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5 steps to living longer – and better
Diabetes care goals decrease chances of early death from heart disease
If you have diabetes, your risk of having a heart attack or stroke is two to four times higher compared to people who don't have diabetes. In fact, 65 percent of people with diabetes die from heart disease or stroke.
"But there's a lot you can do to live longer with a higher quality of life," says Bev Reiman, director of patient services for Allina Medical Clinic.
Allina Medical Clinic and other health care providers across the nation are working to help their patients with diabetes achieve five care goals that can lessen their heart disease risks:
- Stay or become tobacco-free.
- Take aspirin daily.
- Have an A1C level of less than 7 percent.
- Have a blood pressure rate of less than 130/80.
- Have an LDL cholesterol level of less than 100.
"What we're trying to do is prevent early death," says Reiman.
Becoming tobacco-free
Adding smoking to diabetes more than doubles your risk of illness and death from heart disease, stroke and poor circulation.
If you smoke, it's important to speak with your doctor, diabetes educator and even your health insurance provider about quitting tobacco use. Quitting can be very challenging. But there are many resources and medicines available to help you achieve this goal.
Aspirin use
Taking a low dose of aspirin every day helps prevent blood clots that can block the flow of blood and lead to heart attack or stroke. But taking aspirin is not safe for everyone. Be sure to ask your doctor is aspirin is safe for you before you start taking it every day.
Medicine needed: A1c, blood pressure and cholesterol levels
Regular physical activity and good eating habits can help you control your blood glucose, blood pressure and cholesterol. But many people need extra help – medicine – for good, long-term control.
"Losing weight and exercise may keep things at bay for awhile, but they don't keep you from ever needing medicine, especially if you're predisposed to diabetes, high blood pressure or high cholesterol," says Reiman.
- To have a hemoglobin A1c – or average blood glucose level -- of less than 7 percent, you need to work closely with your health care team to be sure you're taking the right kind and amount medicine or insulin.
- To have a blood pressure rate of less than 130/80, you may need to take an ACE (angiotensin converting enzyme) inhibitor. In addition to lowering your blood pressure, this prescription medicine may help keep your kidneys healthy. Two or more medicines are often needed to control blood pressure.
- To have a LDL (low-density lipoprotein or "bad") cholesterol level of less than 100, your doctor may have you take statins. Used alone or with other medicines, statins can help lower "bad" cholesterol levels.
What to expect at your next clinic visit
When the five diabetes care goals become part of your care plan, you may notice some changes at your next doctor's appointment.
"It's very much a team approach that involves you, your doctor, nurse, diabetes educator and others," says Reiman. "We want to make sure today's work gets done today, and you leave knowing what to do next."
For example, many Allina Medical Clinic locations are putting in place these improvements for their patients with diabetes:
- Same-day lab results – The results of hemoglobin A1c tests will be ready during your appointment, not sent to you afterward. This will help you and your doctor determine right away if any changes should be made to your care plan.
- Follow-up appointments – You'll be asked to schedule your next appointment before you leave the clinic, much like what happens at the dentist's office or beauty salon.
- More regular clinic visits – Your doctor may limit your prescription refills to 6 months or less to ensure that you make at least two clinic visits a year for diabetes care.
Having patients visit their clinic more often "is not about making money. It's about good medical care," says Reiman. "Diabetes changes over time, so the way it's treated needs to be checked on a regular basis."
Dialog home page
Heart attack or brain attack (stroke): Are you at risk? Your diabetes care team
Source: Allina Medical Clinic; Allina Patient Education, Basic Skills for Living with Diabetes, dia-ahc-90196; Allina Patient Education, Keeping Your Heart Healthy When You Have Diabetes, dia-ahc-32867; Minnesota Community Measurement; Bev Reiman, director of patient services, Allina Medical Clinic
First published: 07/23/2007
Last updated: 07/23/2007
Reviewed by: Mary Frederick, RN, diabetes program manager, Allina Medical Clinic
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