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She did it! Thanks to diabetes self-management, Sandra Buty lowered her blood-sugar levels. Even losing 7 percent of body weight makes a difference in controlling the disease, says research scientist Trudy Gaillard, PhD, RN (pictured with Buty). Improving eating habits is key.
When Sandra Buty was diagnosed with type 2 diabetes during an annual physical in March 2010, she was surprised because she had no symptoms. However, she had family members with diabetes — some of whom even required amputations — so she took her diagnosis very seriously.
"I knew I must do everything possible to avoid those kinds of consequences," recalls Buty, 66, who has worked at The Ohio State University for 26 years. "I took classes that OSU offers for diabetic patients, and they were extremely helpful in dealing with my condition."
The 'Scarlet and Gray' Approach
Buty attended OSU Medical Center's The Scarlet & Gray Way to Diabetes Self-Management program. "The program consists of two three-hour sessions, held two weeks apart," says Janet Zappe, RN, MS, CDE, clinical program manager.
"We cover the basics of diabetes management," she continues. "But we also help patients apply their knowledge about food and exercise to real life by helping them create a strategic self-management plan. Last year, about 90 percent of patients who completed our program lowered their A1C measurement, which indicates a long-term improvement in blood glucose control." The A1C test measures a person's average blood-glucose levels over the last two to three months.
Type 2, or adult-onset, diabetes results from higher-than-normal blood-glucose levels due to the body's inability to produce insulin. Symptoms include frequent urination, unusual thirst, extreme hunger, unusual weight loss, extreme fatigue and irritability, frequent infections, and cuts or bruises that are slow to heal.
But because some people don't notice these symptoms, it's important to get screened at your annual checkup, especially if you are considered at high risk for the disease. Risk factors include having a close family member with diabetes; being overweight and/or inactive; being African-American or Hispanic; having high blood pressure, heart disease or abnormal cholesterol levels; and having abnormal blood sugar levels in previous blood tests.
Importance of Weight Control
"Even losing 7 percent of your body weight makes a difference," explains Trudy Gaillard, PhD, RN, assistant professor of Medicine Research in the Division of Endocrinology, Diabetes and Metabolism and program director of Prevention of Diabetes in African-Americans in the Diabetes Research Center. "So consider the following: Engage in 30 minutes of daily aerobic exercise; bake and broil food instead of frying it; and increase your intake of fresh fruits and vegetables."
Other healthy measures you can take, according to Dr. Gaillard: "Reduce your stress, if possible; see your primary care provider regularly — we suggest every three months; understand how to properly take prescription medication; and understand and track your A1C levels."
Taking It to the Next Level
Even patients with diabetes who do everything "by the book" may still require specialized care from an endocrinologist if their diabetes is not under control. "Endocrinologists only see about 10 percent of diabetics; most are seen by their primary care doctor," says Kwame Osei, MD, director of the Division of Endocrinology, Diabetes and Metabolism and the holder of the Ralph W. Kurtz Chair in Hormonology.
"However, if the patient's A1C remains over 8 percent even with close monitoring and medications, or if the patient requires large amounts of insulin (more than 200 units a day), a referral to an endocrinologist may be required," suggests Dr. Osei.
After completing the diabetes self-management program, Buty successfully brought her A1C down to 6.3 from 7.9. "Learning about diabetes keeps it from being scary," she explains. "Educating yourself helps you take control of your diabetes, instead of the diabetes controlling you. Take a class and learn more."
Among other class take-aways, Buty now understands that she has to practice portion control and monitor her carbohydrate intake.
"The classes taught me how to eat without depriving myself of food I enjoy," she notes.
Ask Your Advocate
Q: How do I determine if I am diabetic?
A: There are several blood tests that a physician can complete to determine if you have diabetes mellitus. These include a fasting plasma glucose; a glucose tolerance test; a hemoglobin A1C; or a random plasma glucose with symptoms of diabetes mellitus, such as weight loss, blurred vision, frequent thirst and excessive urination.
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Spotlight on Wound Care
Diabetes diminishes the body's ability to fight infection and repair wounds. "Any wound that takes more than 30 days to heal requires treatment," says Richard Schlanger, MD, director of Surgical Services at University Hospital East and clinical director of the Comprehensive Wound Center.
"Other red flags include recurring wounds or ulcers, increasing pain or size of the wound and fever and malaise — a general feeling of ill health."
Diabetics often develop foot problems because of a condition called neuropathy, which results in a loss of feeling to the feet. Here are some tips to prevent diabetic wounds:
- Regularly inspect the soles of your feet for small injuries.
- Check for numbness on the soles of your feet.
- Eliminate shoe irritations; blisters can bring on infection.
- Seek professional help as soon as possible.
- Control your blood sugar through diet or medication.
- Wear shoes that fit correctly.