Curtailing diabetes

Essential Tips for Better Disease Management

Diabetes is the seventh leading cause of death in the United States. It is a major cause of heart disease and stroke as well as the leading cause of kidney failure, non-traumatic lower-limb amputations, and new cases of blindness among adults.

In Polk County, the incidence of diabetes is higher than average—the highest in the area, with 14.2 percent of adults succumbing to the disease, reports Healthy Tampa Bay, using the latest statistics from 2010. The area’s lowest numbers are for Pasco County, which logged an 8.5 percent rate. The state averages 10.4 percent.

“Obesity is probably the biggest factor [behind diabetes],” says Dr. Mary Quillinan, a general internist with Clark and Daughtrey Medical Group, a division of Lakeland Regional Health Systems. “I do see preventable cases. There are people who have just been eating fast food and doing no exercise. Even if we can’t prevent it, we can postpone it.”

Diabetes occurs where there are defects in the body’s insulin production and/or activity, leading to an increase in blood sugar levels. The majority of sufferers have type 2 diabetes, which usually occurs in adulthood. It has been linked to aging, obesity, physical inactivity, family history, and ethnicity. A smaller number has type 1 diabetes, which requires insulin for survival. It more often afflicts children and young adults.

Those with diabetes are more likely to suffer from high blood pressure, and are two to four times more likely to die of heart disease, according to Centers for Disease Control and Prevention data. They also are more likely to have other complications like nervous system disease, which can contribute to lower-extremity amputations.

“The best way to avoid complications is to achieve as good blood sugar control as possible,” says Jamie Moore,clinical nutrition manager at Lake Wales Medical Center, who teaches free diabetes management classes. “The act of moving muscles helps bring your blood sugar back into control.”

Treatment for type 2 diabetes may involve a change in diet, exercise and weight loss, with oral medications frequently prescribed to manage the condition. Insulin also may be added when needed. “Proper diet, exercise and weight reduction can slow progression of impaired glucose tolerance to overt diabetes. And a healthy diet and exercise can slow the progression of diabetes,” says Dr. Joy Jackson, the Polk County Health Department’s medical director. “Weight loss is important. Even a relatively small amount of weight loss can lead to improved glucose metabolism.”

Routine health maintenance, including any necessary treatment for high blood pressure and high cholesterol, also is important. “Regular dental care, eye examinations, foot examinations, flu and pneumococcal vaccinations are all part of recommended care for diabetics,” Dr. Jackson observes.

Diabetes can have a “silent period,” or pre-diabetes phase, where there are few (if any) symptoms. “During this time, damage can occur to the small blood vessels—manifested by damage to the kidneys, eyes, and nerves (neuropathy),” Dr. Jackson warns. “Progression of complications can be slowed with interventions such as aggressive management of glucose control and low doses of certain blood pressure medications, which can help protect the kidneys. Access to health care including screening for conditions such as diabetes, hypertension, and elevated lipids is important to detect these conditions in the asymptomatic phase.”

For diabetics, taking care of the feet is especially important. Dr. Quillinan recommends regular daily inspections for sores, red spots, and callouses. A physician should be consulted about sores. “Avoid soaking feet,” says Dr. Quillinan, who teaches free diabetes classes for Clark and Daughtrey. “Don’t put drug store remedies on the feet.”

Diabetics should get to the root of any callouses by making sure shoes fit properly. While people without the disease may try to cut callouses, diabetics should opt for a pumice stone or see a health care professional, she points out. Cuts and sores may not heal, leading to infection and amputation. Here are some more tips to postpone or manage diabetes:

* Have more regular meal times after you’re diagnosed.

* Avoid empty calories.

* Pay attention to portion sizes, which can rack up extra calories and weight. “Most people don’t realize ten potato chips is a serving,” Moore says. “Four walnut halves is technically a serving.”

* Watch your carbohydrates. Simple sugars are a type of carbohydrate, explains Moore, who recommends more complex carbohydrates like whole wheat bread, fruit, whole grains, and brown rice.

* Get enough sleep. People who are short on sleep may resort to coffee with sugar and cream, or even “designer coffees” like frappes with 250 to 700 calories. “People who are tired tend to eat more to stay alert and to keep themselves awake,” Moore observes.

* Eat out less,and choose food wisely when you do.

* Plan your meals ahead of time if you’re trying to lose weight. When you shop at the grocery, ensure you get all the ingredients you need to prepare your meal.

* Get diagnosed early and take a proactive role in your own care. “Find a medical home to help guide and educate you,” says Dr. Jackson. Management may require a team effort. “Frequently, diabetes management involves a team, including a health care provider, nurse, dietitian, and case manager to assist diabetic patients in achieving a long, healthy life,” says Dr. Jackson, adding free adult health care services are available through the Health Department for eligible patients. “Very important to this team is the patient himself/herself. Diabetic patients must be actively engaged in their own care and act as their own advocate.”

* Take medication as prescribed.

* Make sure you’re testing blood sugar as your doctor recommends, which may be once or twice a day.

* Learn to live with it. “You can still eat good food,” Moore says,explaining you should be “more inquisitive” about how it’s prepared. “It doesn’t mean now you’re destined to dull, bland food.”





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