Finding and treating diabetes early can prevent health problems later on. Some people are at higher risk for diabetes than others.

Risk factors include:

• Being older than 45
  
• Being overweight
  
• Having a close family member who has, or had, diabetes.
  
• Having had diabetes when you were pregnant
  
• Being African American, Hispanic/Latino, Asian American or Pacific Islander, or Native American

Staying active and keeping your weight under control can help delay or prevent the onset of diabetes if you are at risk.

What is Diabetes?
Diabetes is a chronic, progressive disease defined by high levels of sugar in the blood. Normally, the pancreas produces the right amount of insulin (a hormone), to move sugar into the cells of the body. In diabetes, there is either insufficient insulin production, or the cells do not respond well to insulin – this is called insulin resistance.

The most common form of diabetes is Type 2, which features insulin resistance, and eventually a reduction in insulin secretion. This is very hereditary, and often associated with being overweight and/or sedentary. It usually occurs after age 40, but there is a recent, dramatic rise in the incidence among ages 20-40, and even adolescents. Type 1 diabetes is less common, usually occurring in childhood/teen years, and is defined by a total lack of insulin, requiring insulin injections 2-4 times per day. The good news for all people with diabetes is that blood sugars CAN be controlled!

Diabetics have a higher risk of developing serious health problems. Taking good care of diabetes can lower the chances of getting diabetes complications such as:

• Eye disease that can lead to a loss of vision or even blindness
  
• Kidney failure
  
• Heart disease
  
• Nerve damage that may cause a loss of feeling or pain in the hands, feet or legs
  
• Stroke
  
• Lower limb amputation
  
• Dental disease
  
• Serious infections in any part of the body
  
• Dental decay and tooth loss

High blood sugar over time CAN lead to serious complications. Also, controlling blood sugars means that the symptoms of high blood sugar will likely improve; these symptoms are:

• Extreme thirst
  
• Frequent urination
  
• Fatigue
  
• Blurred vision
  
• Abnormal weight gain or loss
  
• Cuts and sores that are slow to heal
  
• Numbness or tingling in feet
  
• Chronic indigestion and bloating

How do I control my diabetes?
Good control of diabetes involves making healthy choices in your life. If you have diabetes, there are 5 important areas that may need improvement:

• Food – what you eat, how much you eat affects your blood sugar
  
• Weight gain
  
• Exercise – regular physical activity increases your sensitivity to insulin and promotes weight loss (and makes you feel better, too!)
  
• Stress Reduction – physical or psychological stress can actually raise blood sugars
  
• Medications – there are now a variety of oral medications that can help control blood sugar, and new types of insulin as well. They need to be taken as prescribed by your doctor.
  
• Oral hygiene – gum infections may be associated with elevated blood glucose.

Self blood sugar monitoring is the best way to assess how well you are doing. Glucose meters and related supplies are covered by nearly all insurance plans. Regular monitoring, which involves a small drop of blood from your fingertip allows you to evaluate the behaviors you are choosing around food and exercise, and helps your doctor adjust your medications accordingly.

How do I prevent long-term diabetes complications?
Make sure you get regular diabetes care supervised by your primary care provider – you have a right to health care regardless of your age, race, disability or ability to pay.

1. See a primary health care provider at least two to four times a year.
2. Get support from family, friends and co-workers.
3. Check your insurance policy for benefits covering blood sugar monitoring supplies.
4. Ask your doctor or clinic staff to help you find resources if you have problems paying for food, medicine and medical supplies.
5. Have lab tests done regularly as prescribed by your doctor. These lab tests should be:

• Cholesterol and other fats in the blood at least once a year
• Hemoglobin A1C – ( a test of overall blood sugar control ) 2-4 times a year
• Urine for hidden protein

6. Have your blood pressure checked, and feet examined at every doctor visit.
7. If you have any foot problems (pain, tingling, infection, irritation, or malformation), ask your doctor about a referral to a podiatrist. Special orthopedic shoes are now covered by Medicare and can be prescribed by your podiatrist.
8. See an ophthalmologist yearly or more often as recommended.
9. See a dentist twice a year for regular check-ups and for treatment of dental decay, infections, and gum disease.

KEEP AN EYE ON YOUR BLOOD SUGAR – It is your best defense against complications of diabetes! Notify your doctor if it is consistently higher than 150, or if you have episodes of blood sugar dropping too while taking diabetes medicine.

Visit our Clinical Services - Diabetes Center page to learn more about the services Alta Bates Summit Medical Center makes available to you.

Other Resources:

American Diabetes Association
Call 1-800-232-3472 for membership information.
Web site: http://www.diabetes.org
Association events, links to home pages of Association affiliates, book ordering information and more.

American Dietetic Association
Call 1-800-366-1655
Web site: http://www.eatright.org
Speak with a dietitian, find a dietitian in your area, or order free information.

National Diabetes Information Clearinghouse (NDIC)
Call (301) 654-3327

International Diabetic Athletes Association
Call 1-800-898-IDAA
Web site: http://www.diabetes-exercise.org
Exercise and activity resources for people with diabetes

Joslin Diabetes Center
Offers up-to-date research on managing your diabetes
Web site: http://www.joslin.org

Email: grayj@sutterhealth.org
Telephone:(510) 869-8219