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Reminders to carry with you about diabetes prevention and care
Reminders to carry with you about diabetes prevention and care
If your doctor said you have “a touch of sugar,” it could mean you have pre-diabetes: a blood-glucose level that’s higher than normal but not yet diabetes. And that’s serious.
The American Diabetes Association warns that some damage to your body — including your heart — may already be under way. “There is no such thing as a touch of sugar that is not harmful,” said Dr. Guenther Boden, chief of the division of Endocrinology at Temple University Hospital.
If you go on to develop full-blown diabetes, you could double or quadruple your risk of dying from heart disease, among other dire consequences.
The good news: At the pre-diabetes stage, it’s possible to prevent Type 2 diabetes by making healthier food choices, losing 7 percent of your body weight and walking briskly for 30 minutes a day, five days a week.
We know you can do it. The big national medical study that proved it, known as the Diabetes Prevention Program, included 155 participants from right here in Philly.
Ask your doctor to write down your fasting plasma glucose (FPG) test number or your oral glucose tolerance test (OGTT) number here _______________________. If your FPG is 100 or more or your OGTT is 140 or more — the benchmarks for pre-diabetes — it’s time to get serious about eating better, losing weight and being more active. In some cases, a doctor may prescribe a protective medicine called metformin.
The National Diabetes Education Program has practical advice in its booklet, “Your Game Plan to Prevent Type 2 Diabetes.” Call 888-693-6337 to order one, or read the booklet online at
» READ MORE: www.ndep.nih.gov/diabetes/pubs/GP_Booklet.pdf
The American Diabetes Association call center at 800-342-2383 can point you to other resources, including doctors who specialize in diabetes treatment and prevention.
If you’re over 75 years old, living out your golden years with a “touch of sugar” might be OK, Boden said, because serious damage from elevated blood sugar can take 10 years or more to develop.
For younger people, it’s definitely not OK. If you’ve got pre-diabetes or a mild case of diabetes, which some doctors also refer to as “a touch of sugar,” aggressive care now can prevent terrible complications later.
Doctors now consider diabetes a cardiovascular disease. At least two out of three of people with diabetes die from a heart attack or a stroke.
That’s why they ask patients who have the disease to control their cholesterol and blood pressure, along with their blood sugar.
The American Diabetes Association urges people with diabetes to keep track of three key measurements of their overall health, known as the ABCs of Diabetes:
is for A1C, one simple blood test that measures what your blood glucose has been, on average, for the past two or three months. If you’re diabetic, you should be tested at least twice a year.
is for Blood Pressure. If yours is high, it can make your heart work too hard and can also damage your kidneys and eyes. Have it checked at every doctor visit.
is for Cholesterol. The bad kind can build up in your arteries, leading to heart attacks and strokes. Get checked at least once a year.
LDL (bad) cholesterol below 100.
HDL (healthy) cholesterol above 40 for men or 50 for women.
Triglycerides below 150.
People with pre-diabetes who lose just a little weight and exercise regularly can prevent diabetes, or at least delay it. People with Type II diabetes can improve their blood glucose numbers and slow down the progression of their disease.
Losing 5 or 10 percent of your body weight is all it takes to start reaping big health benefits.
That’s as little as 19 pounds if you’re 380 now, 11 pounds if you currently weigh 220 and a scant 7 pounds if you’re tipping the scales at 150 (which is overweight for anyone 5-foot-5 or shorter.)
To lose a pound a week, trim about 500 calories a day.
Studies have shown that having an apple-shaped physique increases you diabetes risk.
Women with a waist measurement over 35 inches should ask their doctor about being screened for diabetes.
Men with a waist measurement over 40 inches should consider it.
About 5.7 million Americans have diabetes and don’t know it. The way to find out is to see your doctor for either a fasting plasma glucose test or a two-hour oral glucose tolerance test. Should you be screened? Follow these guidelines:
If you're 45 or older, the National Institutes for Health recommends a diabetes screening.
If you're 45 or older and overweight, screening is strongly recommended.
