Guidelines for Your Diabetes Care

Although these are suggested Guidelines for your Diabetes Care, please check with Your Benefits Plan for Coverage.

A1c test

My last A1c test was on ________. This blood test measures blood sugar control over the past 60 to 90 days. A1c should be tested two to four times a year, depending on how well your blood glucose is managed and whether you have had a recent change in your diabetes medications. The target A1c level is less than 7 percent.

Blood Pressure

My blood pressure is _______. Both the American Heart Association and the American Diabetes Association recommend blood pressure of less than 130/80 mm Hg for people with diabetes. Have your blood pressure checked at every visit to your provider.

Foot Exam

I have an appointment for a foot exam on ________. Inspect your feet every day for signs of redness, warmth, swelling or calluses. In addition, you should have your feet inspected by your provider during every visit and have a complete sensory foot exam done every year.

Eye Exam

My next dilated eye exam is on ________. People who have diabetes should have a dilated retinal examination every year. Remember that this is a special eye exam that is not the same as having your vision checked for glasses.

Lipid Profile

I last had my fasting lipid profile on ________. Lipid profile tests should be done at least once a year so that you and your provider can develop a plan to reduce your risk. The target LDL cholesterol goal is 100 mg/dl or less.

Urinary Protein

My appointment for my urinary protein/microalbumin test is on ________. Measuring your urinary protein will give you and your provider information about the health of your kidneys and blood vessels. You should have an annual test for urinary protein/microalbumin if you have type 2 diabetes or if you have had type 1 diabetes for more than five years.

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Unplug the Stress!

Some activities can help you better manage stress, such as regular exercise. Here are other stress relievers:

• Get a full night's sleep.
• Talk it out. Tell close friends or family members about the things that cause you concern.
• Do relaxation exercises throughout the day, such as taking 10 to 15 seconds every hour to breathe deeply  from your diaphragm.
• Try yoga or meditation.
• Make time every day to do things you enjoy.
• Learn to set limits and say no.
• Take a stress management class.

If you feel overwhelmed, seek help from your doctor or a mental health professional.

Feeling sad? Let the Light In...

During the dark days of winter, some people develop signs of depression that are tied to the changing amount of daylight. This type of depression is called seasonal affective disorder (SAD).

The symptoms of SAD can appear gradually or suddenly, and may be mild or severe, according to the American Psychiatric Association (APA). Symptoms can include fatigue, lack of interest in regular activities, withdrawal from social relationships, a craving for high-carbohydrate foods and weight gain. Symptoms usually ease or disappear when spring arrives.

Up to 80 percent of people with SAD are women, most of them in their mid-20s and mid-30s. People who work long hours inside buildings with few windows or during long periods of cloudy weather are most prone to develop SAD, the APA says.

If you have mild symptoms of SAD, you may find relief by increased exposure to light, says the National Alliance for the Mentally Ill (NAMI). You can increase your exposure by taking long walks outdoors, especially on sunny days, or rearranging your home or workspace so that you are near a window during the day. The brighter the light, the more effective it is. Regular exercise and stress management techniques also may help.

If your symptoms are more severe -- they affect your daily life -- talk to your doctor about light therapy, also called phototherapy. This involves the simple procedure of repeated sessions of sitting in front of a very bright light.

Medication may also help: The antidepressant bupropion was approved by the Food and Drug Administration in 2006 for prevention of SAD. Treatment is started in the fall, before symptoms begin, and tapered off in the spring. It should be used with extra caution in adolescents or children, who should then be closely monitored for suicidal thoughts and behavior.

Walking Safely in Snow Covered Parking Lots

If a sidewalk is cleared and available, please use it.

Be careful walking out from behind piles of snow. Oncoming cars can not stop quickly on slick pavement and the driver may be able to see you.

Keep your hands free so that if you do slip you can catch yourself. If you are talking on a cell phone you are not paying attention to your surroundings.

Just like operating a vehicle, a pedestrian has a duty to proceed cautiously during inclement weather.

Bend your knees a little and take slower steps to reduce your chances of falling when walking. Wear gloves to avoid putting your hands in your pockets.

Use caution when exiting your vehicle and please do not walk between cars to get to your vehicle.

If you have packages to carry in, stop at the entrance and leave them before proceeding to a parking spot.

What are the risks with Gestational Diabetes?

Although any woman can develop gestational diabetes during pregnancy, some of the factors that may increase the risk include the following:

• overweight or obesity

• family history of diabetes

• having given birth previously to a very large infant, a still birth, or a child with a birth defect

• age

Women who are older than 25 are at a greater risk for developing gestational diabetes than younger women.

• race

Women who are African American, American Indian, Asian American, Hispanic/Latino, or Pacific Islander have a higher risk.

• pre-diabetes

Although increased glucose in the urine is often included in the list of risk factors, it is not believed to be a reliable indicator for gestational diabetes.

What causes Gestational Diabetes?

Although the cause of gestational diabetes is not known, there are some theories as to why the condition occurs.

The placenta supplies a growing fetus with nutrients and water, as well as produces a variety of hormones to maintain the pregnancy. Some of these hormones (estrogen, cortisol, and human placental lactogen) can have a blocking effect on insulin. This is called contra-insulin effect, which usually begins about 20 to 24 weeks into the pregnancy.

As the placenta grows, more of these hormones are produced, and insulin resistance becomes greater. Normally, the pancreas is able to make additional insulin to overcome insulin resistance, but when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes results.

Gestational Diabetes

What is Gestational Diabetes?

Gestational diabetes is a condition in which the glucose level is elevated and other diabetic symptoms appear during pregnancy in a woman who has not previously been diagnosed with diabetes. All diabetic symptoms disappear following delivery.

Unlike type 1 diabetes, gestational diabetes is not caused by a lack of insulin, but by blocking effects of other hormones on the insulin that is produced, a condition referred to as insulin resistance.

Approximately 3 percent to 8 percent of all pregnant women in the United States are diagnosed with gestational diabetes.

De-Stressed Is Best

According to the American Heart Association, there is growing evidence that stress contributes to heart disease, although exactly how remains unclear. If you already have heart disease, such as heart failure, stress can make the condition worse. So it's important to understand how stress affects your heart and what you can do to avoid it.

Stress takes its toll

When you react to a stressful situation, stress hormones are released into your bloodstream and your heart rate and blood pressure increase. This increases the demand on the cardiovascular system, particularly on the heart. For people with heart disease, their heart may not be able to keep up with this increased demand, leading to irregular heart rhythms, chest pain (angina) or even heart attack.

Ways to Activate Your Life

Most Americans know that being physically active is good for their health and helps them lose weight by burning calories.

Still, most American adults—up to 63 percent, according to some studies—don't accumulate even an hour of moderate exercise in a week’s time.

One fitness and motivational trainer says he knows a way to motivate adults to get a move on and begin reaping the benefits of an active lifestyle.

“As children we rode bikes, played in the woods, or kicked a soccer ball around, not because we had to or someone told us to, but because we wanted to,” says Jay Snyder, a personal trainer in Springville, Utah. Snyder is certified by the American Council for Sports Medicine. “As adults, we still can tap into that spirit of play and be active because of the enjoyment it provides.”

As a busy person with family, work, and civic responsibilities, how can you find time for yet another activity?

“It’s essential to take a look at and address the circumstances of your life,” says Snyder. “If you’re a parent, for example, it’s easy to put yourself at the bottom of the list. But to nurture others, you have to nurture yourself and make your desire to swim or take a dance class as important as your child’s baseball practice.”