Staying healthy is what it's all about!

Stephen L. Blythe, D.O.

Board Certified, Family Practice

Nutritionist

Machias, Maine 04654

For Our Patients with Diabetes:

Goals:

Since diabetic complications are to a great extent a result of high sugar levels, the goal is to keep the sugar as near normal as possible. Medication can stimulate insulin production, make the body more sensitive to your insulin, or replace insulin. Dietary limitations on sugars and carbs in general (especially pasta, breads, and cereals) can help, and nothing is better than a program of regular exercise. Even a walking program, working up to 45 minutes three times a week (daily would be better) can dramatically improve glucose control.

We will often check your sugar, and every six months we will check a "hemoglobin A1c", also called "A1c". Glucose binds to hemoglobin (the protein in blood cells that carries oxygen) to a small extent, and the percentage of hemoglobin molecules that have glucose attached reflects your glucose level over the past two to three months. A non-diabetic usually has an A1c level below 6.0. We like to see our diabetic patients with a level around 7.0 or a little below. A level above that means more effort is needed in terms of diet, exercise, and medication. sometimes the choice is yours - if you can start walking we may not have to increase your medications or go to injectable insulin.

Monitoring Complications:

We have to watch for complications of diabetes. For this reason we recommend yearly eye examinations. We will also do a yearly foot examination to check for loss of sensation. If you have numbness you need to inspect your feet every night for cuts or injuries which could get infected. Numbness also increases fall risk, so nightlights are advised.

Every six months we check your urine for signs of increased protein (called "microalbumin") which would indicate early kidney damage from the diabetes.

Heart Disease Risk:

With diabetes your risk of a heart attack or stroke is about the same as someone with known heart disease. For this reason we also monitor your cholesterol level every six months to make sure the LDL ("bad cholesterol") is below 100. Medications to lower cholesterol are often prescribed at much lower levels of cholesterol in diabetic patients than in others because of this increased risk. Statin medications (such as Lipitor) can be tolerated by most patients, although some have problems with them.

 Only working together as a team can we make sure you get the best possible care!