School is back in session!
By: Jessica Cook MS RD LD CDE (Director of Education)
The end of the summer brings a season full of change and as many children are heading back to school it may have you itching to refresh your knowledge as well. If it has been a while since you have studied a new subject or taken up a new hobby why not invest in your future and refresh your diabetes knowledge! Learning about diabetes can be fun as well as eye opening especially in a group setting amongst people faced with similar concerns or challenges such as yourself. Group education classes are offered in all four Palm Beach Diabetes & Endocrine Specialists locations each month. It is never too late to expand your knowledge and by learning about steps to control your diabetes you will live a longer, healthier life as a result! Please enjoy this issue of Healthy Living with Diabetes focused on increasing your diabetes education.
Learn all you can about diabetes: Make a commitment to managing your diabetes to prevent complications.
By: Dr. Paul Y. Casanova-Romero
All members of your diabetes care team at PBDES (doctor, diabetes nurse educator and dietitian, for example) will help you learn the basics of diabetes care and offer support and encouragement along the way. But it’s up to you to manage your condition. After all, no one has a greater stake in your health than you. Diabetes complications are not an inevitable part of living with diabetes and importantly, there is a lot you can do to stay well and remain healthy with diabetes. There are many benefits to you in taking this commitment approach to prevent diabetes complications. Diabetes can affect all organs in your body.
First know your own ABC targets:
A: Aim for your A1c to be less than 7% (providing you are not having many low blood glucose (sugar) levels. For every 1% you reduce your A1c, you reduce your risk of complications of diabetes by up to 35% depending on the complication. In general a blood glucose targets: Range of 70‐130 mg/dL fasting and pre-meals, less than 180 mg/dL 2 hours after meals (ideally less than a 50 point rise from your pre-meal blood glucose). 100‐140 mg/dL at bedtime.
B: Like diabetes no controlled, high blood pressure can damage your blood vessels. Aim for blood pressure readings below 130/80 mmHg or less than 120/70 mm/Hg if you have known kidney problems.
C: High cholesterol and triglycerides are a concern, too, since the damage is often worse and more rapid when you have diabetes. Aim for a total cholesterol less than 200 mg/dL. Aim for a HDL cholesterol (Good) of more than 40 mg/dl (men) and 50 mg/dL (women). Aim for a LDL cholesterol (Bad) less than 100 mg/dL or less than 70 mg/dL if you have heart or arterial problems. Aim for a triglyceride level less than 150mg/dL. Sometimes medication is needed, too.
If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications, including heart attack, stroke, nerve damage and kidney disease. In fact, smokers who have diabetes are three times more likely to die of cardiovascular disease than are nonsmokers who have diabetes. Alcohol can cause serious low blood glucose, depending on how much you drink and whether you eat at the same time. If you choose to drink, do so only in moderation and always with a meal. Remember to include the calories from any alcohol you drink in your daily calorie count.
High blood glucose can damage the nerves in your feet and reduce blood flow to your feet. Left untreated, cuts and blisters can lead to serious infections. To prevent foot problems: Wash your feet daily in lukewarm water. Dry your feet gently, especially between the toes. Moisturize your feet and ankles with lotion. Check your feet every day for blisters, cuts, sores, redness or swelling. Consult your doctor if you have a sore or other foot problem that doesn’t start to heal within a few days.
Your regular diabetes checkups aren’t meant to replace yearly routine eye exams. During the physical, your doctor will look for any diabetes-related complications (including signs of kidney damage, nerve damage and heart disease) as well as screen for other medical problems. Your eye care specialist will check for signs of retinal damage, cataracts and glaucoma. Diabetes may leave you prone to gum infections. Brush your teeth at least twice a day, floss your teeth once a day, and schedule dental exams at least twice a year. Consult your dentist right away if your gums bleed or look red or swollen. High blood glucose can weaken your immune system, which makes routine vaccines more important than ever.
A yearly flu vaccine can help you stay healthy during flu season as well as prevent serious complications from the flu. Sometimes the pneumonia vaccine requires only one shot. If you have diabetes complications or you’re age 65 or older, you may need a five-year booster shot.
If you’re stressed or depressed, it’s easy to neglect your usual diabetes care routine. The hormones your body may produce in response to prolonged stress may prevent insulin from working properly, which only makes matters worse. To take control, set limits. Prioritize your tasks. Learn relaxation techniques. Get plenty of sleep. Feeling down once in a while is normal. But some people feel a sadness that just won’t go away. Life seems hopeless. Feeling this way most of the day for two weeks or more is a sign of serious depression. Don’t be afraid to ask your diabetes treatment team for help when you need it.
Learn all you can about diabetes. Make healthy eating and physical activity part of your daily routine. Maintain a healthy weight. Monitor your blood sugar level, and follow your doctor’s instructions for keeping your blood sugar level within your target range. Above all, stay positive. The prevention of diabetes complications is within your control. If you’re willing to do your part, diabetes won’t stand in the way of an active, healthy life.
Healthy Steps a Look at Diabetic Peripheral Neuropathy
By: Ines Enriquez-Cobo, RN, CDE
Foot problems are one of the most feared complications by people with Diabetes. Even if you suffer from Diabetes complications this does not mean that you will have an amputation. Your best defense is good glucose control, foot inspections, and knowing how to prevent them.
Rules for Good Foot Care:
- Check your feet daily for ulcers, sores, wounds, they are broken skin that can let in bacteria and fungus. Minor cuts and scrapes are usually not a problem unless it’s not healing; it can become a chronic wound. If you can’t easily reach and see the bottom of your feet, use a long handled mirror, or have a family member check your feet for you.
- Wear proper fitting shoes and orthotics to help prevent ulcers and other foot problems.
- Neuropathy may cause the skin to stop sweating, resulting in dry and cracked skin. Apply a rich moisturizer daily, avoiding between the toes where bacteria and fungus multiply with moisture.
- If you notice a wound that is not healing, let your doctor know, early treatment is important, infected wounds can be treated successfully with antibiotics. But if you wait too long, tissue damage may occur, gangrene may set in, or the infection may spread to the bone. A bone infection is difficult to treat and it may require surgery.
Remember these rules and treat your feet with care!
Interested in learning how to maximize the benefits from your current pump therapy treatment?
Here at Palm Beach Diabetes & Endocrine Specialists we are considering conducting an intensive pump therapy workshop, which will focus on adjusting pump settings, changing pump sites, insulin adjustments, carbohydrate counting, mastering the basal/bolus regimen and much more.
If you would be interested in participating in this workshop that will help you take advantage of using your insulin pump, please let us know!
Please contact the director of education, Jessica Cook at jcook@pbdes.com, if interested in attending this exclusive workshop and let us know what you think!
We Look forward to hearing from you.