This month, we've been speaking with medical experts at University of Iowa Hospitals and Clinics in recognition of American Diabetes Month. Today, Marcia Gaffney, RN, CDE, patient education coordinator for the UI Family Care Center and in charge of the Family Care Center Diabetes Management Clinic for people with type 2 diabetes, talks about diabetes:
Who is at risk to develop type 2 diabetes?
People who:
- Are over age 45
- Are little overweight
- Are of certain ethnic groups such as African-Americans, Native Americans, Asian-Americans, Hispanic/Latino Americans, or of Pacific Islander heritage
- Have a history of a history of gestational diabetes or giving birth to a baby over nine pounds
- Have cholesterol problems--your good cholesterol is low or your triglyceride cholesterol is high
- Have polycystic ovarian syndrome
- Have an inactive life style
How is type 2 diabetes diagnosed?
The easiest and most common way is to have a fasting blood glucose test. That means you have to fast overnight and come in for a simple blood test. The criteria is: normal is less than 100, prediabetes is 100 to 125, and if it's over 126 fasting, that would be diabetes, but this test has to be repeated.
What is the current treatment for type 2 diabetes?
One of the first things that should be done is get diabetes education. Diabetes is a self-managed illness which means it's important for people to understand how to take care of their diabetes, to understand the illness, and understand their role.
Their role is central to the outcomes of diabetes. Diabetes education includes:
- Going to a diabetes educator to learn how to do home blood glucose monitoring
- Learning when to call the doctor about those numbers
- Learning to manage high blood and low blood sugars
- Taking good care of the foot
It's also important to go to a registered dietitian to talk about a diet plan.
What kind of exercise and how much exercise should a person with type 2 diabetes get?
Exercise is an important part of diabetes management and 30 to 60 minutes of some moderate physical activity is recommended most days of the week. It's important for people to start off slowly if they've been very sedentary and gradually work up to that.
Are drugs also used in treating type 2 diabetes?
Yes, there are pills or oral medications and some of them help the body cells be more sensitive to the action of insulin. Others decrease the amount of glucose made by the liver. Some stimulate the release of insulin. Some people with type 2 diabetes need to give themselves insulin injections if their body is no longer making enough insulin. There are other injections, too, that help stimulate the release of insulin and decrease the amount of glucose made by the liver.
What are the major concerns in teaching a newly diagnosed diabetes patient?
First, I think it's important for them to understand the illness and the complications of the illness if it should not be well controlled, and to understand that the complications can greatly be reduced if the blood sugars, cholesterol and blood pressure are controlled.
It's important for them to realize that their part in this is significant. Their doctor, nurse, and dietitian are more like consultants for them. But ultimately their outcomes depend on what they do. Changing behavior is very difficult. As we get older we get into habits and so talking to them about behavior changes, life style changes in their exercise, and diet is important.
Are people with type 2 diabetes more at risk for other serious complications?
Yes, they are. Significant complications of diabetes have to do with what it does to your blood flow. Basically it really accelerates atherosclerosis, which is the hardening of the arteries. This can affect increased strokes and heart attacks, kidney failure, and eye disease. It's the leading cause of blindness and the leading cause of kidney failure in adults. Circulation problems to the legs can lead to amputations, It's the leading cause of non-traumatic amputation in the United States.
When a person with type 2 diabetes catches a cold or flu, are there other concerns they need to consider?
Yes, people with diabetes are at high risk of complications of influenza, so it's very important that they get their flu shot every year and they also should get pneumonia immunization. And that's just given once and then repeated once after five years. They are at increased risk of complications such as pneumonia with flu.
Does UI Family Care offer classes for type 2 diabetics and their families to learn about the disease?
Yes, here in the Family Care Center we have the Diabetes Management Clinic, which is a multidisciplinary clinic.
Multidisciplinary treatment of diabetes is a nationally recommended approach to diabetes management and education. Lisa Kaufman, MD, and Robert Garrett, MD. MS, see patients at our clinic. Patients are also seen by a clinical pharmacist, a specialist in diabetes management, who reviews their medications and lab studies and makes recommendations for treatment.
Patients are also are seen by a physical therapist and who designs an exercise program for them, talks about foot care, and checks to make sure they have appropriate footwear. Patients are also seen by a registered dietitian, who talks about diet and the effects of diet on diabetes and sets up a specific diet plan for them. I'm the nurse in that clinic and I provide diabetes self management education. So it's very comprehensive. And also, some patients come to see me for individual counseling sessions.
If someone has questions or wanted to learn more about diabetes management, where should they call ?
They can call 384-7774. |
