Take Charge of Your Health
An article by Dr. Kirtland Culmer

November: Diabetes Month
I hate to give the appearance that I am beating this theme to death, but it is so important in our setting that I will look for every opportunity to elaborate on it. As I stated before, diabetes is responsible for so much morbidity (sickness) and mortality (death) in this community that it is worthwhile taking a very careful look at it again. Since ninety percent of diabetics have type 2 diabetes, I will restrict my comments to that group only.

It was pointed out previously that eighty percent of all diabetics are overweight, it is important to re-emphasize how important it is to get your weight down if you are diabetic, and to keep it down if you are not diabetic in order to reduce your chances of ever getting it.

Diabetes is a chronic illness that requires continuing medical care and education to prevent acute complications and to reduce the risk of long-term complications. It does not go away because you do not like the idea of having it. Complications occur mainly because the disease affects blood vessels, and when those that lead to vital parts of the body are affected, then very serious complications occur. Examples of these are the heart, the brain, the kidneys and the eyes. Complications occur more readily when the disease is ignored or not properly controled.

People with diabetes must know enough about the disease to assess the quality of the diabetes treatment that they are receiving. They also need to know how important it is for them to develop expectations for their role in their medical treatment. In other words, it is important that they do their part in cooperating as much as possible in their treatment program, and make suggestions as to how they think it can be improved. Finally, they need to know how they are doing compared to the standard goals of treatment, and if they are not doing well, to keep striving for improvement.

Know that the diabetic treatment should be aimed at lowering the blood sugar level to or near normal levels. When this is done, the diabetic is less likely to go into a coma and die, or get the symptoms of blurred vision, thirst, passing urine frequently, tiredness, weight loss and yeast infections are decreased. Blood vessel damage to the eyes, kidneys and the nerves may also be reduced. Even the cholesterol level goes down when blood sugars are normalized. It is important that intense treatment should be kept up until the sugar is normalized, and then careful monitoring should continue to maintain the normalcy level.

Self monitoring is stressed also. Diabetics cannot take their doctors around with them, but they can take their glucometer kit. So if you are diabetic, and do not own a kit, please go out and get one now. Your doctor can give you directions. They are readily available here at many outlets. Get your kit and monitor your blood frequently so that you can readily know how you are doing.

In addition to self-monitoring, nutrition is of the utmost importance. It is vital that you know what to eat and when. If you are overweight, then you should surely be on a diabetic reducing diet. The nutritionist is a very important part of my diabetic team. When you diet properly, get regular exercise and lose weight, this goes a long way toward reducing the amount of medication required to control the sugar.

The diabetic needs also to know when the sugar goes down too low, and what to do about it. Continung education must also be given on how to handle complications if they do occur. The opthalmologist (medical eye doctor) should be consulted at least once a year to check for possible complications of the retinal vessels.

Take good care of the feet. Learn how to cut the nails properly, and do not venture into uncharted territory without shoes. Avoid as much as possible, trauma to the lower legs and feet. Consult the podiatrist for abnormalities in the lower leg , feet and toes. Be sure to check out or elimate other risk factors to blood vessels, like smoking, high blood pressure, high cholesterol and a significant family history.

Follow your doctors instructions and try to stick very seriously to your diabetic management program. In this way, you will be doing your best to continue with a good quality of life, reducing your chances of developing dangerous and sometimes painful complications, and ensuring yourself of a much longer life than you would have if ignorance prevailed. We call this TAKING CHARGE OF YOUR HEALTH. Happy diabetes month!