Essential Self-Care When You Have Diabetes

Because of recent medical advances, people with diabetes can do a lot more these days to help control their disease.

Important medical tests

Soon after you're diagnosed with diabetes, your doctor will set a schedule for ongoing checkups and routine tests.

Important tests include:

• Eye exam. If you have type 2 diabetes, the American Diabetes Association (ADA) recommends you have a dilated and comprehensive eye examination by an ophthalmologist. If you have type 1 diagnosis, you should have this type of exam within five years of diagnosis. Frequency of future exams will depend on your age and your diabetes.

• Test for microalbuminuria. If you have had type 1 diabetes for five or more years, you should have this test annually. If you have type 2 diabetes, you should have this test when your diabetes is diagnosed.

• Blood pressure check. Have this each time you visit your health care provider—generally, every three or four months. The recommended blood pressure for people with diabetes is 130/80 or lower.

• Cholesterol test. This should be done annually, or more frequently if your blood lipid values do not meet current goals. In 2005, the ADA's goals for blood lipids for people with diabetes were: LDL ("bad") cholesterol, less than 100 mg/dl; HDL ("good") cholesterol, 50 mg/dl or higher; and triglycerides, less than 150 mg/dl.

• A complete foot exam. This should be done once a year, or more often if you have existing foot problems.

If you have several other risk factors for heart disease, your doctor also may order a stress test and an electrocardiogram, depending on your age, your overall health status, and how long you've had diabetes.

Self-care steps

These are important steps to take on your own:

• Examine your feet every day for any cuts, blisters, redness, or swelling. If you have an injury, seek care early—a small problem that's not treated quickly can easily lead to serious complications. Other prudent foot-care tips include washing and carefully drying your feet every day, keeping toenails trimmed as needed, wearing shoes and socks at all times, and protecting feet from heat and cold. If you have any numbness of the feet, make sure that someone else helps examine your feet carefully and trims your toenails.

• Check your blood sugar according to the doctor's recommendation. Keeping your blood-sugar levels under control is critical for preventing a wide variety of complications.

• Take care of your skin. Up to one-third of people with diabetes experience skin disorders, such as infections. Keep skin clean and dry; don't bath or shower in extremely hot water; avoid bubble baths and scented soaps; and prevent dry skin by using a moisturizing skin cream.

• Manage your oral health. People with diabetes have an increased risk for oral infections and gum problems. To help prevent gum disease, brush your teeth twice a day, floss daily, and visit your dentist at least twice a year.

Lifestyle changes

Most of the complications from diabetes are related to its damaging effects on blood vessels. That means anything you do that further damages your blood vessels—such as smoking, not exercising, or eating high-fat, high-calorie foods—can significantly increase your health problems.

These are elements of a healthy lifestyle for a person with diabetes:

• Eat nutritious foods. Aim for a balanced diet low in fat, cholesterol, and sugar. Work with a nutritionist, and particularly ask for help in developing meal plans and learning how to shop for groceries. Eating well becomes much easier if you have healthy foods at hand.

• Exercise regularly. Physical activity improves circulation and helps you manage weight and stress levels, among other important benefits. Talk with your health care provider about choosing the best fitness options for you.

• Lose weight. Obesity increases the body's resistance to insulin and contributes to heart disease, circulation problems, and many other health issues. By losing weight, many people with type 2 diabetes can decrease their diabetes medications. Ask your doctor or nutritionist for help in maintaining a sensible weight-loss program.

• Limit or avoid alcohol. Drinking alcohol makes it more difficult to control blood sugar. Alcohol can severely lower blood sugar in some people with diabetes, and it can interact with certain diabetes medications.

• Manage stress. Physical or mental stress tends to raise levels of adrenaline and stress hormones, which can throw off your blood-sugar levels. Find ways to limit sources of stress, and explore relaxation therapies.

• Quit smoking. Smoking damages and constricts blood vessels and raises the risk for nerve damage and kidney disease, making it one of the unhealthiest habits a person with diabetes can maintain.

Key to success

How do you make self-care go smoothly? Make it a habit.

Another key is to seek out experts who can be helpful to you. Focus on finding a good physician, nutritionist, and nurse educator.