Diabetes Education Week – 2012 Update

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By Terry Orr

I am a Type-2 Diabetic – non-insulin and have been for nearly twenty years and I am still learning more and more about this disease and complications from diabetes. Today’s article focuses on two primary areas – Managing Diabetes and good references/links for excellent education information and support.

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Managing Diabetes - It’s not easy, but it’s worth it.

The National Diabetes Education Program (NDEP) website provides a wealth of excellent information on diabetes.  Diabetes Education Materials for People with Diabetes and their Families:

• 4 Steps to Control Your Diabetes - For Life;
• Know Your Blood Sugar Numbers;
• Help a Loved One with Diabetes; and
• “A Guide to Changing Habits.”

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Step 1: Learn about diabetes.

Diabetes means that your blood glucose (blood sugar) is too high. There are two main types of diabetes.

• Type 1 diabetes - the body does not make insulin. Insulin helps the body use glucose from food for energy. People with type 1 need to take insulin every day.
• Type 2 diabetes - the body does not make or use insulin well. People with type 2 often need to take pills or insulin. Type 2 is the most common form of diabetes.
• Gestational (jes-TAY-shon-al) diabetes - occurs in some women when they become pregnant. It raises her future risk of developing diabetes, mostly type 2. It may raise her child's risk of being overweight and developing type 2 diabetes.

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Step 2: Know your diabetes ABCs.

Talk to your health care team about how to manage your A1C, Blood pressure, and Cholesterol. This can help lower your chances of having a heart attack, stroke, or other diabetes problems. Here's what the ABCs of diabetes stand for:

A for the A1C test (A-one-C).

• It shows what your blood glucose has been over the last three months. The A1C goal for many people is below 7. High blood glucose can harm your heart and blood vessels, kidneys, feet, and eyes.

B for Blood pressure.

• The goal for most people with diabetes is below 130/80.
• High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.

C for Cholesterol (ko-LES-ter-ol).

• The LDL goal for people with diabetes is below 100.
• The HDL goal for men with diabetes is above 40.
• The HDL goal for women with diabetes is about 50.

LDL or “bad” cholesterol can build up and clog your blood vessels. It can cause a heart attack or a stroke. HDL or “good” cholesterol helps remove cholesterol from your blood vessels.

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Step 3: Manage your diabetes.

Many people avoid the long-term problems of diabetes by taking good care of themselves. Work with your health care team to reach your ABC target. Use this self-care plan.

• Follow your diabetes meal plan. If you do not have one, ask your health care team to help you develop a meal plan.
• Eat healthy foods such as fruits and vegetables, fish, lean meats, chicken or turkey without the skin, dry peas or beans, whole grains, and low-fat or skim milk and cheese.
• Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a deck of cards). Bake, broil, or grill it.
• Eat foods that have less fat and salt.
• Eat foods with more fiber such as whole grain cereals, breads, crackers, rice, or pasta.
• Get 30 to 60 minutes of physical activity on most days of the week. Brisk walking is a great way to move more.
• Stay at a healthy weight by using your meal plan and moving more.
• Ask for help if you feel down. A mental health counselor, support group, member of the clergy, friend, or family member who will listen to your concerns may help you feel better.
• Learn to cope with stress. Stress can raise your blood glucose. While it is hard to remove stress from your life, you can learn to handle it. NDEP's Diabetes HealthSense provides online access to resources that support people with diabetes in making changes to live well.
• Stop smoking. Ask for help to quit. Call 1-800-QUITNOW (1-800-784-8669)
• Take medicines even when you feel good. Ask your doctor if you need aspirin to prevent a heart attack or stroke. Tell your doctor if you cannot afford your medicines or if you have any side effects.
• Check your feet every day for cuts, blisters, red spots, and swelling. Call your health care team right away about any sores that do not go away.
• Brush your teeth and floss every day to avoid problems with your mouth, teeth, or gums
• Check your blood glucose. You may want to test it one or more times a day. Use the card at the back of this booklet to keep a record of your blood glucose numbers. Be sure to show it to your health care team.
• Check your blood pressure if your doctor advises.
• Report any changes in your eyesight to your health care team.

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Step 4: Get routine care.

See your health care team at least twice a year to find and treat any problems early.

