Nikki Sommer, a nurse with Key West Surgical Group, joined Good Morning Keys on KeysTalk 96.9/102.5 FM for Medical Matters this morning.
November is National Diabetes month and yesterday was National Diabetes Awareness Day. The disease occurs when a person’s blood glucose is too high and 37 million Americans, including adults and youths, have been diagnosed.
Sommer said, “Diabetes if it’s uncontrolled, meaning your blood sugar remains high all the time, it can damage your eyes, kidneys, the nerves and your heart and it has even been linked to some types of cancer.”
The diabetes ABC is important to remember.
Sommer said, “A is for the A1C and every health care professional knows what that is and patients with diabetes will know too. So it measures your average blood glucose levels. Some people with diabetes will use a glucose monitor to track their daily sugar, but the hemoglobin A1C is what your doctor will usually order every three to six months or even annually depending on the severity of your diabetes, meaning if it’s well controlled or not, and that gives you an idea of how your blood sugar is controlled over time.”
B is for blood pressure and C is for cholesterol.
Sommer said, “They all play into effect with each other. So it’s the ABCs. All of those need to be within good ranges, normal ranges, healthy ranges, when you have diabetes.”
Lifestyle changes can really make a difference.
Sommer said, “Eating healthy meals, being physically active, getting enough sleep, not smoking, those can all contribute to an unhealthy lifestyle leading you down the road to having diabetes later on in life and high blood pressure and high cholesterol. They all kind of play into each other. So it’s just better to start being healthier, the sooner the better.”
Taking medication on time also helps.
Sommer said, “Medication, especially when you’re diagnosed with any new disease that you’re told to take medication, diabetics sometimes I find in my experience have a harder time because sometimes there’s some GI upset and side effects with certain medications. Do not stop taking them. Let your let your doctor know. See if there’s a way you can work through it or he or she just needs to prescribe something else to you. Not taking your medicine will hurt you in the long run, then just trying to find what’s the right fit for you.”
Taking care of mental health is also important.
Sommer said, “Stress can increase the level of blood glucose in your blood. It’s just kind of like a metabolic reaction. So if you are prone to diabetes, and you’re prone to having your blood sugar high, mental health is important. For everyone, not just people with diabetes, but it can affect your overall physical health as well as your mental health.”
Uncontrolled diabetes can get in the way of elective and a non elective surgery.
Sommer said, “If your blood sugar is out of control, and God forbid, you need a major medical procedure that’s an emergency, you probably will have a longer healing time than anyone else. The stress of surgery alone can spike the blood sugar, so you want to have it under control before you have to have any type of surgical procedure.”
Keeping track of foot ulcers is important, too.
Sommer said, “Again, with uncontrolled diabetes, you have a problem with your circulation, usually and even the smallest cut, even if you cut your toenails and you accidentally clip the skin, in a diabetic with uncontrolled blood sugar and poor circulation can become a very huge problem with healing. Long term side effects of that could actually be amputation. I’ve met people in the past that it started with a toe and then they had an above the knee amputation.”
Diabetic neuropathy can also happen in the legs and feet.
Sommer explained, “You don’t have the sensation of when you might cut your foot, the bottom of your foot or bump something, so you can be walking around with a really big laceration on the bottom of your foot and unless you see the blood or you don’t look at it, you might not know it’s there.”
What’s the best way to treat a diabetic ulcer?
Sommer said, “The first thing would be to do is take pressure off the area where the ulcer is. A lot of times it may need debridement. That sometimes can be done in our office and sometimes it has to be done actually in the operating room, depending on the severity of the ulcer. Sometimes what it is when it can heal, it’ll form like a crust and it’s black and it’s a necrotic area. So it’s preventing the wound from healing. So the doctor’s got to go in, scrape that out and get it to heal and put on some type of special dressing. It’s going to be long intensive wound care if it gets to that point.”
Preventing infection is really the key with a diabetic ulcer.
Sommer said, “It’s really just starting with having your blood sugar under control. Diabetes is hard, because diabetics, it really affects them longer, because once their sugar is out of control, it’s a lot harder to bring them back in.”
With Thanksgiving right around the corner, things can get tricky.
Sommer said, “The holidays are coming. That’s when everybody tends to fall off the wagon.”
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