My 'top' ten list for people with diabetes

(Note: Not everything here applies to everyone with diabetes... speak to your doctor to know what the goals are for you).

 

Click here to see the movie version of my Top Ten list. 

Question 1:  How do I become educated about my diabetes?

Answer: 

  • Attend a Diabetes Education Centre.  Stay current!  (I'm always learning, the educators are always learning; shouldn't you?).

Question 2:  How do I know if my blood sugars are under control?

Answer:

  • Use a blood glucose meter regularly (1-4 times per day).
  • Have your A1C measured 3-4 times per year.

Question 3:  What should my blood sugars be?

Answer:

  • Aim for ideal readings (blood glucose 4-6 before meals, 5-8 two hours after meals, A1C 6.0 or less).
  • But, as these are often exceptionally difficult to achieve, and because such "tight" control can put you at undue risk for hypoglycemia (low blood glucose), you may have to accept less than ideal readings (blood glucose 4-7 before meals, 5-10 two hours after meals, A1C 7.0 or less).

Question 4:  When (and by whom) should I have my eyes examined?

Answer:

  • Have a yearly (dilated) eye exam by a highly skilled eye specialist (optometrist or ophthalmologist).

 Question 5:  What should my cholesterol level be and how often should it be checked?

Answer:

  • Aim for an optimal LDL of under 2.0; cholesterol/HDL ratio below 4.0.
  • Have your cholesterol level checked yearly (more often if a change in cholesterol medication has been made).

 Question 6:  What should my blood pressure be?

Answer:

  • Ideal: 130/80 or less.
  • But, this is not easy to achieve and typically requires multiple drugs (often 3 or 4 different types of blood pressure pills).

 Question 7:  How do I know if my heart is okay?

Answer:

  • Tell your doctor if you have chest pains or difficulty breathing.
  • Ask your doctor if you should have an exercise stress test.
  • Ask if you should take aspirin (coated; 325 or 81 mg).

 Question 8:  How do I know if my kidneys are okay?

Answer:

  • Do a yearly urine test for microalbumin (typically ordered as a urine albumin/creatinine ratio).

 Question 9:  Am I at risk of a foot ulcer or infection, and if I am what can I do to avoid these?

Answer:

  • Your are at increased risk of a foot ulcer or infection by virtue of having diabetes however your risk is particularly increased if you have foot numbness or, especially, lack of feeling in your feet.
  • Inspect your feet carefully DAILY (have someone else do it if you can't): look for areas of ulceration, blisters, inflammation, pus or other evidence of infect 
  • Have your toenails cut carefully.
  • Have your physician examine your feet yearly (more often if you have known foot problems).

 Question 10:  How can I avoid pneumonia?

Answer:


Be sure to also have a look at my Ten Golden Rules for Preventing Complications.