Good diabetes control is more than just tracking blood sugar

By Michaela Gibson Morris / NEMS Daily Journal

TUPELO – Tupelo firefighter Jimmy Avery fights a daily war on many fronts.
The battle ground isn’t a house fire, but inside his blood vessels in the form of diabetes. He monitors not just his blood sugar, blood pressure and checks his feet for signs of non-healing wounds. He struggles with keeping portion sizes in check at meal time.
“It’s a constantly changing battle,” said Avery, who was diagnosed in 2005. “What works today doesn’t work tomorrow.”
The stakes are high. If diabetes is left unchecked it can burn you – damaging eyes and kidneys, jeopardizing limbs with unhealing wounds and dramatically increasing the risk of heart attack and stroke.
The fight against diabetes isn’t easy, but it is far from hopeless.
“This is an ongoing struggle,” said Tupelo endocrinologist Dr. Jay Dey. “There’s no cure, but we do have good ways to control it.”

Holistic approach
Diabetes is more than just a blood sugar disease.
The chronic condition touches every part of the body, and if left unchecked can cause a great deal of damage.
“It takes more than prescriptions,” Dey said. “It takes a holistic approach.”
In Type 2 or insulin resistant diabetes, the body slowly loses its ability to keep blood sugar regulated. The chronically elevated blood sugar irritates and inflames blood vessels all over the body.
The body has to work harder to get blood throughout the body. People with diabetes who don’t already have high blood pressure when they are diagnosed are more likely to develop it because of this chronic inflammation. It also makes people with diabetes much more likely to suffer a heart attack or stroke.
“Not all people with diabetes have these problems, but diabetes makes it likely they will develop them if they don’t already have them,” Dey said.
The constant irritation is also hard on the tiniest blood vessels that feed the eyes, kidneys, fingers and toes – which is why complications from diabetes show up there.
For most people, who are used to managing their health care one cold or sprained ankle at a time, a diabetes diagnosis can be a significant adjustment.
“It’s so different from a sore throat or sore tummy,” said nurse practitioner Nat Collins, who works with Dey. “It’s not 7 to 14 days of antibiotics, and you’ll be fine.”
Registered nurse Mary Foley, who teaches a diabetes management class at Baptist Memorial Hospital, said she sees people who are still in denial years after they were diagnosed.
“They didn’t embrace the fact they have diabetes until they had complications,” Foley said.

Good coaching
Complications are not inevitable with diabetes. A good team of health care providers can help people with diabetes put together a game plan of medication, lifestyle changes and regular screenings.
The real work of diabetes management happens day-by-day with choices on food, exercise and daily monitoring.
“We’re like those big rolling tool boxes people have in their garage,” Collins said. “We have lots of tools to share, but we can’t turn the wrench.”
Diabetes management classes can help people with diabetes learn more about what they are up against and craft individual plans to deal with the condition. Education and persistence are key.
“It takes time to do all this,” Foley said. “Planning for sugar checks, exercise, blood pressure checks and healthy meals is work, but it’s worth it.”
Once a person with diabetes has good control, the work doesn’t stop there. The balancing act continues.
“Diabetes is a progressive disease,” Foley said. “You will have to change your regimen, no matter how well controlled you are.”