Diabetes Tips

People with diabetes have elevated blood sugars which can eventually lead to multiple complications. The goals are to maintain blood sugar, blood pressure and cholesterol levels and try to ward off diabetes-related complications. Long term complications may include heart disease, kidney failure, nerve ending problems, sexual problems, retinopathy (causing blindness in the eyes) and amputations. Discover some solid tips to limit diabetes complications and keep you feeling your best.

There are two common types of diabetes:

Type 1

• Type 1 does not allow the pancreas to produce any insulin, the hormone that helps your body use glucose from food for essential energy. People with type 1 must take several daily insulin shots or receive insulin from a pump device. Diabetes type 1 is considered an autoimmune disease and accounts for approximately 5-10% of all diabetes cases.

Type 2

• In diabetes Type 2, the body initially makes insulin but is unable to use it efficiently. After time, the pancreas may stop producing insulin which then requires insulin shots. Many people with type 2 usually start on a diet and exercise/lifestyle program. They may eventually end up on medications including pills, injectables or insulin shots. Type 2 is much more common and accounts for 90-95% of all diabetes cases.

Gestational Diabetes

A less common form of diabetes is gestational diabetes. Gestational diabetes may occur in some women during pregnancy - especially during the third trimester. Gestational diabetes increases your future risk of diabetes type 2 by fifty percent.

The most prevalent form of diabetes in the United States is pre-diabetes. Pre-diabetes occurs when a person's blood sugar is higher than normal (60-99 mg/dl) but not quite the range of diabetes, which is diagnosed on two separate occasions at 126 mg/dl or more.

Here are some important tips for anyone with diabetes or pre-diabetes:

