Good Health by the Numbers: A DIY Approach
Effective diabetes management requires an effective plan.
with Amy Tenderich
Editor's Note: While this columnist is no longer writing for dLife.com and we have ceased to update the information contained herein, there is much to be read here that is still applicable to the lives of people with diabetes. If you wish to act on anything you learn here, be sure to consult your doctor first. Please enjoy the column!
I probably don't need to point out why the "do-what-your-doctor-says" approach falls short: you can't be passively dependent on a provider to manage your diabetes, because this condition requires dynamic day-to-day management from you, rather than minimal check-ins with your doctor just 3-4 times a year. Likewise, the "try-to-do-everything-at-once" plan is a bomb: trying to make drastic lifestyle changes can be incredibly overwhelming and frustrating. More often than not, people just give up and give in to inertia, and doing nothing is a surefire way to increase your risk of long-term damage.
I've been lucky enough to spend a lot of time lately with Dr. Richard Jackson, a leading physician from Joslin Diabetes Center in Boston, who's taught me all about a new, proactive approach, which he calls "Do-It-Yourself-Good-Health-With-Diabetes."
Essentially, this consists of learning to understand, track, and prioritize your own 5 most critical health factors – A1c, blood pressure, lipids (HDL, LDL, triglycerides), microalbumin, and yearly eye exam. These 5 simple medical tests are the best and only measures available today indicating each person's own individual health risks with diabetes. Yet despite being widely accessible and easy to administer, fewer than 42% of adults with diabetes have even had these tests, let alone understand what the results mean, according to an April 2006 report by USA Today. Those are miserable statistics for a dominant western nation like ours!
Doing Poorly, On the Whole
Just a few weeks ago, Forbes reported that "diabetes is dragging down America's health (statistics)." A good half of the estimated 21 million adult Americans with diabetes currently rate themselves as having only "fair" or "poor" health, according to new data from the U.S. Centers for Disease Control (CDC). Which means, of course, that a great number of people in this country are headed straight down the path towards diabetic complications, including blindness, kidney failure, cardiovascular disease, and limb amputation. Oy vey! This doesn't have to be the case.
Even without ideal health insurance coverage, we PWDs (people with diabetes) can manage our health a heck of a lot better than we're doing on the whole right now. All we need is the right basic information to help us prioritize our efforts, and of course, access to some rudimentary health care – even if that's obtained at a free clinic. If you haven't had these tests recently, call your doctor or local clinic to schedule them right now:
- A1c blood test – should be taken every three months
- blood pressure - every six months at least (take advantage of every doctor's appointment to have this checked)
- microalbumin, lipids, and eye exam – all annually (unless you've got concerns that might require more frequent checks)
Just having these tests and getting the results on paper yourself is a huge step in the right direction – because knowing where you stand with your diabetes is the most important first step to outliving this disease.
The Missing Link
In his wonderful new book Cheating Destiny, James Hirsch points out that the so-called "therapeutic goals" for diabetes patients are well-publicized, but nobody gives us much of an idea how to achieve them! We're left groping about on our own, and feeling guilty when we don't hit the mark.
The missing link, in Dr. Jackson's opinion, is a DIY approach, so that patients can take achieving a healthy life into their own hands. We need to regularly obtain results for these 5 critical health tests, and then – if any results are out of range – hone in on doable action plans to address the ONE or TWO most critical issues. You might find, for example, that your A1c and triglycerides are in pretty good range, but your blood pressure is quite high. In fact, blood pressure may be even more important to your overall health than glucose control. For every 10 points you reduce your systolic pressure (the top number in your blood pressure result), you reduce your chance of heart attacks and strokes by 15% to 20%.
The point here being that you're much more likely to significantly improve your health if you: 1) pinpoint your focus, and 2) take a step-by-step approach to addressing your most critical risks.
A Head for Numbers?
A new company called HealthiNation, which produces short instructional videos on various health subjects, is also tooting the "know your numbers" horn. Their newest tagline is: "You know your social security number, but what's your LDL?"
They go on to say, "When it comes to remembering numbers, most people can rattle them off with ease. They know their date of birth, social security numbers and even their credit scores. But if you ask people if they know their cholesterol, hypertension and blood sugar levels – they have no clue. Knowing the RIGHT numbers can make the difference between life and death, especially for those prone to heart disease, high blood pressure and diabetes."
Dr Jackson sums it up this way: "So often people focus on the stuff they feel guilty about (usually weight or food), when that may not even be their most critical health issue… What they don't usually do is get the hard facts on where they stand in terms of their own diabetes health risks. But this is what's really going to improve the quality and length of their life." Amen!
* Amy Tenderich is co-author of the new book, Know Your Numbers, Outlive Your Diabetes.
Read more about Amy Tenderich.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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Well maybe not so much a furor as a controversy. The question, bluntly put, is whether or not a single HbA1c reading should be sufficient and adequate to diagnose diabetes — and whether the conditions under which the test was conducted should have any bearing on the diagnostic or non-diagnostic value of the test. The lede from