Twenty-eight years ago I lost my first husband, James, due to complications caused by unmanaged diabetes. I learned a lot from James and there are lessons for you too.
I learned:
1. I couldn’t keep him alive or control him. Everyone is responsible for their own self care.
2. No two people with diabetes are alike. I saw that it was important to listen to the person with diabetes and know what was important to him/her. James did best when he was involved in the decision making. (Now I use that approach with my clients.)
3. When people get diabetes, they don’t know about diabetes. They need help. I learned that teaching and helping people with diabetes is where I can make a big difference.
Most diabetes management decisions happen outside the doctors’ office. The person with diabetes makes most of the decisions.
James didn’t know enough, do enough, or get the help he needed.
Here’s what you can do to prevent complications from unmanaged diabetes.
Learn your A1C and maintain it at a healthy level. For most people, it is recommended to have an A1C less than 7. Continue to learn about diabetes, and get help when needed.
Get these simple tests every year to detect problems early so they can be treated.
Dilated eye exam. A dilated eye exam allows the optometrist or ophthalmologist to see the retina and look for signs of diabetic eye disease. Early problems can be treated.
James didn’t go to the doctor until he had a lot of trouble seeing. By this point he was already legally blind. Even though he had several surgeries it was too late to preserve his vision.
Kidney function tests. Two different tests show early signs of kidney problems.
- eGFR stands for estimated glomerular filtration rate. It is a lab test that measures how well your kidneys are filtering. Normal is above 60.
- uACR stands for urine albumin to creatinine ratio. This urine test detects protein in your urine. Kidneys filter blood and keep the protein in the blood and get rid of water and waste products. If they are not working properly protein is found in the urine. Normal uACR, also called microalbumin or protein in the urine, is less than 30.
There are no symptoms of kidney disease until you are at advanced stages. High blood pressure also can damage kidneys, so if you have been diagnosed with high blood pressure, it’s important to use a home blood pressure monitor to make sure your numbers are at a healthy level.
James didn’t realize the consequences of high glucose and high blood pressure and didn’t do enough to take care of his diabetes. He generally based his insulin dosing on how he felt and to avoid low blood sugar. Many people still make these same mistakes.
Despite these errors in self-care, James was a wonderful man. He was creative, smart, funny, warm and introspective. He died before our second anniversary. His life and death inspired me to a career dedicated to helping people with diabetes.
You can live a long and healthy life with care and attention to your diabetes.
Make sure you get your eyes and kidneys checked yearly.
Download this list of items people with diabetes should have checked, and document your results over time. It’s based on the American Association of Clinical Endocrinology standards of care.
For more than 25 years I’ve enjoyed helping people understand and live well with diabetes. I’m a better dietitian and diabetes care and education specialist because of James.
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