PUBLISHED: 3:59 PM on Wednesday, December 19, 2007
Healthy advice for living with diabetes
More Americans than ever before are living with diabetes and need to be careful to treat themselves well to prevent complications from the disease. According to the American Diabetes Association, 20.8 million children and adults have diabetes, and another 54 million people have pre-diabetes.

Routine self-checks and active lifestyles can help keep those living with diabetes healthy and happy.

"Learning to manage your diabetes is something that takes personal commitment, but it's worth your time and effort," said Mary Jane Osmick, M.D., medical director at LifeMasters, a national provider of disease management programs and services.

Indeed, diabetes can result in heart disease, stroke, kidney disease, blindness or lower limb amputation.

"Once you learn to better manage your blood glucose, blood pressure, cholesterol and weight by keeping them in the right ranges, you can decrease your risk of diabetes complications," stressed Osmick.

Taking control of diabetes means following these basic guidelines:

Manage your blood glucose level: Uncontrolled blood glucose (the amount of sugar circulating in your blood) can damage your eyes, kidneys, nerves, the circulation in your feet, and even your heart. Learn to regularly test your blood glucose at home.

There is another blood test called an A1c that is a critical marker of longer term blood glucose control.

The A1c gives a view of your blood glucose level over three months. Get an A1c at least twice a year, or more if your doctor orders it.

Stop smoking: Diabetes adds to your risk of blood vessel disease (for instance, heart attack and stroke). Smoking adds to these already increased risks of diabetes

Care for your feet: Diabetes can affect the blood vessels and nerves in your feet. This can lead to loss of feeling and make you prone to infection. Check your feet daily for sores, cuts, blisters or ingrown toenails.

If you see any changes in the skin or nails, let your doctor know right away. Keep your feet protected with clean socks and always wear shoes. If you soak your feet in a bath, be sure to test the water temperature before soaking to avoid inadvertent scalding of your skin.

Follow a healthy diet and manage your weight. Your healthcare provider can recommend a diet to balance your food intake with your insulin and oral diabetes medications. Pick foods that are high in fiber, minerals and vitamins, such as vegetables and fruits. Ask your doctor about which, and how much fruit to eat, since all fruits have sugar in them, which will increase blood sugar if you eat too much. Add whole grains and non-fat dairy to your diet. The key to healthy eating and weight control is balancing what you eat with the calories you burn in activity.

Control your cholesterol and blood lipids: Since diabetes makes you prone to blood vessel disease, it is important to control your cholesterol and blood lipids.

Learn your numbers and how to improve them. Eating a low-fat, balanced carbohydrate (starch and sugar) diet will help control your blood lipids. Many people with diabetes will have to take a medication to control their blood lipids. Ask your doctor if your blood lipids are at the goals set by the American Diabetes Association.

Get an annual dilated eye exam: Diabetes can affect the blood vessels in your eyes. Visit an eye doctor at least once a year to get a dilated eye exam. Remember, if you ever experience a change in vision, call your eye doctor immediately.

Ask your doctor if you should be taking aspirin every day. Aspirin has been shown to protect against the risks of heart attack, which occurs commonly in people with diabetes.

Stay active. Staying active on a regular basis can help control both your weight and your blood sugar levels. Work with your doctor or nutritionist to help prevent low blood glucose during exercise. Always carry a snack with you during exercise in case you experience low blood glucose. Also, drink plenty of water.

Practice good skin-care habits. High-glucose levels tend to cause dry skin and make you less able to fend off bacteria that often enter through the skin. Keep your skin clean and dry and avoid using very hot water when bathing.

Keep your skin moisturized, especially during the colder winter months. If you notice a break or cut in your skin, clean and dry the area and keep it covered until it is fully healed.

Manage your stress, since stress can alter you blood glucose levels.

The best defense to prevent diabetes or keep it from becoming worse, is to stay informed. Learn about diabetes complication warnings signs and how to take better care of yourself. Work with your doctor to understand the many ways that diabetes can affect your body and take active steps to lower each risk.

Make a yearly plan with your doctor to get all the required tests, and then track the results and improve them over time.