By Mary Sikora-Petersen, MSE, RD, CDE
“You have diabetes and I’d like you to see a diabetes educator.” Diabetes is on the rise and many people may hear this from their doctor this year. After being diagnosed with diabetes, many thoughts race through their mind. “Will I need to give myself shots?” “Can I ever have sweets again?” “Will I be able to stay active?” The role of a certified diabetes educator is to help people with diabetes and their families understand the disease so they can make informed decisions regarding the management of their health.
A diabetes educator is usually a nurse or dietitian but could also be a pharmacist, physician, exercise physiologist or other health professional. They first assess the person’s medical background and listen to their questions and concerns about the disease. Then they tailor a learning plan for the individual and assist them in making lifestyle changes and medical decisions to manage their health. The ABCs of diabetes is a common education starting point.
“A” – A1C test is a lab measurement of the average blood sugar level over the last two to three months. The American Diabetes Association (ADA) recommends an A1C of 7 or less, which corresponds to a long term average blood sugar level of 170 mg/dl. To improve their score, an individual may be advised by a dietitian to follow a controlled carbohydrate plan. This should not be confused with popular low carbohydrate diets which may be too low in carbohydrate and nutrients to maintain health. Sweets are allowed in small amounts.
“B” – Blood pressure that is too high is a complicating factor for patients with diabetes. Having both diabetes and high blood pressure puts a patient at high risk for blindness, kidney disease, heart disease and poor circulation which can lead to amputation. Persons with diabetes should maintain their blood pressure lower than 130/80, according to the ADA. To lower blood pressure, an individual may be advised to eat less salt, and eat more foods with calcium, magnesium and potassium. Dairy products are good sources of calcium. Magnesium is found in nuts, seeds and whole grains. Good sources of potassium include plenty of fruits and vegetables.
“C” – Cholesterol levels influence a patient’s risk for having a heart attack or stroke. According to the ADA, 65 percent of diabetes patients will die of heart disease or stroke. A person with diabetes who has never had a heart attack is just as likely to have a heart attack as someone who has already had one. The ADA recommends a total cholesterol level under 200, an LDL (“L”ousy cholesterol) less than 100, and an HDL (“H”appy cholesterol) over 40 for males or over 50 for females. To lower their cholesterol, an individual would be advised to eat less saturated fats and trans fats and eat more unsaturated fats. This means eating more poultry without skin, fish and lean red meats like 93 percent lean beef or pork tenderloin; choosing low fat dairy products; and avoiding fried foods, pastries and snack foods that may contain trans fats. We generally advise people to eat more nuts and soy-based foods for protein, and replace “hard” fats such as stick margarine and butter, with tub or spray margarine.
These healthy diet habits should accompany an exercise routine that might include walking 30 minutes a day. Other important lifestyle changes to help manage a person’s ABCs include quitting smoking, taking medications as prescribed, and keeping regular contact with the your diabetes management team which includes your medical providers, dietitian and diabetes educator.
Hearing “You have diabetes and I’d like you to see a diabetes educator” is the start of managing the disease so you can have long and healthy life.
Mary Sikora-Petersen, MSE, RD, CDE is a dietitian and certified diabetes educator for Howard Young Health Care in Woodruff and Eagle River.