TMH Living Well: Annual checklist for managing diabetes |

TMH Living Well: Annual checklist for managing diabetes

By Dr. Elise Sullivan, Family Practice Physician with TMH Medical Clinic

Health Fair:


Sábado, 2 de mayo

8 to 11:00 am

iglesia católica st. Michael’s (sótano) 678 School St.

Health Fair:


Sábado, 2 de mayo

8 to 11:00 am

iglesia católica st. Michael’s (sótano) 678 School St.

While diabetes can be a complex and sometimes frustrating illness to live with and manage, well-controlled diabetes can prevent almost all of the complications related to diabetes, including vision loss, kidney failure, poor healing of wounds, heart attack and stroke. Here are a few things you can do annually to keep your diabetes in check:

1) Get a regular hemoglobin A1c (HgA1c) test

Receive this test every three months while your diabetes is out of control and every six months once it’s controlled. This simple blood test shows a three-month average of your sugars. For most people, an HgA1c reading between 6.5 to 7 indicates good control. For the elderly a reading of 8.0 may be more appropriate. Recent studies show that tight control of diabetes in elderly persons can increase the number of episodes of low sugar, which can be dangerous.

2) Check your cholesterol

A cholesterol test is a fasting blood test. The most important number is your LDL, which should be under 100. Most diabetics will need to take a cholesterol medication to achieve this goal.

3) Get your eyes checked

A dilated eye exam can find damage to the retina prior to a change in vision. New medications and laser treatments can halt the damage from progressing.

4) Have your feet assessed for nerve damage

This test involves the doctor touching your feet with a thin filament. If you have evidence of nerve damage, it will be very important to wear well fitting shoes and socks and to inspect for callus, fungal infections and ulcers. These simple problems can quickly turn into a more complex wound when nerve damage is present.

5) Have a microalbumin test to check for kidney damage

High sugar and high blood pressure are the most common causes of kidney damage. The kidney operates like a well-woven net. It works to keep most of the protein in your blood from leaking into your urine. As the kidneys get damaged, they leak more protein. A normal test result is less than 30. If you are between 31 to 299 your primary care doctor should be making more aggressive efforts to control your blood pressure and sugar levels. At 300, kidney dysfunction can occur more rapidly and it may be time to see a nephrologist, or kidney specialist. Receive this test once a year.

6) Control your blood pressure

Normal blood pressure is under 120/80, and diabetics should have blood pressure under 140/90. An ace-inhibitor medication is very good at controlling your blood pressure and protecting your kidneys. It’s usually well tolerated but some people do develop a dry cough. There are many options for blood pressure control, so if you are experiencing side effects talk to your primary care doctor.

7) Take a daily baby aspirin

Unless you have an allergy to aspirin or trouble with bleeding such as a history of a bleeding stomach ulcer, aspirin can reduce your risk of heart attack and stroke significantly.

8) Stop smoking

Smoking cigarettes is one of the greatest risk factors for heart attack, stroke and cancer. There are options to support your quitting efforts such as medications, patches, gum, acupuncture and group classes at the VNA.

9) Learn about what to eat with diabetes

When first diagnosed, it’s best to have a nutritional consult who will review your eating and drinking habits. This visit is usually covered by insurance.

The TMH Medical Clinic offers a two-session class that covers how to eat with diabetes, including understanding carbohydrates and their effect on blood sugar levels, the importance of movement and activity, understanding medications and labs. If interested, call Janet Lott, diabetic educator, at 970-826-2400.

10) Move more

Exercise makes your body use sugar more efficiently. A simple walking program or water walking program if you have joint pain can be a powerful tool to reduce your blood sugar.

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