Every Month is Diabetes Month!

by Charlotte Hodge, R.N., Nurse Practitioner

As a National observance, one month a year is set aside to highlight the chronic condition of diabetes.  However, for people with diabetes every month is diabetes month.

Daily, patients with diabetes are asked to monitor finger stick blood sugars from 2-6 times, eat specially designed meals and snacks at regular intervals, and develop a consistent activity or exercise plan.  Perhaps they must take 1-4 daily injections, for others oral medications are required.  All are advised to avoid undue stress.  This is a pretty tall order, not only for someone who is newly diagnosed, but for those who must meet the challenge of dealing with diabetes year after year.

In the United States, diabetes is the sixth leading cause of death by disease. 16 million Americans have diabetes and 1/3 have not yet been diagnosed.

Hispanics are diagnosed with diabetes 3 times as often as non-hispanics.

Presently this chronic disease cannot be cured , but it can be controlled with help from a healthcare team which includes the patient, physician and diabetes educators.  The person with diabetes can achieve good blood sugar control and improve their quality of life by preventing or delaying the onset of diabetes complications.  The long term complications of diabetes include blindness, amputations, heart attacks, stroke and kidney failure. 

Today, those who have a diagnosis of diabetes can benefit from years of research which has lead to improved oral medications with fewer side effects, insulins which are identical to that produced by humans.   Improved blood glucose monitoring systems, smaller needles, insulin pumps and special centers with highly trained clinicians and diabetes educators such as we have available at Riverside Community Hospital, all help improve the quality of life for patients on a daily basis.

Nationally over 3 million people with diabetes are admitted to a hospital each year costing over 90 billion dollars.  In Riverside  these patients comprise approximately 18%-20% of all admissions and 20%-25% of all patient days.  The resource consumption and length of stay for a person with diabetes in the hospital exceeds that of a comparable patient without diabetes by 30-40%.

We are fortunate to have a coordinated approach for inpatient and outpatient diabetes care in Riverside, which when appropriately utilized, can reduce length of stay in the inpatient setting and ideally help avoid unnecessary ER and hospital visits altogether. 

To assist and better inform the public of their rights to care, the American Diabetes Association has developed Standards of Care to be used as guidelines for people with diabetes.  These include:

• ·     Hemoglobin A1c – This blood sugar test measures blood sugar control over the past 90 days the closer the value is to that of those without diabetes the less chance patients have of developing damage to heart, eyes, kidneys and blood vessels.  This test should be performed 2-4 times a year, depending on the type of diabetes.

•       Foot Inspection – Patient should inspect their feet daily and remove their shoes and socks during each visit to the doctor to assure foot inspection by a healthcare team member.

•       Foot Examination – Loss of feeling in the feet as a major sign of damage or injury, which can lead to amputation.  An annual foot exam determines how much feeling is left in the feet and helps the doctor determine current or future problems.

•       Dilated Retinal Eye Exam – A dilated eye exam is important in order to find changes in the back of the eye.  Left untreated, problems can lead to blindness.  This exam should be done every year by an ophthalmologist of an optometrist trained to look for a diabetic eye disease. 

•       Fasting Lipid Profile - People with diabetes have heart attacks at a higher rate and at an earlier age than people without diabetes.  High levels of lipids (fats) in the blood can lead to a heart attack.  Done once a year, this blood test includes total cholesterol level, LDL level, HDL level, and triglyceride level.  Knowing blood lipid levels allows the physician to design an appropriate treatment plan.

•       Blood Pressure – 50% of all diabetics have high blood pressure which left untreated can lead to heart attack, stroke or kidney disease.  It is important to have blood pressure checks regularly.   Appropriate medications should be utilized if other measures fail to bring the blood pressure below 130/85.

•       Microalbumin/Serum Creatinine – Protein in the urine can be a warning sign of kidney damage.  A urine test can detect small amounts of protein and a blood test can detect kidney problems.  If treatment is started early kidney disease can be successfully treated.  If patients have no sign of kidney disease the urine and blood test should be performed at least one time per year.

•       Flu Vaccine – If  a person with diabetes catches the flu they will likely become much sicker than those without diabetes.  A yearly flu vaccination can help avoid the flu which frequently leads to hospitalization.

•       Pneumonia Vaccine – Pneumonia can be a serious problem with people with diabetes.  Being vaccinated for pneumonia once before age 65 can lessen the chance of developing pneumonia.  People over 65 should check with their doctor about a follow up vaccine. 

•       General Health – Patient should seek out additional information on women’s health, men’s health, smoking cessation, dental care, weight management and other topics from their health care team.

Recent major studies have demonstrated the benefits associated with providing effective metabolic control for patients with diabetes. Following these guidelines will assist in this process.  Each year during Diabetes Month it is important to reevaluate how we can support and improve the lives of our patients with diabetes.   

Diabetes Solutions was founded in February 2000 by three Certified Diabetes Educators with an accumulation of 48 years experience in educating and supporting patients with diabetes.  After working 16 years for a large for profit national organization, it became clear that many community hospitals were unable to support the cost of such multi-level programs. The company provides cost-effective support to physicians and hospitals in caring for patients, without incurring the overhead inherent in large corporations.  Diabetes Solutions collaborates with hospitals, payers and physicians who desire to provide education to patients, professionals and the public and teams with community resources in order to work with all populations regardless of a patient’s resources. The programs of Diabetes Solutions are broad based but also reach out to specialized needs, including diabetes and pregnancy, children with diabetes, insulin pump patients, support groups for adults, youth and parents and Spanish speaking individuals. Diabetes Solutions works closely with the American Diabetes Association, and the Juvenile Diabetes Research Foundation.   

E-Mail them for more information, or call Diabetes Solutions offices at (909) 276-8243.
 
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