WORTHINGTON — We've covered a lot of information in the past seven topics about type 2 diabetes. Now let's look at a more comprehensive approach.
The aim is to analyze highly complex topics and provide steps to avoid a diagnosis of type 2 diabetes or better navigate the situation towards improved long-term outcomes.
Remember that no medical provider or medication can solve this problem without your own determination to face the situation head on and adjust your life.
The goal for most people with type 2 diabetes is to have an A1C below 7%.
Jason Turner, Registered Pharmacist
Let's talk about the basics of type 2 diabetes in terms of the ABCs.
A is the A1C test, which is a simple blood test that measures your average blood sugar level over the past three months. This is different from a test where you poke your finger and read your current blood sugar level. A finger stick test gives you a snapshot of your blood sugar levels at that moment.
The goal for most people with type 2 diabetes is to have an A1C below 7%. The first goal for prediabetics is to avoid reaching the 6.5% of people diagnosed with type 2 diabetes. The ultimate goal is to get below the range considered pre-diabetic (less than 5.7%).
B is blood pressure. Blood pressure goal is less than 130/80. High blood pressure can cause many complications in diabetics, such as diabetic eye disease and kidney disease.
Increased blood pressure can further damage small capillaries in the kidneys and eyes that are already damaged by high blood sugar levels. Up to 40% of people with diabetes develop chronic kidney disease and 26% develop diabetic eye disease (retinopathy).
Additionally, diabetes causes plaque formation and arteriosclerosis, which can lead to a diagnosis of cardiovascular disease. Not only can this cause high blood pressure, but it can also increase your risk of heart attack, stroke, and kidney failure.
C stands for cholesterol, also known as blood lipids or fats. There are three main types that need to be monitored for possible intervention.
LDL is known as “bad cholesterol” and is the main cause of atherosclerosis, the formation of plaque that narrows and blocks arteries in the body. The goal is to reduce these to less than 70 mg/dl in diabetic patients aged 40 to 75 years. For people with diabetes or existing heart disease, this goal is less than 55 mg/dl.
HDL is known as “good cholesterol.” This is because adequate levels of this type, when high enough, are known to help scavenge 'bad cholesterol' and remove it from the body. You want this level to be higher than 40 mg/dl for men and 50 mg/dl for women.
Triglycerides are another variation of lipids that we track, and this level should be below 150 mg/dl.
The key to successfully managing diabetes lies in you. Consider implementing these ideas. You'll see that you can influence each of the three characters commonly used to represent fundamental parts of the big picture.
The best investment your family can make is to get rid of the oversized plates that have become the norm in our culture and buy smaller 9- or 10-inch plates. This makes it harder, at least psychologically, to overeat because you feel like you need to fill up a big plate. I had this done at my house a few months ago and had no complaints. What's interesting is that people haven't even noticed an increase in the number of people ordering second helpings due to this change.
Changes in the composition of what ends up on the plate are also important. Half of your plate should consist of vegetables that are low in starch (starch is quickly converted into glucose in the body). More desirable vegetables include carrots, greens (lettuce, spinach, kale), broccoli, zucchini, tomatoes, cucumbers, and asparagus.
A quarter of your plate should be lean proteins such as chicken or turkey breast, fish, beans or lentils, cottage cheese, Greek yogurt, or tofu. The remaining quarter of your plate should consist of whole grain foods, including brown rice, wild rice, or quinoa. This includes breads made with whole grains.
Become a little more active than you are now and increase your activity level. Instead of taking the stairs and searching for the nearest parking spot, opt for a walk during your lunch break. Ultimately, aim for 150 minutes of moderate-intensity exercise over at least five days a week.
If you're overweight, targeting 5% to 7% weight loss through these actions can lower your A1C by a surprising amount.
If your health care provider has prescribed medication, take it as directed. If you miss or forget to take a dose, you are likely not going to meet your goals and it will be very difficult to adjust your medication properly.
According to the CDC, only 26% of U.S. adults diagnosed with diabetes meet all three ABC goals. I would like to see a significant change in that statistic. Is there someone else you would like to help affect this change?
jason turner She is a pharmacist with a Master's degree in Pharmacy (Medication Therapy Management), is Board Certified in Advanced Diabetes Management (BC-ADM), and is a Certified Diabetes Prevention Program Coach. He has worked as a community pharmacist in Worthington since his 1994.