If you're under 45 and overweight, get screened if you have one or more of these risk factors:
A family history of diabetes.
Low HDL cholesterol and high triglycerides.
High blood pressure.
A history of gestational diabetes (diabetes during pregnancy) or a baby who was born weighing more than 9 pounds.
A family background that is African-American, Hispanic/Latino or Asian (including Indian). American Indians and Pacific Islanders are also at higher risk.
Go to
» READ MORE: www.diabetes.org/risk-test.jsp
for an interactive quiz that will help you calculate your risk of developing Type 2 diabetes.
If you have diabetes, you may know that Medicare covers doctor visits, blood-sugar monitoring supplies and important regular health screenings like eye and foot exams. But did you know it will pay for shoes?
Here, five little-known benefits that can be highly beneficial to your health. (Some private insurers also cover them.)
Diabetes education refreshers every year. Medicare covers up to 10 hours of diabetes education the first year you go — and up to 2 hours every year after that. "Many doctors and many educators don't realize that you can go back," said Dr. Richard Wender, chairman of family and community medicine at Thomas Jefferson University.
Annual refreshers for medical nutrition therapy. Medicare covers up to three hours of counseling from a registered dietitian or nutrition expert the first year and two hours every year after that.
A pair of diabetes shoes and inserts once a year. Ask your primary doctor for a "letter of medical necessity" if you qualify for one. Then see a podiatrist, who will write a shoe prescription and point you to a store with the expertise to fit you correctly.
Weight Watchers membership. Certain Medicare Advantage plans will cover your fees.
Smoking cessation programs. You may be eligible for up to eight counseling sessions a year to help you quit.
Type II diabetes is not at epidemic level in kids, the way it is in adults, said Dr. Lorraine Levitt Katz, a pediatric endocrinologist at Children’s Hospital of Philadelphia. But childhood obesity is widespread, and it can lead to diabetes later.
The American Diabetes Association recommends that children get tested for diabetes starting at age 10 if they’re overweight and have two of these risk factors:
A close relative with Type 2 diabetes, or a mother with either diabetes or gestational diabetes.
African-American, Hispanic, Asian-American, American Indian or Pacific Islander heritage.
Conditions like high blood pressure and polycystic ovarian syndrome that are associated with insulin resistance. Another condition to watch for is a dark, velvety thickening of the skin on the back of the neck, under an arm or near any fold of fat.
Some people with diabetes need to be extremely careful about hurting their feet because any nick or cut can be dangerous.
Indeed, diabetic wounds can be more deadly than some types of cancer, said Dr. Kathya Zinszer, director of outreach for diabetes education at Temple University’s School of Podiatric Medicine.
If your doctor tells you that you’re at risk, try to avoid salon pedicures. If you must indulge occasionally as a member of a bridal party or some other pampering party, these are Zinszer’s orders:
Never clip your cuticles. They're your defense against infection.
No "cheese graters" allowed. Ask the pedicurist to use a pumice stone instead.
Nail color is fine, and so are large emery boards for filing (straight across). But leave the nail trimming to your doctor's staff. Any sharp object could do damage.
Zinszer said people with diabetes should get into the habit of checking their feet every day for cuts, cracks and other changes. That way if you notice a problem, you’ll know it’s no more than 24 hours old.
Wearing white or light socks is another smart precaution. “They’re a flag,” Zinszer said. “If there’s drainage or there’s blood, you’re going to see it.”
The American Diabetes Association runs a toll-free helpline staffed by experts who can answer your questions in English or Spanish. They’re available weekdays from 8:30 a.m. to 8 p.m. at 800-342-2383.
The ADA Web site,
» READ MORE: www.diabetes.org
, has up-to-date information about everything from medicines, monitors and insulin pumps to support groups that are held at local churches.
Or consult the National Diabetes Information Clearinghouse, run by the National Institutes of Health, at
» READ MORE: www.diabetes.niddk.nih.gov
.
Illustrations by Amy Raudenbush / Daily News