• A person with diabetes should always take medications as prescribed by their physician. Talk to your doctor before stopping or changing any medications. If you are experiencing side effects or financial problems, discuss it with your doctor to find out ways to change your medication regimen without hurting your blood sugar control. It is important to take your medication and insulin on a schedule to avoid blood sugar fluctuations. Check with your pharmacist if you are unsure of the proper timing of your medications or possible drug interactions.
• Use a glucose meter to check your blood sugar levels daily, at different times throughout the day, or as recommended by your health care provider. Make sure it is within an acceptable range, which should have been previously discussed. Document the results of your blood glucose tests in a log book or download them to a spread sheet to bring to your physician. This will allow your doctor a chance to examine your testing history so he/she can help with your future diabetes management.
• Schedule an A1C blood test every 3-4 months, or in accordance with your doctor's advice. An A1C of 6.5-7% is considered controlled with reduced risks of complications.
• Make smart choices about the foods and beverages you consume. Monitor your carbohydrate choices and portion sizes to help keep blood sugar levels down. Choose high-fiber carbohydrates including whole grains, starchy vegetables, beans and fruit. Eat lean meats and fish, green vegetables and low-fat dairy products. Eliminate empty calories such as soda, packaged cakes and crackers, and sugary or salty snacks. Look into low glycemic food choices and resistant starch. Treat yourself to a piece or two of sugar-free candy to ward off the temptation of sweets. Eat small meals and snacks throughout the day to avoid blood sugar fluctuations. Always eat a bedtime snack consisting of a protein and a carbohydrate. Try fresh fruits and vegetables loaded with antioxidants to help boost your immune system - dark green leafy vegetables and deep colored fruits are perfect choices. Drink plenty of water or sugar free beverages to stay hydrated. Eat 25-30 grams of fiber daily to help maintain blood sugars and weight control.
• Exercise aerobically at least 30 minutes per day and 5 times a week. Try to make exercise fun and accessible. Play with the kids or take a walk with the dog. Join a fitness group or a dance class. Go walking, running, swimming and rowing. Invest in fitness equipment for your home such as a treadmill or elliptical. Go to the mall or a big box store to do your walking. Include strength training and stretching in your routine such as resistance training, bands or weight lifting 2-3 times a week for increased muscle mass and a boost to your metabolic rate. Pilates, yoga and tai chi are excellent choices for core strength and relaxation. Exercising reduces stress, may help you keep the weight off and boosts your overall health and energy level. If time or fitness is a factor, you can reduce the 30 minutes into three 10 minute sessions.
• People with diabetes may develop complications including heart attack, stroke, kidney failure, vision problems, tooth and gum decay and a loss of sensation in the nerves (called diabetic neuropathy) if blood sugars remain out of control. Keep your cholesterol, blood pressure and triglyceride levels down to reduce the risk of heart disease. Use a blood pressure monitor and report irregularities to your health care team. Avoid saturated or trans-fats (often found in processed or bagged foods). Choose mono-unsaturated fats such as olive oil, olives, canola oil, salmon and avocados to improve heart health.
• See your primary care physician or your endocrinologist every 3 months to maintain a complete diabetes self-management plan. The increased sugar in your mouth can lead to tooth decay, dry mouth and gum disease. Visit your dentist or periodontist at least twice a year for a checkup and cleaning. Schedule an annual appointment with an ophthalmologist for a dilated eye test. Other disciplines to include on your yearly schedule are a podiatrist, cardiologist, diabetes nurse educator and dietitian. Make changes as recommended by your health care team based on your health and schedule.
• Taking proper care of your feet and teeth are an essential part of any diabetes self-management plan. Wash your feet daily with warm water and gentle soap. Dry them gently and completely with a soft towel. Apply moisturizer to dry areas of your feet, but avoid the areas between the toes. Use powder between toes to keep moisture down. Wear supportive shoes that fit properly and diabetic socks that do not impede your circulation. Try not to wear open shoes or sandals. Always keep feet covered, including slippers in the house and pool shoes in the water. Cut your toenails straight across and file sharp edges with an emery board. Have them trimmed by a podiatrist if you have fungus or in-grown nails, which is generally covered by insurance. Use a tongue scraper in the morning and then brush your teeth. Floss daily. Chew sugar-free gum with Xylitol to help reduce bacteria after meals. A fluoride rinse can help fight cavities. If you have dry mouth, consider rinses which may increase saliva production.
• Reduce negative behavior. If you smoke, stop! Minimize or eliminate your intake of alcoholic beverages. If you're overweight, losing just 5-10% of your body weight can make a huge difference. Keep in mind the rule of one if you occasionally indulge - such as one small cookie or treat. Take immediate steps to try to reduce stress in your life. Sleep for 7-8 hours each night to minimize fatigue and weight gain.
• Keep plenty of diabetes supplies on-hand. Have a checklist of what you need. Make sure insulin is stored at the proper temperature and is not used past the expiration date. Use new needles and lancets for a clean stick and to avoid contamination. Dispose of needles properly in a red or hard plastic container labeled as "Sharps". Keep extra supplies in your gym bag, purse and at work. Always carry supplies when traveling. Know the signs of hyperglycemia and hypoglycemia. When your blood sugar plummets, be prepared with fast-acting carbohydrates, like glucose tablets. If you take diabetes medication and frequently have low blood sugars, report them to your health care provider. Report unusually high blood sugars immediately to your doctor, too, as ongoing high blood sugar can lead to organ damage. Drink plenty of water when blood sugars are elevated.
• Enlist as much support as possible when you have diabetes. Work with a dedicated team to help you maintain your diabetes self-management plan. Wear an emergency bracelet or necklace which indicates "diabetes". Keep a list of your medications and health issues in your wallet. Carry a heart stent card in your wallet if you have a stent. Let friends, neighbors and a trusted co-worker know you have diabetes, in case of an emergency. Bring your own tasty, healthy dishes and never go hungry to parties. Find a workout buddy or walking companion to help you stay motivated. Get a headset or MP3 player to keep you entertained with music. Talk to a counselor if you feel stressed or depressed for more than a few weeks. Consider working with a dietitian, diabetes nurse educator and/or personal trainer to develop a better fitness routine. Some people also find support groups beneficial. Take a diabetes management training session which is usually covered by insurance.

These basic diabetes tips can help you make the right choices for optimum well-being. With a few simple lifestyle changes, you can lead a happy and healthy life with diabetes.