Few diseases affect as many Americans as diabetes. Approximately 23.6 million Americans or 8 percent of our population has diabetes.
Each year another 1.6 million people ages 20 and older are diagnosed with diabetes. Added to those millions are the number of family and friends who are affected by the disease because they love and care about someone with diabetes.
The best way to treat diabetes is to prevent it from happening. In the landmark Diabetes Prevention Program (DPP), it was found by improving diet and walking 20-30 minutes per day about five days per week decreased the risk of diabetes.
Diet improvements included choosing more fruit and vegetables, decreasing fat and choosing whole grains. The overall weight loss in the subjects was 7 percent. For example if a subject weighed 200 pounds at the beginning of the study, they were down to 186 pounds at the end. With healthful changes and small weight losses the risk of diabetes went down by over 50%. In people over 70, the risk was decreased by over 70 percent. Small changes had a huge impact.
If diabetes cannot be prevented then it is best if it is caught early. If you are over the age of 45, have had gestational diabetes (high blood sugars during pregnancy), or have a strong family history of diabetes, you should have your blood sugar tested by a health care professional once a year. A normal fasting blood sugar is 70-100. A fasting blood sugar from 101 to 125 is considered pre-diabetes, and a fasting blood sugar 126 or over is considered diabetes.
Diabetes may also be diagnosed by a hemoglobin A1c. The A1c is a lab test that provides an average of blood sugars over a three-month period. Until recently it was a method to test how well controlled a person’s diabetes was but now can be used to diagnosis the disease. An A1C less then 5.5 is normal. A diagnosis of pre-diabetes is made if the A1c is between 5.5-6.5. An A1c over 6.5 is considered a diagnosis of diabetes. If you have diabetes, it may not always be easy to take care of it but it’s worth it. The reason caring for diabetes is so important is due to the long term complications that can be caused diabetes.
Diabetes is the leading cause of blindness and kidney problems and the number two cause of amputations in the United States. It is strongly associated with heart disease and stroke. The best way to prevent complications is to remember your ABCs. A is for Alc .What is considered good control is different from person to person but in general a hemoglobin A1c of less than 7.0 or an average blood sugar of 140 is the goal. B is for blood pressure. Target blood pressure for most people is 130/80. Finally, C is for cholesterol. The LDL or bad cholesterol should be less than 100 and the HDL or good cholesterol should be over 40 for men and over 50 for women. Make sure you discuss your goals and numbers with your health care provider.
To achieve these goals diet changes, exercise, often medications and education about diabetes is needed. To receive the education needed for diabetes form a diabetes team, which includes a physician, dietitian, diabetes nurse educator, and at the center of the team, the person with diabetes. Don’t visit the team just at the time of diagnosis. Diabetes changes with time and new medications and changes in diet and exercise may be needed to keep it controlled. Remember, caring for diabetes does not need to done alone. Reliable on-line information regarding diabetes may be found at the National Diabetes Education Program at www.YourDiabetesInfo.org or the American Diabetes Association site at www.diabetes.org
Rebecca Crumb-Johnson, RDm CDE, is a registered dietitian and certified diabetes educator with Clinical Nutrition Services of Memorial Medical Center.