feb 2015

MEDICAL
COMMON,
MANAGEABLE
By Dr. Allison Holley, MD
Many times, when patients hear the diagnosis of diabetes, they
become afraid and worried. Diabetes is extremely common and
is a chronic disease that is manageable. Diabetes is the leading
cause of blindness, amputations, and kidney disease, but it does
not mean that everyone with diabetes will
have one of these outcomes. Diabetes can
be managed by diet, exercise, oral medications,
insulin or a combination of these.
In fact, many people live with diabetes for
years and are able to control it and enjoy
happy, healthy lives. Patients who are at
risk for diabetes due to obesity, other illnesses
such as high cholesterol or high blood pressure, or a family
history of diabetes, should be tested for this on a yearly basis. Early
diagnosis is one of the keys to preventing complications and progression
of this disease.
Once the diagnosis of pre-diabetes or diabetes is made, it is helpful
for a patient to attend a diabetes education class or visit a nutritionist
which is often covered by insurance. Diabetics should have
a yearly eye exam in order to check for diabetic eye complications
such as diabetic retinopathy and should have a yearly foot exam by
their primary care provider or podiatrist to check for and prevent
or treat foot problems such as calluses, safe toenail trimming, and
education on proper foot care. Patients with diabetes should never
go barefoot and should always wear supportive, well-fitting shoes.
Certified pedorthists can fit diabetics with special shoes to ensure
a good fit that does not rub or irritate the skin. Diabetics should
check their feet on a daily basis to find any small cuts, blisters,
wounds, or calluses that can be treated early to prevent them from
developing into diabetic ulcerations or infections which could lead
to amputations.
Patients with diabetes should
never go barefoot and should
always wear supportive, wellfitting
shoes.
The American Heart Association recommends exercising for 150
minutes per week of moderate exercise. An easy way to remember
this is thirty minutes per day, five days per week. For many people
that sounds like a lot of exercise. I recommend that patients start
slowly and increase on a weekly basis.
For example, if the patient is not really
doing any exercise at all, they can start
with doing 10 minutes of walking per day
for five days for the first week. Then they
can increase to 15 minutes for five days
per week for the next week and continue
increasing the length of time as well as
the intensity until they reach the recommended amount of time.
Walking, swimming, biking, jogging, strength training, core exercises,
yoga, and sports activities are just a few ways to get moving.
If the patient has arthritis, swimming or water aerobics may be a
good option to prevent worsening of their arthritis pain.
There are many diets out there including fad diets. It is important
to remember that it should not be a temporary diet to lose weight
quickly, but a lifestyle change to lose weight in a healthy manner.
A weight loss of one to two pounds per week is considered a safe
amount of weight to lose. Unfortunately, there is no miracle pill
or fountain of youth. Weight loss takes time, determination, and
consistency. Counting calories through programs like Weight
Watchers, free online tools, or apps for the smartphone or following
the Mediterranean diet are healthy lifestyle approaches that
can be sustained long-term. P
Dr. Allison Holley, MD is a Family Medicine physician at South
Florida Family Health & Research Centers in Plantation.
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FEBRUARY 2015