OakLeaf Medical Network Healthy Viewpoints, Winter 2003
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Dr. Kristine Haig

Diabetes Awareness

By Kristine Haig, DO
Internal Medicine
Eau Claire Medical Clinic

Diabetes Mellitus, or high blood sugar, is a chronic disease which directly affects the blood vessels, small and large, making them prone to developing plaques and blockages. Diabetes affects approximately 8% of people in the United States. About that same number, is yet to be diagnosed with the disease and is, therefore unaware and untreated. Complications from diabetes mellitus accounted for nearly 14% of health care expenditures in the United States, which translated into 132 billion dollars in 2002. Diabetes is a costly disease in many ways, especially to the patient with damage to vital organs as a result of poor blood sugar control.

The development of adult onset type diabetes is often difficult to recognize, as it occurs over a number of years. Risk factors include obesity and a positive family history of diabetes. Screening is simple and involves annual testing of blood sugar after fasting. Levels of blood sugar greater than 126 make the diagnosis. Also non-fasting levels of greater than 200 are diagnostic and can be used as well. If patients are not screened, often small vessel changes from diabetes are present at diagnosis. Small vessels affected most often include the arteries to the kidneys, eyes, legs, and small nerves. The results can be devastating if control of blood sugars is not achieved. Kidney failure, blindness, and infected foot ulcers due to the development of blockages in the vessels are among the common complications of long-standing, uncontrolled blood sugars.

Changes to the large blood vessels, especially those in the heart and the brain, can predispose patients with diabetes to stroke and heart attack. Those with diabetes are considered very high risk for stroke and heart attack. Treatment to lower blood sugar, lower cholesterol and lower blood pressure is essential. Aggressive treatment is aimed at diet changes, the start of a regular exercise program and the prescription of medications. The medication regimen often includes multiple treatments to lower cholesterol, blood sugar and blood pressure. Diabetics are assumed to have coronary vascular disease and are treated using the parameters developed for those with known heart disease.

Adequate control of diabetes is a collaborative effort involving the patient, the physician, the nutritionist, and the diabetes educator. After the diagnosis of diabetes is established, patients and physicians will often enlist the assistance of a “diabetes educator” to teach the affected person about careful monitoring of their diet, weight control and weight loss, as well as the use of blood sugar testing materials. Taking oral medications and the commitment of the patient to adhere to a diet and exercise program is the cornerstone of initial treatment. If diabetes is diagnosed early and the patient is willing to actively participate in the lifestyle changes and medication regimen recommended, insulin may be avoidable. However, if the patient’s blood sugar levels can not be brought under control, insulin injection may be necessary. Personal involvement and education of the diabetic patient yields the best results in blood sugar control, and the prevention of the onset of complications.

Talk with your healthcare provider about any questions or concerns you might have and be sure that blood sugar testing is part of your annual physical examination.

If you’ve been diagnosed.

Because diabetes can affect the blood vessels of the eye and potentially cause blindness, diabetics should have regular eye examinations including an annual dilated eye exam. Any rapid changes in vision should be reported to your healthcare provider immediately. Laser therapy to the eye can stop the progressive loss of vision that can occur. Annual urine checks to monitor for kidney disease, and annual foot testing to assess for changes in circulation and vascular damage are equally important. In addition, a blood test should be performed every three to six months to assess blood sugar control over several months, along with a review of a patient’s personal blood sugar logs.

Controlling diabetes is an effort that involves a team of health care professionals and the patient in all aspects of treatment. The level of patient cooperation dramatically impacts the outcome of the disease.

For more information, or to schedule an appointment with Dr. Haig, » 715.839.9280, or www.eauclairemedical.com.