Diabetes: A Serious Disease that Needs Serious Action

Diabetes is a chronic condition that affects over 37 million Americans and is the eighth leading cause of death in the United States. With its health risks come estimated costs of $327 billion in medical costs and lost work and wages. ^[1]

As the numbers escalate to epidemic proportions, diagnosing and caring for people with diabetes can be complicated. Managing this long-term disease is more than just consistently checking blood sugar or taking insulin or another medication to regulate your blood sugar. Managing diabetes is also more than just limiting or avoiding sweets and cakes. Smart diabetic management requires a multi-faceted approach to address the appropriate level of care for a patient's unique and changing healthcare needs and to help keep overall costs in check.

Managing Diabetes Requires Thoughtful Oversight

A person with diabetes is at higher risk for many co-morbid conditions that can affect major organs and organ systems, such as the heart and blood vessels, kidneys, lungs, pancreas, digestive system and brain. Uncontrolled blood sugar can also affect the mouth and teeth, eyes, skin and sexual organs.^[2] The diagnosis requires comprehensive oversight and a coordinated action plan between the patient and their providers and pharmacy benefit manager to monitor the condition and manage how it may impact the patient's health. Plus, diabetes doesn't discriminate by age. People develop diabetes -Type 1 or Type 2- at younger ages, which means that treatments have to be long-term, and they will most likely change over time.^[1]

A strong diabetes management program and treatment of care should provide a patient with education, support and the resources needed to improve quality of life. The program should also promote and encourage patients to make sure their disease and its symptoms are managed, delayed or possibly prevented by doing the following throughout their treatment.

Know the diabetes ABCs

Understanding and managing the following levels can help a patient lower the chances of a heart attack, stroke or other diabetes problems.^[3]

• A1C (blood sugar level over time) - High levels of blood sugar can harm the heart, blood vessels, kidneys, feet and eyes.
• Blood Pressure - A high blood pressure makes the heart work too hard, which can cause a heart attack, stroke and damage the kidneys and eyes.
• Cholesterol - LDL or "bad" cholesterol can build up and clog blood vessels, which can lead to a heart attack or stroke.

Get regular vision checks

An overwhelming majority of those with Type 1 and Type 2 diabetes for at least 15 years (98% and 78% respectively) have some degree of retinal damage called diabetic retinopathy This can cause blurry vision or loss of vision and the damage can occur before a patient notices any symptoms.^[4] Eye doctors can check for this condition as part of a regular dilated eye exam and medications and treatments are available to slow or reverse the condition.

Watch for nerve damage in legs and feet

High blood sugar often damages nerves in the legs and feet leading to diabetic neuropathy. Symptoms of this are tingling, pain, weakness and numbness in the foot. This is dangerous because a patient could injure a foot and not know it or feel any pain.^[5] This delays treatment and can lead to bigger problems. Regular at-home care and making sure the doctor checks the feet at every visit is key to preventing foot problems and stopping small problems from becoming serious ones.^[6]

Maintain an active lifestyle

Physical activity helps control blood sugar levels, lowers the risk of heart disease and nerve damage and makes the body more sensitive to insulin, which helps manage diabetes. ^[7] Staying active for 20-25 minutes a day can help in the overall treatment. This can be anything from a brisk walk, to mowing the lawn, to housework, to dancing, to playing with a pet. The key is to find the right activity and do it consistently.

Manage stress and mental health

A person under stress may skip meals or forget to take their medication, which will ultimately affect the blood sugar level.^[8] When a person manages their stress appropriately, there's a better chance they will eat better, sleep better, stay active, and take their medications appropriately, all of which will help to keep the diabetes under control.

Get enough rest

Everyone needs a good night's sleep, but for those with diabetes, too little sleep - less than seven hours a night - can increase insulin resistance, negatively impact what and how much a person eats, raise blood pressure and increase depression and anxiety making diabetes harder to manage.

Get consistent dental check ups

High glucose levels in saliva help harmful bacteria grow, which can lead to plaque that can cause tooth decay or cavities. Plus, for those with diabetes, gum disease can be more severe, take longer to heal and make blood glucose hard to control. Consistent check-ups and cleanings with the dentist can keep this all under control.

Coordinating a Long-term Approach to Diabetes Care

You'll notice that many of the above checks work together to not only manage blood sugar levels and the impact of diabetes but also the quality of a patient's life. A diabetic management solution should help a patient holistically and adjust as necessary as the patient ages or their symptoms change.

While a treatment plan may start with clinically appropriate medications and supplies, it should also include education, support, counseling and health check reminders. These personalized aspects to treatment will help a patient stay engaged in their care by eating healthier, getting enough rest, staying active, managing their stress and taking care of not just their diabetes, but their whole body.