Prevention of Diabetes
The lifestyle choices are your key tools of management to prevent development of diabetes these tools or jobs are.
The aim of diabetes treatment is to maintain blood glucose levels within the normal range, which is between 4.0 and 6 mmol/L before meals and 4.0 and 8mmol/L two hours after meals. This will help prevent possible long-term problems that can affect the heart, blood vessels, eyes, kidneys and nerves.Keeping your blood pressure and cholesterol within the recommended range is very important to help prevent these long-term problems. Healthy eating, achieving and maintaining a healthy weight and doing regular physical activity can help you do this. Sometimes tablets and then insulin may also be needed.
Persistently high blood glucose levels (BGLs) over a period of time can damage the body’s organs. This damage is referred to as diabetes related complications.
While these complications are serious and can be life threatening, with sustainable lifestyle changes and attention to blood glucose control, people with diabetes can substantially reduce the risk of these complications and manage their disease well.
How are my blood glucose levels measured
Blood glucose levels for those with diabetes are measured in two distinctly different ways. Both ways are important for different reasons.
What does it measure?
Haemoglobin (the Hb of HbA1c ) is present in everyone’s red blood cells. It’s what makes your blood red. Glucose sticks to the red cells and the more glucose there is in your blood stream, the more glucose sticks to the red cells. The average life span of a red blood cell is 120 days (three months), and if we measure how many red cells have glucose attached to them, it gives us a guide to the glucose levels in your blood over the last 120 days. It gives us an average level, which in turn indicates your risk of developing problems with your health.
What does it not measure? Glycated haemoglobin (HbA1c,) is not a measure of blood glucose as you would get it if you were doing a finger prick and testing your blood with your meter. It doesn’t measure sudden changes
in your blood glucose, or what your blood glucose level is right at the moment of testing.
HbA1c Units change
HbA1c has recently changed the way in which it is represented below is a very good chart compare the old terminology with the new
Blood glucose self-testing
Testing you own blood glucose levels is also a crucial tool but help understand your disease and its management. If you spend some time researching the topic you will find much disagreement as to how often or even how useful it is however as a dietitian and diabetes educator I believe it is vitally important. There is no argument that it is vitally important when starting out and if you are own medication particularly insulin that can cause your blood sugars to drop but some are questioning if those that are on basic medication gain much from self-testing.
In my opinion as well as adding significant value to medication management self-testing particularly for the newly diagnosed is an absolute must. Many a time have I come across someone that is convinced they are fine and don’t have diabetes until they test their blood glucose levels and understand blood glucose levels and food interactions. Don’t go and get one from you chemist or doctor visit a dietitian or Credentialed Diabetes Educator and work through what to do and why.
In 2107 access to subsidized blood glucose testing strips has now been changed
- People with type 2 diabetes not using insulin will receive an initial six-month supply of subsidised blood glucose test strips under the NDSS. This means registrants will be able to access blood glucose test strips, as required, over a six-month period, starting any time on or after 1 July 2016.
- After six months, registrants will be able to continue to access subsided test strips if their doctor, nurse practitioner or Credentialed Diabetes Educator considers that there is a clinical need for them to continue to monitor their blood glucose levels.
Unfortunately, the mighty dollar has won the battle as to justify weather or not self-testing is useful for basic diabetes, personally I would never suggest individuals test without a plan and test often if they are well controlled, but it is worth noting that less than 1/2 of all Australians with diabetes are at target.
A word on the studies that have led to reduced testing strip access
what all the studies that suggested testing with “stable diabetes” has limited value have in common is that they do not define who is giving the education or what education was given.
I believe all these studies are showing is that if we give mediocre quality education or do not collect data to a specific plan its not useful . that’s not evidence self testing with stable diabetes is not valuable its evidence collecting data without meaning and quality education/plans is not valuable.
Blood glucose monitoring is a valuable diabetes self-management tool, which enables you to check your own blood glucose levels as often as you need to, as recommended by your doctor of Credentialed Diabetes Educator.
Blood glucose level pattern changes can alert you and your health professionals to a possible need for a change in how your diabetes is being managed.
Testing your blood glucose levels will help you to:
- Develop confidence in looking after your diabetes
- Better understand the relationship between your blood glucose levels and the exercise you do, the food you eat, other medication you may take, and other lifestyle influences such as travel, stress and illness
- Find out immediately if your blood glucose levels are too high (hyperglycaemia) or too low (hypoglycaemia)
- Alert you to seek the advice of your diabetes team about adjusting your insulin, tablets, meal or in-between meal planning when blood glucose goals are not being met.
To test blood glucose levels, you will need:
- A blood glucose meter
- A lancet device with lancets
- Test strips.
It is a simple procedure and the results are displayed within seconds.
Blood glucose meters are usually sold as kits giving you all the equipment you need to start. There are many different types, offering distinctive features and at different prices to meet individual needs. Most of these are available from Diabetes Australia in your state or territory, pharmacies and some diabetes centres.
Your doctor or a Credentialed Diabetes Educator can help you choose the meter that’s best for you. It is important that you talk to your Credentialed Diabetes Educator about how to use your meter correctly so that you can be sure your results are accurate.
When diabetes is left undiagnosed or unchecked for too long, it can be responsible for a number of diabetes related complications such as heart disease, kidney disease, blindness, limb amputation, erectile dysfunction and persistent infections. • Diabetes and eye disease
Diabetic retinopathy is the leading cause of blindness in Australians aged under 60. The development of retinopathy is strongly related to the length of time diabetes has been present and the degree of blood glucose control. Regular checks and treatment can prevent blindness caused by retinopathy.
Diabetes and kidney disease
Your kidneys help to clean your blood. They remove waste from the blood and pass it out of the body as urine. Over time diabetes can cause damage to the kidneys which causes them to leak. You won’t notice damage to your kidneys until it’s quite advanced, so it is important you have the recommended tests to pick up any problems early. Information can be found at Kidney Health Australia Kidney health Australia
- Diabetes and lower limbs
Neuropathy or peripheral nerve disease and vascular damage may lead to leg ulcers and serious foot problems from which lower limb amputation may result. Personal daily foot checks and thorough annual foot examinations conducted by your doctor or podiatrist will are essential to help to reduce your risk of lower limb complications. •
Diabetes and heart disease/stroke
Those with diabetes are at a higher risk of heart disease and stroke due to raised blood glucose levels (BGLs), in association with high blood pressure and cholesterol. Your best source on information on diabetes and heart disease is the Heat Foundation http://www.heartfoundation.org.au/Pages/default.aspx