Friday, December 2, 2011

What if ! you are empowered to become your doctors number one assistant caring for your diabetes.

Wow ! why not become the number one medical assistant in caring for my diabetes.

Your doctor , diabetes educators and dietitians have the knowledge and wisdom to direct your diabetes care. They provide you with the tools and it is up to you to use those tools.

Many people with diabetes rely on their doctor or other health care provider to remind them when a test is needed and are satisfied when they are told every thing looks OK. You may say that understanding all of those test is just to difficult. I am here to tell you that all of the diabetes test results are just numbers. The recommended goals for those numbers is available from the American Diabetes Association or your doctors office.

All of our life situations are different and the recommended goals may not be the best goal for you . Your doctor can help you adjust the recommended goals to your specific situation. You and your doctor decide on specific target goals. "Just numbers". Now any number that is not at its recommended level is a reason for discussion with your doctor.

I would like to go back to our imaginary statistical primary care doctor from a few days ago who has 72.5 patients with diabetes and 223 patients with pre-diabetes and trying to track and manage 3546 test.

Your doctor could now have 295.5 trained diabetes medical assistants . As one of those assistants your job will be to track and manage 12 test on the person who is the most interested in their own health. You

Great things can happen with you being the number one medical assistant responsible for winning this game of numbers. Review this information from the National Institutes of Health and you decide if it is worth the effort.

Preventing Diabetes Complications. This information was taken from the, National Institute Of Diabetes,Digestive and Kidney Disease .

Glucose Control

  • Studies in the United States and abroad have found that improved glycemic control benefits people with either type 1 or type 2 diabetes. In general, every percentage point drop in A1C blood test results, for example, from 8.0 to 7.0 percent, can reduce the risk of microvascular complications—eye, kidney, and nerve diseases—by 40 percent. The absolute difference in risk may vary for certain subgroups of people.
  • In patients with type 1 diabetes, intensive insulin therapy has long-term beneficial effects on the risk of cardiovascular disease.


Blood Pressure Control

  • Blood pressure control reduces the risk of cardiovascular disease—heart disease or stroke—among people with diabetes by 33 to 50 percent and the risk of microvascular complications—eye, kidney, and nerve diseases—by about 33 percent.
  • In general, for every 10 mmHg reduction in systolic blood pressure, the risk for any complication related to diabetes is reduced by 12 percent.
  • No benefit of reducing systolic blood pressure below 140 mmHg has been demonstrated in randomized clinical trials.
  • Reducing diastolic blood pressure from 90 mmHg to 80 mmHg in people with diabetes reduces the risk of major cardiovascular events by 50 percent.


Control of Blood Lipids

  • Improved control of LDL, or bad, cholesterol can reduce cardiovascular complications by 20 to 50 percent.


Preventive Care Practices for Eyes, Feet, and Kidneys

  • Detecting and treating diabetic eye disease with laser therapy can reduce the development of severe vision loss by an estimated 50 to 60 percent.
  • About 65 percent of adults with diabetes and poor vision can be helped by appropriate eyeglasses.
  • Comprehensive foot care programs—ones that include risk assessment, foot-care education and preventive therapy, treatment of foot problems, and referral to specialists—can reduce amputation rates by 45 to 85 percent.
  • Detecting and treating early diabetic kidney disease by lowering blood pressure can reduce the decline in kidney function by 30 to 70 percent. Treatment with particular medications for hypertension called angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) is more effective in reducing the decline in kidney function than is treatment with other blood pressure lowering drugs.
  • In addition to lowering blood pressure, ARBs and ACE inhibitors reduce proteinuria, a risk factor for developing kidney disease, by about 35 percent.

Having diabetes is not all bad. You know your enemy and you have the tools to win the battle. Pick up those tools and go to work. Your doctor and other health care providers are your best partners in this battle.

Dr. Calder

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Your comments and questions are appreciated. David Calder,MD