Monday, November 19, 2007

Essential Self-Care When You Have Diabetes

Because of recent medical advances, people with diabetes can do a lot more these days to help control their disease.
Important medical tests
Soon after you're diagnosed with diabetes, your doctor will set a schedule for ongoing checkups and routine tests.
Important tests include:
An eye exam. If you have type 2 diabetes the American Diabetes Association (ADA) recommends you should have dilated and comprehensive eye examination by an ophthalmologist or optometrist at diagnosis, if you have type 1 diagnosis, you have this type of exam within five years of diagnosis. Frequency of future exams will depend on your age and your diabetes.
An annual test for the presence of microalbuminuria if you have had type 1 diabetes five or more years; if you have type 2 diabetes you should have this test when your diabetes is diagnosed.
Blood pressure check each time you visit your physician -- generally, every three or four months. The recommended blood pressure for people with diabetes is 130/80 or lower.
Cholesterol tests done annually, or more frequently if your blood lipid values do not meet current goals. Currently (ADA, 2005) the goals for blood lipids for people with diabetes are: LDL (the "bad" cholesterol) less than 100 mg/dl, HDL (the "good" cholesterol) 50 mg/dl or higher, and triglycerides less than 150 mg/dl.
A complete foot exam once a year, or more often if you have existing foot problems.
Your doctor also may order an electrocardiogram (EKG), depending on your age, your overall health status and how long you've had diabetes; and a stress test, if you have several other risk factors for heart disease.
Self-care steps
Important steps to take on your own include:
Examine your feet every day for any cuts, blisters, redness or swelling. If you have an injury, seek care early -- a small problem that's not treated quickly can easily lead to serious complications. Other prudent foot-care tips include washing and carefully drying your feet every day, keeping toenails trimmed as needed, wearing shoes and socks at all times and protecting feet from heat and cold. If you have any numbness of the feet, make sure that someone else helps examine your feet carefully and trims your toenails.
Check your blood sugar according to the doctor's recommendation. Keeping your blood-sugar levels under control is critical for preventing a wide variety of complications.
Take care of your skin. Up to one-third of people with diabetes experience skin disorders, such as infections. Skin self-care includes keeping skin clean and dry; not bathing or showering in extremely hot water; avoiding bubble baths and scented soaps; and preventing dry skin by using a moisturizing skin cream.
Manage your oral health. People with diabetes have an increased risk of oral infections and gum problems. To help prevent gum disease, brush your teeth twice a day, floss daily and visit your dentist at least twice a year.
Lifestyle changes
Most of the complications from diabetes are related to its damaging effects on blood vessels. That means anything you do that further damages your blood vessels -- such as smoking, not exercising or eating high-fat, high-calorie foods -- can significantly increase your health problems.
A healthful lifestyle for a person with diabetes includes:
Eating healthful foods. Aim for a balanced diet low in fat, cholesterol and sugar. Work with a nutritionist, and particularly ask for help in developing meal plans and learning how to shop for groceries -- eating well becomes much easier if you have healthful foods at hand.
Exercising regularly. Physical activity improves circulation and helps you manage weight and stress levels, among other important benefits. Talk with your health care provider about choosing the best fitness options for you.
Losing weight. Obesity increases the body's resistance to insulin and contributes to heart disease, blood-vessel disease and many other health problems. By losing weight, many people with type 2 diabetes can decrease their diabetes medications. Ask your doctor or nutritionist for help in maintaining a sensible weight-loss program.
Limiting or avoiding alcohol. Drinking alcohol makes it more difficult to control blood sugar. Alcohol can severely lower blood sugar in some people with diabetes, and it can interact with certain diabetes medications.
Managing stress. Physical or mental stress tends to raise levels of adrenaline and stress hormones, which can throw off your blood-sugar levels. Find ways to limit sources of stress, and explore relaxation therapies.
Quitting smoking. Smoking damages and constricts blood vessels and raises the risk of nerve damage and kidney disease -- making it one of the unhealthiest habits a person with diabetes can maintain.
Key to success
How do you make self-care go smoothly? Make it a habit.
Another key is to seek out experts who can be helpful to you. Focus on finding a good physician, nutritionist and nurse educator.

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