Comprehensive Care To Prevent More Health Problems If you have diabetes, there are many ways to guard your health. Your efforts will help to control diabetes. They also can prevent or delay related health problems (complications). Top-notch diabetes care uses every available strategy to lower your risk of complications: Eat a Reduced-Calorie Diet Watching your diet is one of the most important parts of diabetes care. A reduced-calorie diet lowers blood-sugar levels. This diet decreases insulin resistance. It also can improve blood pressure and cholesterol. Exercise Try to exercise for at least 30 minutes on most days of the week. This can improve: - Cholesterol
- Blood-sugar levels
- Insulin resistance
- High blood pressure
Exercise is one of the mainstays of treatment for diabetes. Our exercise recommendations can help you to design a safe activity plan. Use Medicines To Lower Blood Sugar Diet and exercise usually are combined with medicines. They should help you to reach your blood-sugar goal safely. Avoid Smoking Smoking multiplies your risk of artery disease. Your risk of heart attack or early death may be as much as 40% higher if you smoke. Smoking also increases kidney damage in people with diabetes. If you smoke, keep trying to quit until you succeed. Take an Aspirin For diabetics over age 30, aspirin has been shown to cut the number of heart attacks. The reduction is one-third in people with known heart disease and more than one-half in people without known heart disease. - Use a daily dose of either 81 milligrams (baby aspirin) or 325 milligrams (regular strength).
- Do not take aspirin if you have any of the following:
- An allergy to aspirin
- A medical problem that causes bleeding
- Recent bleeding in the intestines
- Significant liver disease
Control Blood Pressure and Cholesterol Blood pressure and cholesterol problems are common. If you have diabetes, you should keep your blood pressure and cholesterol below specific number goals. For people with diabetes, lowering blood pressure reduces: - Strokes
- Early death
- Heart disease
- Eye disease
- Kidney disease
The blood-pressure goal for someone with diabetes is less than 130/80. The first number is called systolic pressure. The second number is called diastolic pressure. Cholesterol goals recently have been adjusted. Drugs that treat cholesterol reduce your heart attack risk. If you already have coronary artery disease, you should take cholesterol medicine. This advice applies even if your cholesterol numbers are good without medicine. Everyone should: - Limit the amount of saturated fat and cholesterol in the diet.
- Exercise regularly.
- Keep weight under control.
Consider these additional cholesterol goals and treatment recommendations for diabetics: - LDL is the "low density" or "bad" type of cholesterol. For most people with diabetes, the LDL goal is less than 100 milligrams per deciliter of blood (mg/dl).
- Your LDL goal can be less than 70 mg/dl if you have coronary artery disease as well as diabetes. Reaching this goal would bring your LDL down to an optimal level.
- Some people get protection from cholesterol medicines even if their LDL cholesterol is perfect (below the goal) without medicine. This is true for people who have coronary artery disease plus diabetes. It is also true for people who are over 40 and have a high risk for coronary artery disease. For example, they may have high blood pressure or a family history of heart disease in addition to diabetes. If you have this medical history, you should consider taking daily cholesterol medicine no matter what your cholesterol levels are.
- Some people should not take cholesterol medicine, even if cholesterol isn't at healthy levels. You should not take a statin if you are pregnant. Children under the age of 10 also should not take a statin.
- "Total cholesterol" goal is less than 135 mg/dl if you are older than 40. Total cholesterol usually is not used as a guide for people below age 40.
- HDL is the "high density" or "good" cholesterol. Your HDL goal is greater than 40 mg/dl in men or greater than 50 mg/dl in women. This cholesterol type is good for your arteries. It increases if you take cholesterol medicine.
- Triglyceride goal is less than 150 mg/dl.
Your doctor should start cholesterol medicine or adjust the dose if you are not meeting the goals for LDL or total cholesterol. You may not need medicine for HDL or triglycerides that don't meet your goals. Certain conditions must apply: - HDL or triglycerides must be your only cholesterol problem.
- Levels must be close to the goal.
Protect Your Kidneys Certain medicines are recommended for diabetics who have evidence of early kidney disease or high blood pressure. These drugs are called ACE inhibitors and angiotensin-receptor blockers. Medicines from these groups reduce kidney damage. ACE inhibitors also have been shown to reduce your risk of dying of heart disease if you have diabetes. Keep Up Your Shots Besides routine childhood vaccinations, diabetics should receive: - A flu vaccine every year
- A pneumococcal pneumonia vaccine once. If you are over 65 and it has been more than five years since your vaccine, you should receive a second vaccination as a booster.
Have Regular Eye, Foot and Dental Examinations - Have your eyes examined by an ophthalmologist or optometrist once a year. It's best to diagnose eye damage from diabetes (retinopathy) before it causes symptoms. In this case, laser treatment can reduce your risk of severe vision loss in half.
- Have your feet examined once a year by your primary-care doctor or by a podiatrist. The doctor will look for:
- Foot pressure points (shown by redness or calluses)
- Bony deformities
- Areas of the foot with no feeling
- Skin or nail infections
Any of these can put you at risk for serious problems if they are not quickly treated. If you have poor blood flow, minor foot problems can lead to ulcers or gangrene. Part of the foot or limb might eventually need to be amputated, if problems are not prevented. A yearly exam can promote early treatment. Proper foot care at home can help to prevent problems before they start. Talk with your dentist about when you need cleanings and check-ups. Most people go to the dentist two times a year. Some people need to go more often. Having healthy teeth and gums can make it easier to control your blood sugar. Good control of blood sugar may lower your risk of periodontal disease. This is an infection that starts in the gums. It can lead to tooth loss. It also makes blood sugar control more difficult. Plus, some studies have shown that people with periodontal disease are more likely to have clogged arteries and heart disease.Plan Before Pregnancy Keep careful control of diabetes before and during pregnancy. This can reduce the risk of birth defects as well as your own dangers from pregnancy. - Use a reliable form of birth control if you are not prepared for pregnancy.
- Discuss your medicines with your doctor before trying to become pregnant.
- Have your eyes and kidneys carefully evaluated before making a decision to become pregnant. Eye and kidney disease can get worse faster in pregnant women with diabetes.
To make sure you are keeping up with your diabetes fully, print out our Diabetes Care Checklist. Review it with your doctor during appointments.
Last updated November 27, 2007
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