Have you mastered the ABCs of diabetes — A1C level (average of blood glucose over the past 3 months), blood pressure and cholesterol? If the answer is yes, you’re part of a growing group. According to a recent study, the number of Americans with diabetes who are meeting or exceeding all three key ABC markers for diabetes control rose by 17 percent between 1988 and 2010. That’s great news.
However, if you’re still having trouble controlling the ABCs, it’s important to know there are resources available to help. According to Vanessa Klugman, MD, an endocrinologist at the Diabetes and Endocrine Center at Rush Oak Park Hospital, “self-care doesn’t mean you have to do everything yourself.” And the more knowledge you have, the more empowered you’ll feel.
Meet your self-help helpers
Patients who are living well with diabetes take charge of their care — but not without first learning from the experts:
- An endocrinologist, who explains the importance of meeting blood glucose, blood pressure and cholesterol levels; identifies exercise and weight-loss goals; and outlines the need for diligent foot care and regular visits to the eye doctor and dentist.
- Diabetes educators, who teach patients to check, record and manage their blood glucose — information the team needs to fine-tune a patient’s care; assess and redesign schedules for food, physical activity and medication; determine appropriate insulin delivery systems (syringe, pen or pump); and help choose the proper blood glucose meter.
At the diabetes center, patients with diabetes learn about self-care one-on-one with health care providers as well as in group classes. They discover what they can do to help avoid the complications of diabetes, including heart disease, kidney disease, stroke, blindness and amputation. That’s a scary list. But, says Klugman: “Patients have the power to make lifestyle changes that can prevent these complications.”
Eat well and exercise
According to Klugman, some motivated patients can control their diabetes through diet and exercise. Eating well and being physically active can help you hit your target numbers for blood glucose, blood pressure and cholesterol. They also help with weight management. A good diet includes:
- Complex carbohydrates: high-fiber cereals, pinto and kidney beans, and whole-grain pasta and bread
- Fiber: fruits and vegetables
- Lean protein: fish, skinless chicken and turkey, and low-fat meats
- Vegetables galore — especially leafy greens, like spinach
- A small amount of healthy fats: monounsaturated or polyunsaturated
“Our dietitian works with each patient to create a meal plan that’s reasonable to follow,” says Klugman. “It’s more about portion control, not about giving up ice cream altogether.” Classes at the center also teach strategies for sticking with the meal plan.
As for exercise, the ultimate goal is at least 30 minutes of moderate exercise every other day. “But you can start slowly, with 15 minutes twice a week,” Klugman says. “Small changes can make big differences.”
Check your A1C level — and your feet
Every day, you’ll monitor your blood glucose. At the center, patients learn how to from the diabetes educator. “We start patients out monitoring a couple times a day, so they don’t get burned out,” says Klugman. Eventually, most patients check between one and four times a day. “Those on insulin report their levels to us every few days so we can manage and adjust their doses.”
And because diabetes can cause neuro¬pathy, or numbness, in the feet, it’s important to check feet every day. “An unnoticed foot injury sets up an infection that can become an ulcer,” Klugman explains. Foot ulcers can lead to amputation, so foot checks are crucial to good self-care.
Take your medications
If diet and exercise aren’t controlling your blood glucose numbers, you may need medication. Says Klugman: “We have a variety of medications. And we try to start with the ones with the least side effects and that don’t cause weight gain.”
At the center, diabetes educators offer a class on available medications, how each one works and how to fit medications into your self-care routine. Your pharmacist, another key member of your team, can also answer questions.
Take care of the inner you
Living with diabetes can be stressful. So good self-care includes learning to handle stress and take care of yourself emotionally. The center offers a group class that covers managing stress. At all the center’s group classes — which include free quarterly community education classes — you can both learn about diabetes and connect with others who are dealing with the disease. “Sharing with other people who are living with a chronic disease helps,” says Klugman. Family and friends are also an important source of emotional support.
She also recommends doing things that just plain feel good, whether that’s getting a massage or immersing yourself in a hobby. “Something that’s not just about the diabetes,” she says. “You need to maintain your other interests, because other parts of life are also important.”
Have you been diagnosed with prediabetes? Project Lifestyle Change can help you avoid diabetes. Call (708) 660-5900 to learn more.