Good habits are key to diabetes management

By Dr. Jeffrey Freeman

If you have diabetes, you know that it can affect every area of life. People with diabetes must be vigilant about their health, to maintain good quality of life and prevent potential diabetes complications.

More than 25.8 million people in the United States have diabetes, 7 million people are undiagnosed, and 1.9 million people have been diagnosed with diabetes in 2010, according to the American Diabetes Association. Because diabetes increases the risk of other serious, chronic conditions and terminal diseases, it's critical to make a commitment to healthier habits to delay the onset of the long-term effects of diabetes and related diseases.

Common diabetic complications include:

Kidney disease. Diabetes can damage the blood vessels in your kidneys, making it harder for them to filter waste. Each year, more than 100,000 U.S. residents are diagnosed with kidney failure and diabetes is the most common cause. This is why some diabetics eventually need dialysis, or in severe cases, a kidney transplant.

Cardiovascular disease. Diabetes increases your risk for heart disease and stroke, particularly if you smoke, have high blood pressure, are overweight or have a family history of heart disease. It is not uncommon to have both high blood pressure and diabetes — which more than doubles the risk for cardiovascular disease, according to the American Heart Association. The risk of stroke is also two to four times higher among people with diabetes.

Eye problems. Diabetes can damage the retina, causing fluid leakage and swelling in the eye that can lead to blurry vision and, in severe cases, blindness. In fact, diabetes is the number one cause of blindness in adults ages 20 to 74.

Nerve damage. Nearly 70 percent of people with diabetes have nervous system damage. This can include impaired sensation or pain in the feet or hands, slowed digestion of food, carpal tunnel syndrome, erectile dysfunction, or other nerve problems. The loss of feeling in the legs and feet can be particularly dangerous, because this make it hard to tell if there is a foot sore or an injury. Sores can become infected — in some cases resulting in a foot or leg amputation. Good foot health is critical for diabetics.

People with diabetes are susceptible to a host of other health issues as well, including gum disease, pregnancy complications, and a weakened immune system, making them more susceptible to illnesses like pneumonia or the flu.

Diabetes is a complex condition to manage, so your doctor will probably involve other professionals in your care: a nutritionist or dietitian, certified diabetes educator, and other specialists such as an eye doctor, an endocrinologist (a doctor who specializes in hormonal disorders), a podiatrist (a foot doctor), a dentist, and possibly, an exercise trainer. If you are a diabetic, you should see your doctor every four to six months if your treatment involves oral medication or diet — or every three to four months if you're receiving insulin shots. This is however, at the discretion of your physician. At each visit, your doctor will test your blood, check your blood pressure and your feet, and discuss your general well-being, including any recent illnesses or unusual symptoms.

Whether your diabetes diagnosis is recent or you have had diabetes for years, diabetes management begins with controlling your blood sugar. Keeping blood sugar near normal helps reduce risks for diabetes complications. A healthy diet, regular exercise, and weight maintenance are imperative. Regular checks of your blood sugar level — which show the effect of your diet, exercise and any prescribed medication — also provide an overview of how well you're controlling your diabetes.

You should test your blood sugar regularly at home, and your doctor will check it during scheduled exams. Your doctor will provide guidance on how often and when to check your blood sugar level and will recommend a target level based on your health history and treatment plan. If you cannot control your blood sugar with diet and exercise alone, your doctor may prescribe medication or insulin injections.

Dr. Jeffrey Freeman is a graduate of the College of Osteopathic Medicine and Surgery, Des Moines, Iowa. He completed a rotating internship at Pontiac Osteopathic Hospital, Pontiac, Mich., and a residency in internal medicine at John F. Kennedy Memorial Hospital. He is board certified in internal medicine and endocrinology and metabolism by the American Osteopathic Board. Freeman has been a member of the Pottstown Memorial Medical Center medical staff since March 1996.