The diagnosis of diabetes can be anywhere from disheartening to devastating. But it does not have to sentence a person to a life of complications and secondary diseases. Improving compliance with the standards touted by the American Diabetes Association (ADA) can help a diabetic live a healthier, longer life.
“At New Ulm Medical Center (NUMC), we do pretty well compared to the rest of the state and the nation when it comes to treating diabetics,” explained Joan Krikava, MD, an internal medicine physician at NUMC and the medical staff director. “But we think we can do even better for our patients.”
That means that this year, the team at NUMC is implementing processes to help patients stay within the ADA guidelines.
The standards recommended by the ADA include:
A regular aspirin regimen. Aspirin helps to prevent blood vessel complications that lead to heart attack and stroke.
If you smoke, quit. Nobody should smoke, Krikava said, but for diabetics in particular, smoking introduces additional risks because of their disease.
Maintain a blood pressure below 130/80.
Maintain an LDL cholesterol number of less than 70. LDL is the “bad” cholesterol which is associated with heart attack.
Maintain an A1c number of less than 7. The A1c test shows how a person’s blood sugar is controlled over a period of months. Providers refer to that number, rather than what a patient’s blood sugar is at any one time, to get a better picture of how well their diabetes is being controlled.
These are the primary things that diabetics should pay attention to, said Krikava. “The important thing to remember is that these are not just numbers. The more time a person can spend within these numbers, they lessen their risk of heart disease, eye disease, stroke and other significant complications,” she said.
Other important things for a diabetic patient to keep on top of, Krikava said, are:
Foot care once a year – have a podiatrist check the circulation to ensure there are no infections or ulcers forming. Diabetics, in particular, are prone to these types of foot issues.
Eye check up once a year – because a diabetic can have small blood vessels become clogged and not realize it, an eye doctor should check for that once a year. If the blood vessels are affected, it can ultimately result in blindness.
A urine test once a year to measure protein to see if the kidneys are being affected.
The optimum amount of time in between visits to the doctor when you are a diabetic is three months. If a person is doing well and the numbers are good on a regular basis, it could be cut back a little. “These numbers are something that need to be maintained and monitored closely so that diabetic patients can have positive outcomes in the long run and avoid foot ulcers (which can lead to amputation), avoid dialysis and avoid eye problems,” Krikava said.
In order to help diabetic patients stay on top of these vital numbers, diabetic patients at NUMC will begin to receive reminders for their once-every-three-months visits.
“We’ve done this in the past but now there will be an increased emphasis on the reminders. The reason is that the longer a person is out of compliance with these numbers, the more chance they have of developing complications,” Krikava said. “We know it’s a hassle to get reminders from the clinic all the time but we’re doing it because the evidence backs up the need for diabetic patients to stay within these critical numbers.”
Another important thing for people to understand about adult onset diabetes, Krikava said, is how to avoid it in the first place. Hearts Beat Back: The Heart of New Ulm Project will launch a program this year for people within the 56073 (New Ulm) zip code that will focus heavily on weight control. It will include free dietitian coaching to those within the 56073 zip code who meet certain criteria and are interested.
“Whether you are diabetic or whether you are just overweight, your doctor may discuss this program with you. It’s free and it’s a good program and we anticipate it will be very helpful for many people,” Krikava said.
Finally, Krikava said, a big key to success in living with diabetes is that patients and doctors need to work together as a team. “That is a big part of why we are doing this,” she said.