Managing Diabetes from Head to Toe

November is National Diabetes Month www.nei,nih.gov/diabetes. If you have diabetes, keep your health on TRACK and get a dilated eye exam at least once per year. There are a series of icons showing medications, monitoring, exercise, eating properly, and no smoking

Editor’s note: November is National Diabetes Month, and VisionAware is updating a series of posts on living with diabetes and blindness or low vision, written by Audrey Demmitt, RN, BSN, a Diabetes Nurse Educator and an APH VisionAware Peer Advisor. At age 25, Audrey was diagnosed with retinitis pigmentosa and continued to work as a nurse for 30 years with her visual impairment. 

Diabetes Requires Self-Care

Diabetes is a serious disease and affects all parts of the body. It demands constant monitoring and a disciplined routine of self-care. There is no taking a break from this chronic condition. Many people who have diabetes become “burned out” in taking care of it. Some lack the resources or information to live with diabetes.

The results can be life-threatening and debilitating. Maintaining blood sugar control helps you feel better, stay active, and reduce the risks of devastating complications.

Whether this is a review or a primer for you, think about steps you can take to better manage your diabetes. Build a team of support including family, friends, and healthcare providers so you are not alone. You are the most important member of your team — the captain. Find your motivation and inspiration and renew your commitment to good self-care practices. Even small changes in your diabetes routines can make a difference. Remember — self-care is the best healthcare! 

Striking a Balance 

Managing your diabetes means striking a balance between healthy eating, being physically active, and taking your medicines correctly. There are many strategies and techniques to learn to achieve the right balance for you.

If you have not taken nutrition and diabetes education courses recently, this is strongly recommended. Contact your doctor, local hospital or the American Diabetes Association to inquire about classes in your area. If you are blind or low vision and having trouble with diabetes care, contact your local vision rehabilitation services for adaptive training and devices. It is important to learn all you can and keep your knowledge up to date so you can control your disease. 

Take Control of Your Diabetes 

Are you controlling your diabetes or is it controlling you? In which areas can you improve your self-care practices? What actions can you take to learn more about diabetes? What steps can you take today to live well with diabetes?

Seven Steps to Managing Diabetes 

  1. Diabetes can cause damage to the fragile blood vessels in the eye. This can result in diabetic retinopathy, glaucoma, and cataracts. Vision changes happen because of high blood sugars. Some changes may be temporary as blood sugars fluctuate daily. Chronic high blood sugars damage the retina and optic nerve causing permanent vision loss. This can occur silently with no symptoms so it is important to visit an eye doctor regularly and have a dilated eye exam at least once a year. If you experience blurriness, flashes, halos around lights or blind spots, see an eye doctor immediately. 
  2. Everyone gets plaque on their teeth from chewing food. It is sticky and full of germs. People with diabetes are at higher risk for gum disease, tooth loss, and bad breath because high blood sugars make the germs multiply. There is some evidence that infection in the mouth and gums causes high blood sugars, so this can be a continuous cycle. Visit your dentist to have your teeth cleaned every six months and ask about ways to cut down on plaque and prevent problems in your mouth. 
  3. High cholesterol and high blood pressure are common in people with diabetes. Fatty deposits build up in the blood vessels, causing damage and blockages. This leads to circulatory problems and diabetics are at higher risk for heart attacks and strokes. To avoid these complications, you must control your cholesterol levels, blood pressure, and weight — along with your blood sugar. These values need to be monitored regularly with the help of your healthcare provider. Know your numbers and ask how you can improve them. Set goals to improve your A1C, blood cholesterol, blood pressure, and weight. 
  4. Nerves are damaged by high blood sugars. This can lead to numbness and tingling in the feet, hands, and legs, called diabetic neuropathy. Loss of feeling in hands and feet puts you at risk for falls and other injuries. Other parts of the nervous system which control digestion, the heart, the bladder, and sexual function can be damaged by high blood sugars. Test your blood sugars regularly to keep tight control. Record the readings daily so you can make adjustments and notice patterns and problems. Talk to your doctor about nerve damage. 
  5. The parts of the kidney that filter blood can be damaged in the early stages of diabetes. Kidney damage results from both high blood sugars and high blood pressure. You should be tested early and regularly for protein in the urine, an early sign of kidney disease. Monitor your blood pressure and talk to your doctor about medicines to lower it if necessary. Again, keep a tight control on your blood sugar levels. Have a urine protein test at least once a year. 
  6. Your feet are especially prone to nerve damage and decreased blood flow when you have diabetes. This can result in injuries you cannot feel such as blisters, cuts, cracks, and bruises. Poor blood circulation can lead to slower healing and serious infections. Protect your feet by wearing comfortable socks and shoes daily. Check your feet every day for redness, sores, cuts, and dry cracks. Treat these conditions immediately to avoid infections. Keep feet clean, dry, and moisturized. Have a foot exam every time you visit your doctor. Visit a podiatrist for care of nails and calluses which is often covered by insurance. Avoid salon pedicures. 
  7. Diabetes can take a toll on emotional health. It often can be overwhelming and stressful to live with this disease. Some people will become depressed, isolated, and anxious. These negative emotional states can affect blood sugars and your ability to care for yourself. Learning new coping strategies, stress management, and self-advocacy skills can help. Don’t neglect this important area of your health. Talk to your healthcare team about counseling options and consider attending a diabetes support group.


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