Orlando F. Mills, MD, MPH

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Diabetes Care Guide

A1C Blood Tests

By now you know that Dr. Mills will order and monitor your blood sugars through a lab test called “A1C”. Your A1C level measures your average blood sugar levels over a three-month period by taking a sample of hemoglobin A1C molecules—a specific component of your red blood cells.  For people with diabetes, the American Diabetes Association (ADA) recommends an A1C of less than 7%.

 

Weight

There's no question about it: If you're overweight and have diabetes, losing weight can help you to lower your blood sugar and help you to feel better. The American Diabetes Association says that even losing 10-15 pounds can improve your health by reducing your blood pressure, improving your cholesterol levels, and lowering the stress on key joints such as hips, knees, and ankles. In addition, you will have more energy, have an easier time getting around, and will be able to breathe easier.

 

Nutrition

The best meal plan for someone with diabetes is low in fat, low in salt and low in sugar, with a personalized goal for carbohydrate intake. When purchasing foods, check the nutrition label for the amounts of these ingredients. The most important part of any meal plan is to watch your portion size so you can maintain a healthy weight. For more information, see our brochure on tips for eating healthy or ask to meet with the RN.

 

Blood Pressure & Blood Vessels

Monitor and control your blood pressure. High blood pressure can damage your eyes and other blood vessels. If your blood pressure is higher than 130/80, you may want to check your blood pressure regularly at home.

 

Diabetes adversely affects the arteries, predisposing them to atherosclerosis, a condition in which the arteries become hardened. Atherosclerosis can cause high blood pressure, which if not treated, can lead to blood vessel damage, stroke, heart failure, heart attack, or kidney failure.

 

Having diabetes increases your risk of developing high blood pressure and other cardiovascular problems.  When it comes to preventing diabetes complications, having a normal blood pressure is as important as having good control of your blood sugars.

 

Cholesterol

If you have diabetes, you're more likely to have high cholesterol — which contributes to cardiovascular disease. Managing your cholesterol reduces your chance of developing cardiovascular disease and other complications. People with diabetes who lower their LDL or “bad cholesterol” level can reduce their risk of cardiovascular complications by 20 to 50 percent. Your yearly cholesterol blood test will measure all cholesterol levels including HDL, LDL, triglycerides, and total cholesterol. See our brochure on Cholesterol for more information. 

 

Urinary Kidney Function Test

High blood sugar of diabetes can damage tiny blood vessels in the kidneys. Protein that is meant to remain in the body can leak into the urine, a condition called “microalbuminuria”.  Microalbuminuria is an early symptom of kidney disease.  A simple urine test must be done yearly so that if levels are high, steps can be taken to help prevent additional damage to your kidneys.

 

Complete Foot Exams

You should check your feet every day, or have someone else look at your feet if you cannot see them. Be on the lookout for ingrown toenails, corns, and calluses. Never cut or open a blister; have it checked immediately.

Always protect your feet by wearing shoes or hard-soled slippers or footwear. See our patient brochure on the diabetic foot care for a detailed description on how to complete this at home.

 

Dr. Mills will also check your feet, inspecting closely for redness, increased warmth, or tenderness when touching any area of your feet.

You may be referred to a podiatrist if there are problems with your feet. 

 

Dental Exams

Uncontrolled diabetes impairs white blood cells, which are the body's main defense against bacterial infections that can occur in the mouth.  People with diabetes face a higher risk of:

  1. Dry mouth, which can further lead to soreness, ulcers, infections, and tooth decay.
  2. Gum inflammation (gingivitis and periodontitis). Periodontal disease is a bacterial infection and people with uncontrolled diabetes may experience severe gum disease.
  3. Fungal infection of the mouth and tongue. The fungus thrives on the high glucose levels in the saliva of people with uncontrolled diabetes.

 

Eye Exams

If you have Diabetes, Type I or Type II, see your eye care professional for a yearly diabetic eye examination.  See our patient education brochure on Diabetic Retinopathy for more information.

 

Flu Vaccination Injection (Shot)

For people with diabetes, the flu can be more than aches and pains. It can mean longer illness, hospitalization, even death. Uncontrolled diabetes can make the immune system more vulnerable to severe cases of influenza ("the flu").  Everyone with diabetes, of any age, should get this inexpensive and easy form of protection. You may develop some mild flu-like symptoms which may slightly increase both blood sugars and medication requirements temporarily for a few days.  See our patient education brochure about Influenza for more information.