While the management of blood sugar has always been and remains a cornerstone of diabetes care, diabetes requires a comprehensive program that includes management of blood glucose, management of blood pressure and management of cholesterol. We call these key components of care the ABC’s of diabetes: A standing for A1C, B is for blood pressure, and C is for cholesterol.

Diabetics are at an increased risk for heart disease and stroke. Almost 66% of diabetic patients die from these complications every year. This is a very scary statistic that I see come true almost every week at the hospital.

It is very important for health care providers as well as patients to talk about ways to reduce these risks. I know that doctors visits can be, well, less than satisfying. Your doctor rushes in and out, spends 2 minutes with you and expects you to be good for another 3000 miles. The American Diabetes Association and The American College of Cardiology has made this easier by initiating a Make the Link! program for diabetics.

A recent Make the Link! survey shows that 68% of people with diabetes do not consider cardiovascular disease to be a serious complication of diabetes. Furthermore, 60% of people with diabetes surveyed do not feel at risk for either high blood pressure or cholesterol problems.

We need to educate ourselves and each other. Have questions written down before your doctors visit and push your doctor for the answers you want. Take it from a cardiac nurse, persistence is good!

You can lower your risk by keeping your ABC’s of diabetes on target with wise food choices, physical activity, and medication. Losing weight can also help you manage your ABC’s and prevent heart disease. Every step you take will help. The closer your numbers are to your targets, the better your chances of preventing heart disease or cutting your risk for another heart attack. If you smoke, get help to quit.

via American Diabetes Association

Post from: Blisstree

Diabetics Are At An Increased Risk For Heart Disease And Stroke

My Mom is a type 2 diabetic, diagnosed 2 years ago. She controls her diabetes by diet and exercise and has dropped 50 pounds in the last year and a half. Her original surgery time was for 1 PM. This was concerning.

Try to get the first morning time slot in the operating room. There will be less of a chance for high or low blood sugar reactions while you are waiting for your operation and are unable to eat.

After she contacted her doctors office to ever so gently, hahaha, remind them of being a diabetic, they changed her surgery time to 8 AM. Much better. My next concern was how her blood sugar would be affected both during and immediately following surgery. Surgery is very stressful on the body, which can cause either a quick rise in blood sugar, or a sharp drop if the diabetic is dependent on insulin. Fortunately, my mom has me. A loud mouthed, opinionated nurse for a daughter. Others who are not so lucky, haha, need to take matters into their own hands and be their own patient advocate before surgery. You are not being pushy, just safe!

Talk to your anesthesiologist- This is the doctor who is responsible for monitoring your diabetes while your surgeon is performing the operation. Tell the anesthesiologist about your medical history, including details about your diabetes. Be sure to include your current medication regimen and any diabetes-related complications you have.

Following surgery, one of the biggest complications among diabetics is wound healing and infection. As a nurse, I am always concerned with keeping a post surgical, diabetic patient’s blood sugar between normal limits. Promoting good blood flow and proper dietary habits to allow for optimal incisional healing is also important.

Underlying systemic disease in a patient with a wound can dramatically diminish the probability that the wound will heal in a timely fashion. Diabetes mellitus is a classic example. Wound healing is often delayed because of interruption of the inflammatory and proliferative phases. Infection thus prolongs the inflammatory phase. When erythrocytes are affected by glycosylation (as measured by hemoglobin A1c levels), they become less pliable, leading to microvascular sludging and ischemia. Low tissue oxygen tension impairs cellular proliferation and collagen synthesis as previously described.

Does that sound like blah, blah, blah? In plain English, a diabetics vascular system is compromised due to narrowing of blood vessels. Poor blood flow leads to infection. See, that wasn’t so hard.

My last piece of advice is be willing to make changes. Like mentioned above, surgery is very taxing on a diabetics body. Medications, diet and insulin regimens may have to be adjusted to promote the best healing possible.

After surgery, you may need to adjust your medication or insulin doses based on your blood sugar level. Ask your doctor how you should manage your diabetes so that you can prepare in advance.

Surgery is scary. Diabetes is a disease that you live with everyday. Be loud. Be obnoxious. Be whatever you have to in order to get all the questions you have answered. If you have specific concerns related to your diabetes, ask away. And if the doctor dismisses any of them, find a new doctor!

via The Diabetes Monitor

Clinical Diabetes

eMedicine

eMedicine from WebMD

Post from: Blisstree

Diabetic Considerations Before, During And After Surgery

On the drive home I got to thinking, “was it me who was the moron and didn’t understand the risks associated with the very disease I live with”? I did what any overly compulsive person would, I researched the topic for 2 days. I know, my life is exciting!

Higher blood sugar that accompanies diabetes gives the bacteria a greater supply of sugars and starches, leading to production of even more acid. Damage from this acid increases the risk of tooth decay (cavities).

Oh thank goodness, I am not as out to lunch as I was led to believe. Diabetics are at risk for an increased incidence in tooth decay and gum disease. We need to be on alert for signs and symptoms that could lead to infection, cavities and gum issues.

Patients with diabetes are at greater risk for periodontal disease. Diabetes causes blood vessel thickening, which slows down the flow of blood to body tissues, including the gums and dental bones. Blood flow is crucial in providing important nutrients and eliminating harmful wastes from body tissues. As a result of lowered blood flow, the gum and bone tissue supporting the teeth become less healthy and less resistant to infection from bacteria found in dental plaque.

In my searching I also found that most dental professionals advise that diabetes and gum disease is a 2 way street. Diabetics need to be compliant with regularly scheduled cleanings and preventive care.

“We have data that shows if patients are diabetic and we treat their periodontal disease, their diabetes improves markedly,” Dr. Ciancio observed.

Proper dental care is a win-win situation when it comes to diabetic patients. If nothing else, you will have prettier pearly whites and nice breath, which is a bonus for all persons involved!

via Web Md

CNN.com/Health Library

Family Gentle Dentle Care, Nebraska, USA

LSU Health Sciences Center

Post from: Blisstree

The Link Between Diabetes, Tooth Decay And A Healthy Mouth