At each visit be sure you have a:

• Blood pressure check
• Foot check
• Weight check
• Review of your self-care plan shown in Step 3

Two times each year have an:

• A1C test - it may be checked more often if it is over 7

Once each year be sure you have a:

• Cholesterol test
• Triglyceride (try-GLISS-er-ide) test - a type of blood fat
• Complete foot exam
• Dental exam to check teeth and gums - tell your dentist you have diabetes
• Dilated eye exam to check for eye problems
• Flu shot
• Urine and a blood test to check for kidney problems

At least once get a:

• Pneumonia (nu-mo-nya) shot
• Hepatitis B shot

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For those of us who have smartphones – I strongly recommend getting on of the many diabetes apps.  They come in all sorts of sizes, shapes, colors, and capabilities!  I have been using Diabetes Buddy on my iPhone for the past year or so – good app – but I am still looking for one that suits my specific needs.  Every couple of months, I begin my research looking for “that app” which may satisfy my needs. One feature that you should insist on is the ability to email those results to y our medial team.  Some automatically do so monthly – nice feature and many doctors appreciate getting the email and enter into your medical record.

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References and Links:

• http://ndep.nih.gov/partners-community-organization/campaigns/CydflManagingDiabetes.aspx
• http://www.cdc.gov/DIABETES/ndep/
• http://diabetesandmetabolism.com/
• http://www.galenmedical.com/www/docs/127.44/diabetes-education-chattanooga-tennessee
• http://www.nlm.nih.gov/medlineplus/ency/article/003996.htm

First Aid Overview and Quiz

The definition of first aid is "the immediate care of the injured or ill". This could be a stranger, a family member or even yourself. To administer first aide one must know what to do and also just as important one must know what not to do. The whole object of first aide is to aid the injured or ill without ever doing harm.

The first and most important thing in first aide is to always prevent harm to yourself. Do not jump into a automobile without first making sure that there is no danger of fire or of the auto moving and causing you or another rescuer injury.

Remember these "ABCs" of first aid

A) Be sure that the person has an open Airway.

B) Secondly be sure that the person is Breathing. An open airway does not mean that the person is breathing. Everyone from young children to elderly adults should be trained in CPR. This training is given free of charge. Check with your local fire department for a location near you.

C) Check for proper Circulation. Check for signs of bleeding. Check for open wounds and for blood soaked clothes. Most bleeding can be temporarily controlled by applying direct pressure to the area. Once you have applied pressure to the area using a clean cloth or gauze pads or whatever you have at hand, do not remove the cloth or gauze from the wound. If it becomes blood soaked apply another pad over the soaked one and continue to apply pressure. In this day and age I would also advise any first aide person to wear gloves. There are a number of infections that can be transported via body fluids. These include AIDS as well as Hepatitis. Your welfare is to be considered before your patient's.

If you are coming to the aid of a victim of a fall or trauma type accident where the person has a deformity due to a broken bone(s), do not move the appendage that is involved. If you must splint the appendage, do so in the position found. Check for a pulse distal to the injury before splinting and check for a pulse after splinting. Distal is further from the heart than the fracture.

If the fracture is open and bleeding or bone is visible do not apply direct pressure. Cover the area with a clean dressing. Call 911 at once.

Anytime that a person is injured from a fall or a trauma, remember to keep the person still and hold the head in place. Do not allow the head to rotate. This one simple step may save the person’s life. Crouch or lay at the top of the patient and place your hands on both sides of the head. Hold firmly but gently. If the person is awake, talk to him (her) in a soft, even voice. Assure the patient that you are there to help until an ambulance arrives. Assure the patient that you will not leave him (her) alone. Comfort the patient with your voice. Have someone call 911 or yell for assistance. Do not release the head until trained help arrives.

Medical emergencies are not in the realm of most first aid rescuers. If you come on to a person that is unconscious or their level of consciousness is low, call 911. Assure that the person has an open airway and is breathing. Check for bleeding (circulation). What may have started out as a medical problem may turn into a trauma situation due to a fall or other accident brought on by a low level of consciousness. Look at the whole picture, not just what is obvious at first glance.

This is a very simple overview of only two types of situations that call for first aid intervention. Many courses can be taken through the Red Cross as well as other agencies. Learn what you can before the incident happens. The life you save maybe your loved one or even yourself. Don't wait. Learn first aid and CPR today.

First Aid Quiz

http://firstaid.about.com/library/quiz/bl_firstaidQuiz1.htm