to avoid blood-glucose lowering medication, but that’s not the recommended approach for type 2 diabetes today,” Warshaw says. “There are many different kinds of medications designed to address the various reasons why blood glucose is out of control and insulin resistance is up, to get your glucose under control and keep it there.” Experts recommend that you begin taking a blood glucose- lowering medication that targets insulin resistance as soon as you’re diagnosed.
EXTRA CREDIT: Pay attention to how your body responds to your blood-glucose-lowering medications and talk to your doctor about reactions or concerns you have.


ASSIGNMENT: TARGET YOUR EFFORTS BASED ON YOUR RISKS.
Many people who have diabetes worry about complications that may not be a concern for them, and ignore the more likely scenarios. “A big fear is, ‘I’m going to lose my sight or my feet.’ But the reality is, the large-vessel diseases—heart disease, heart attack and stroke—are typically a bigger concern in type 2 diabetes,” Warshaw says. “So it goes back to managing your ABCs.”
EXTRA CREDIT: Ask your healthcare provider what complications you’re most at risk for, so you can gear your daily actions toward preventing them.

Find an Online Community in Gwinnett Connect with GMC’s Diabetes & Nutrition
Education Center (DNEC) at facebook.com/gmc.dnec. The certified dieticians at DNEC are here to help you. The can develop a customized plan to meet your specific needs and goals. To learn more, visit gwinnettmedicalcenter.org/diabetes.

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