Taking Preventative Measures With Your Diabetes

Taking Preventative Measures With Your Diabetes

It appears much more education of people with diabetes needs to be done.  A recent study in the United States looked at five requirements a diabetic should be seriously involved with:

1. patient self-testing of blood glucose levels
2. hemoglobin A1c (HbA1c) testing
3. four visits per year to your health care provider
4. an annual dilated eye examination
5. regular three monthly feet checks

The results revealed the following:

• only 3% of insulin users and 1% of non-insulin users carried out all five
• one in five diabetics do not test their blood sugars
• three out of four have not heard of the HbA1c
• one in four do not even make an annual visit to their health care provider
• two in five have never had their feet examined or a dilated eye examination 

 1.  Why is self monitoring a must?  You cannot feel the level of your blood glucose unless you are hypoglycemic.  There is tremendous variation in glucose levels in a relatively short time, especially in association with food.  Even in the fasting state before breakfast.

2.  What does hemoglobin A1C (HbA1c) testing reveal?  This is a blood test that measures your average glucose level over the previous two to three months.  It indicates the percentage of hemoglobin (the oxygen carrying part of blood) that has become glycated.  Glycated means it has a glucose molecule attached.  This is always proportional to the amount of glucose in your blood.  The higher the level of HbA1c, the greater the risk of developing diabetic complications.  This should be measured two to four times a year, depending on your type of diabetes.  You should aim to keep it under 7%.

3.  Why visit your health care provider for a three or four monthly review?   You need to continually work with your health care provider or team to:

• evaluate the effect of your diet and exercise plan
• review your medications and frequency of blood glucose monitoring
• assess glucose results direct from your meter or your log book
• check for any interaction of new medications with your diabetes treatment
• assess diet
• test for random blood glucose, or HbA1c
• carry out urine test to check for protein, glucose, ketones
• record weight and blood pressure
• examine feet and check for cuts, circulation and sensation
• check for related illnesses, eg. urinary tract infection
• organize referrals to podiatrist, diabetes educator or dietitian if required

4.  Checking for eye problems.  An annual eye examination by an ophthalmologist will help preserve your vision.  Drops are instilled into your eyes to check the pressure, the appearance of your lens and, most importantly, the retina of your eyes.  All kinds of procedures can be done as abnormalities are found, the earlier the better.

5.  Taking care of your feet.  50% of amputations are done on diabetics and it is preventable.  It is important to check your feet daily for cuts, blisters, redness, swelling or other problems.  A visit to the podiatrist every three months is ideal.

Type 2 diabetes is really not one disease, it is a symptom of many diseases.  These symptoms need to be continually checked.