Getting DEEP Into Diabetes

Many Montanans have seen their health and enjoyment of life decline because of high diabetic blood sugar. This is a serious health condition that requires medical intervention. In addition to physician-directed routines, there are lifestyle changes that can be made to improve outcomes. Several community health programs are available to help. One of these is a free MSU Extension-sponsored series of classes called DEEP (Diabetes Empowerment Education Program). How do you know if diabetes is impacting you or a loved one and where can you find resources?

It’s a “DEEP” problem
According to the Center for Disease Control (CDC), 29.1 million Americans have diabetes. Of that number, 1 out of 4 do not know they have it. An additional 86 million people have pre-diabetes with 9 out of 10 unaware of the problem. According to the CDC, 15 – 30 percent with pre-diabetes will develop type 2 within five years.  In 2015 more than 65,000 Montana adults (9 percent) were diagnosed with diabetes, an increase from 2.8 percent in 1990. Nineteen percent of Montana’s American Indian/Alaska Natives had diagnosed diabetes, compared to 7.3 percent of white non-Hispanics. Diabetics pay about 2.3 times more for annual health care than non-diabetics.

Types of diabetes:
Pre-diabetes is a condition where health factors indicate a strong chance of developing diabetes;
Type 1 diabetes, often referred to as juvenile diabetes, is insulin-dependent, meaning your body does not produce insulin, and usually strikes children through early adults;
Type 2 diabetes is insulin-resistant, meaning your body can’t use insulin effectively, and usually develops in adults, but is now being seen in youth;
Gestational diabetes affects women during pregnancy.

Diabetes has “DEEP” Symptoms and Risk Factors
There are significant concerns that undiagnosed diabetes damages vital organs. Early diagnosis is the key. The first step in taking control and bringing about change is to see if you have any symptoms.

Do you:
• urinate often?
• feel very thirsty?
• feel very hungry, even though you are eating?
• feel extreme fatigue?
• have blurry vision?
• have cuts and bruises that are slow to heal?
• experience weight loss, even though you are eating more (type 1)?
• have tingling, pain, or numbness in your hands or feet (type 2)?

It is important to be aware of common risk factors that make you more prone to having diabetes. Take time to answer the following questions.

Are you:
• older than 45?
• of African American, Latino, Asian American or Native American heritage?

Do you:
• have a Body Mass Index (BMI) over 25?
• use tobacco?
• have a family member with diabetes?
• have high blood pressure (140/90)?
• have a sedentary lifestyle?
• have a history of diabetes during pregnancy?
• have high cholesterol (over 240) or triglycerides (over 200)?
• have dark patches of skin on neck, armpits or elbows?

Make “DEEP” Changes – Take Action Steps
A thorough and honest inventory of your symptoms and risk factors can help you decide if you need to make an appointment with your medical care provider. In addition to talking with your doctor, there are steps you can take immediately.

1. Get 30 minutes of moderate physical activity, at least 5 days a week. (Moderate activity creates a light sweat and a little faster heartbeat… for instance, walking like you are in a hurry.)
2. Lose a small amount of weight, if overweight. A seven percent weight loss has been shown to be effective in helping people prevent or delay diabetes. This is about 15 pounds for a 200 pound person.
3. Monitor blood sugar. Check with your insurance about what types of glucose monitors and test strips are covered. Your physician will set up a monitoring plan based on your type of diabetes, age and overall health. Regular monitoring is critical for diabetes care.
4. Monitor blood pressure. Check your blood pressure several times per day. Your local pharmacy will have blood pressure cuffs for purchase. You can go to a local pharmacy, clinic, county health department or hospital for a free blood pressure check.
5. Monitor blood cholesterol. Cholesterol monitors can be purchased online and are similar to blood sugar monitors. Cholesterol may be checked at a local health fair or by your primary care physician.

Benefits may reduce risk of cardiovascular events such as heart attack or stroke and, if diagnosed early, lower overall health care costs. This adds up to a better quality of life. For more information about MSU Extension’s DEEP classes, please contact Lisa Terry at lterry@montana.edu or 406-322-8035, or your local Extension office.

SIDEBAR

Don't Get in "DEEP" Trouble - Get Tested

If you recognize any of the described symptoms or risk factors, it is important to see your primary care physician and begin the conversation about diabetes testing. Your physician will determine which test is needed, but you can become familiar now with some of the diagnostic tests used.

1. A1c test. This test evaluates average blood sugars over the past 3 months. An A1c of 5.7%-6.4% is pre-diabetes range and 6.5% or higher indicates diabetes. The advantage of using an A1c test is that it does not require fasting.
2. Fasting blood sugar. A blood sugar of 100-124 mg/dl is in the pre-diabetes range. A blood sugar of 125 mg/dl or higher is in the diabetes range.
3. Oral glucose tolerance test (OGTT). Tests blood sugars at fasting and hourly up to 1-3 hours after drinking a measured glucose drink. The pre-diabetes range is 140-199 mg/dl. Diabetes is 200mg/dl or greater.
4. Casual or random blood draw is used in someone with severe diabetic symptoms. A blood sugar of 200 mg/dl along with symptoms can be used to diagnose diabetes, but not pre-diabetes.
5. Dilated eye exam. High blood sugar and high blood pressure can harm the tiny blood vessels in the eyes. Your eye doctor will examine the inside of your eyes with eye drops that enlarge (dilate) your pupils for a short time. With dilation, your eye doctor will be able to see signs of leaking blood vessels.
6. Regular foot checks. Diabetes may slow circulation in feet and legs, and cause a loss of feeling. The American Diabetes Association recommends annual foot exams. The doctor will check feet for redness, cracks, sores, or open wounds. People can perform daily checks at home with a foot exam mirror that has an expanding handle or you can have a family member check your feet. You must also wear properly fitted shoes and socks that absorb moisture.