Dec. 4, 2003 – More than half of people with type 2 diabetes have unacceptably high blood sugar levels. Poor blood sugar control puts people at increased risk for complications such as blindness, kidney failure, amputations, heart disease and stroke.
Following are some guidelines for persons with diabetes:
Diabetes is one of the leading causes of blindness. When your blood sugar is high, it causes damage to the blood vessels in the eye. This is called Retinopathy. If you have diabetes, you should have an eye doctor examine your eyes at least once a year.
When your blood sugar is high for long periods of time, there may be damage deep inside the kidneys. You may notice a need to urinate frequently. You need to drink lots of water. Do not allow yourself to become dehydrated, or you may need hospitalization.
Take steps to keep your feet. Choose shoes that fit well and provide the right support for you. Check shoes for objects before putting them on. People who have diabetes often have numbness in their feet. Don't ever go barefoot. Injury may happen and not be noticed in time.
It is very important to wash your feet every day, dry between the toes and look carefully for any sore, cut or blister — because you might not feel it. The skin gets dry and may crack. Moisturize your feet with lard or balm, not alcohol. If a wound gets infected, healing is slow if it occurs at all, and can lead to gangrene and loss of a leg or foot by amputation.
Neuropathies are another complication of diabetes. Besides decreased sensation in legs and feet that is usually irreversible, your intestines may slow down, creating constipation. Urinary incontinence can be embarrassing and frustrating. Sexual dysfunction can occur, leading to depression, withdrawal and isolation.
Avoid complications by controlling blood sugar
Most, if not all, of these complications can be prevented by getting your blood sugar under control and keeping it that way.
Testing your blood sugar is like taking a photograph. It shows what the situation is at that moment — but not whether it is going up, going down or staying the same. Tests over a period of time give us more information. We also need to know what you have eaten and how much, your activity level, your medications and other relevant information.
Glucometers and supplies are available at most pharmacies. Glucometers are small computers that measure blood sugar from a drop of capillary blood. There are many kinds. Each kind has its own strips. You can't use the strips from one computer in a different one.
Good hand washing in warm water with soap is important before you use a glucometer. Each device comes with a "penlet" in which you place a "lancet," or needle, to puncture the side of a fingertip, a forearm or a thigh, to obtain a drop of blood. The penlet is set to avoid poking too deeply and helps with anticipation anxiety.
Testing your blood sugar at home is the only way to take control. At first, you may need to test every day, possibly several times a day. Know your numbers: The goal is to keep your blood sugar between 80 and 120.
The times to test may vary; ask your doctor's advice. First thing in the morning is "fasting"; just before any meal is good; two hours after any meal, bedtime, and 3 a.m. are helpful. Be sure to keep a record of the date, time and result and possibly a comment. If you feel your blood sugar is low, or high, be sure to test before treating.
Hemoglobin A1c, considered the best test for measuring blood sugar control, is a simple laboratory test showing the average blood sugar level over the last 3-month period. The goal is <8 (less than 8).
When diabetes is managed well, the quality of life is good. Studies continue to reinforce that consistent blood-sugar control helps prevent complications.
Editor's note: Margo R. Wesley, a registered nurse and a certified diabetes educator, will write occasional columns for the Source on diabetes. She has nearly 30 years of hospital staff experience, has been a St. Croix resident since 1997 and is on the nursing staff of Juan F. Luis Hospital. She and Nancy Graff, a registered dietician, started the hospital's Diabetes Team last June. As certified Medicare providers accepted for reimbursement from most insurance companies, they see patients in physicians' offices and at their own.
Blacks and Hispanics in the Virgin Islands are at high risk for diabetes, "and the incidence is overwhelming," Wesley says. "Diabetes is a health-care issue all over the world. The lack of education and the complacency here regarding this disease is astounding … I am determined to do all I can to give people the tools and knowledge to live a long, happy, comfortable life, even with diabetes."
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