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Four Steps to Control Diabetes
- 1. 4 Steps to Control Diabetes for Life Beverly Thomassian Diabetes Nurse for a really long time
- 12. Natural History of Diabetes Development of type 2 diabetes happens over years or decades Yes! NO
- 13. Can we stop the progression? Insulin Resistance Pre Diabetes Diabetes and what about cardiovascular risk factors?
- 17. The Good News About Diabetes
- 20. A1C Blood Test
- 25. Keep Your Blood Pressure In Check
- 31. Your Diabetes Care Team
- 46. Schedule Regular Visits with Diabetes Care Providers
- 47. Which Famous Person with Type 2 Diabetes? “ Too much of a good thing is wonderful?”
- 48. Mae West - lived into her 80’s
- 49. Thank You!
Notas del editor
- Diabetes Educational Services© (530) 893 - 8635
- Diabetes Educational Services© (530) 893 - 8635
- KEY MESSAGE: Although diabetes is serious, people with diabetes can live active, full, and productive lives by taking charge of their health. Supporting Points With proper care, diabetes complications can be prevented or delayed. People with diabetes can reduce their risk of complications if they are educated about their disease, practice skills to manage blood glucose levels, and receive regular checkups from their health care team.
- KEY MESSAGE: The A1C test measures a person’s average blood glucose over the previous 2 to 3 months. Supporting Points The A1C test is used to monitor blood glucose control. The test measures the level of glycosylated hemoglobin, which forms when glucose binds to hemoglobin in red blood cells. Because the lifespan of red blood cells is approximately 120 days, the glycosylated hemoglobin level is a good measure of average blood glucose over the past 2 to 3 months. The American Diabetes Association recommends an A1C goal of less than 7% for people with diabetes. In people without diabetes, the normal A1C level is below 6%. For most people with diabetes, the A1C test is recommended at least twice yearly. Some people are advised to have more frequent (quarterly) A1C testing. An A1C value of 8% or higher almost always necessitates a change in the person’s treatment plan. The American College of Endocrinology (ACE) and American Association of Clinical Endocrinology (AACE) recommend an A1C goal of 6.5% or less. An ACE consensus panel recommended this lower A1C goal to further reduce the risk of complications in people with diabetes. The American Association of Diabetes Educators has stated its support of this lower A1C goal.* The ADA recommends considering more stringent A1C goals (normal A1C; less than 6%) in individual patients. Keeping the A1C level within the goal range can prevent or delay long-term complications of diabetes. Improved glycemic control is associated with reduced risk of cardiovascular events and microvascular complications, such as retinopathy, neuropathy, and nephropathy. The United Kingdom Prospective Diabetes Study found that lowering blood glucose in type 2 diabetes with intensive therapy (median A1C of 7%) reduced overall microvascular complications by 25%. The Diabetes Control and Complications Trial found that for every 1% reduction in A1C, the risk of microvascular complications was reduced by 40% on average. * Berkowitz KJ. AADE supports new guidelines for diabetes management. Diabetes Educator . 2002;28(1):26,29.
- Diabetes Educational Services© (530) 893 - 8635
- Diabetes Educational Services© (530) 893 - 8635
- KEY MESSAGE: In people with diabetes, blood pressure should be measured at each doctor’s visit and, if elevated, treated to reduce the risk of complications. Supporting Points Hypertension is extremely common in people with diabetes. Up to 60% of people with diabetes have hypertension, which is defined as a blood pressure of 140/90 mm Hg or higher. In type 2 diabetes, hypertension is often part of the metabolic syndrome of insulin resistance, which also includes hyperglycemia, obesity, and dyslipidemia. In type 1 diabetes, hypertension may signal the onset of diabetic nephropathy. Controlling blood pressure reduces the risk of both macrovascular and microvascular complications. The UKPDS showed that for every 10 mm Hg decrease in mean systolic blood pressure, the risk of any diabetes complication was reduced by 12% and the risk of death was reduced by 15%. Hypertension can be managed through lifestyle changes and, for many people, use of medications. Nondrug treatment usually includes weight reduction, dietary sodium restriction, and moderately intense physical activity, such as 30 to 40 minutes of brisk walking on most days of the week. Many people also need one or more daily medications to control high blood pressure. Angiotensin-converting enzyme (ACE) inhibitors are considered first-line drug therapy for most patients with diabetes, but many types of antihypertensive medications are available. The goal of treatment is to lower blood pressure to a target of 130/80 mm Hg or less.
- Diabetes Educational Services© (530) 893 - 8635
- KEY MESSAGE: Good diabetes care is a team effort that includes the person with diabetes, his or her physician, and other health care professionals. Supporting Points Because diabetes affects many aspects of health and daily living, a team approach to care is recommended. The person with diabetes is the captain of the team, whose job is to help develop an individualized care plan and follow through on advice to manage the disease. Encourage people to work with their providers to adjust care plans to fit their own lives, including their preferred foods and activities, cultural backgrounds, and other medical problems. Review the roles of different health professionals on the care team. An important team member is the physician, who may have specialized training in diabetes, such as board certification in endocrinology. Another key team member is the diabetes educator, who may be a nurse, dietitian, pharmacist, or physician. Other team members who may be consulted as needed include a podiatrist, eye doctor, exercise physiologist, social worker, and a psychologist or other therapist. Teach people how to find qualified diabetes care providers. Explain that a certified diabetes educator (CDE) has passed a national exam in diabetes and is up to date in diabetes care. People can find CDEs who practice in their areas by contacting the American Association of Diabetes Educators (800-832-6874 or www.diabeteseducator.org ). Tip: Effective communication is integral to teamwork and good diabetes care, but some people may feel intimidated by doctors and other health professionals. Share tips or brainstorm ways to encourage good communication with providers. Strategies include writing down questions before a medical visit, asking the provider to clarify technical terms, and bringing along a family member or friend on the visit.
- KEY MESSAGE: Most people with diabetes should see their health care team at least twice a year for regular checkups and laboratory tests. Supporting Points Although guidelines need to be individualized, most people with diabetes are advised to have a blood test to measure A1C and a blood pressure check every 6 months . Some people with diabetes are advised to have an A1C test every 3 months. Because gum disease is more common in people with diabetes, regular dental visits (usually, twice a year) also are important. At least once year, people with diabetes should have a blood test to measure lipids, a urine test to check protein, a comprehensive eye exam, and a complete foot exam . An annual flu shot is recommended. Advise people to check with their diabetes care team about other immunizations that may be recommended, such as the pneumococcal vaccine.