There's good news: Controlling diabetes—which means keeping your blood sugar at healthy levels and reducing your chances of diabetes complications ranging from heart disease to foot damage—is something that you can do.
But here's the bad news: Keeping your diabetes under control is up to you, and it's not always easy.
"If you have cancer, you go to your surgeon or you go to your doctor to get chemotherapy," says Yvonne Thigpen, RD, a certified diabetes educator and the diabetes program coordinator at Mount Clemens Regional Medical Center in Michigan. "But patients with diabetes can do a lot to control their diabetes by making healthy lifestyle choices in addition to working with their physician."
If a patient is a "take-charge person, they take it as good news, if they are not, they don't like that news," she says.
Many people don't control their blood sugar
A lot of people with diabetes, unfortunately, aren't in good control. A 2005 study from the American Association of Clinical Endocrinologists (AACE) involving more than 157,000 people with diabetes found that more than two-thirds weren't adequately controlling their blood sugar, which put them at risk for blindness, kidney failure, foot amputation, and other complications.
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These people exceeded 6.5% on their hemoglobin A1C test, which is a common test that shows your average blood sugar level over the past two or three months. The American Diabetes Association and the National Institutes of Health recommends keeping yours under 7% to prevent complications, and the AACE recommends under 6.5%.
However, it's not clear if going even lower is better. Government researchers halted part of a 2008 study when patients with type 2 diabetes and a high risk of heart attack and stroke were found to have a higher risk of death when they tried to achieve a hemoglobin A1C of less than 6% compared with those who aimed for less than 8%.
Diet, exercise, and testing blood sugar
While researchers are debating how low is too low, getting hemoglobin A1C lower than 7% is a goal that's attainable, says Elizabeth Hardy, a 47-year-old nurse from Dallas who has type 2 diabetes. She uses a variety of tools to keep her A1C at 5.8%.
She has lost 20 pounds and is trying to lose more; she walks and swims regularly; she carefully "micromanages" her blood sugar with insulin injections. She has even learned to do without one of her favorite foods, potato bread, because it makes her blood sugar zoom up.
"It's controllable. It's not the end of the world. There's a lot that people can do to impact the disease," she says. "Diabetes is one condition where the patient has so much control over the outcome as long as they're provided with the tools."
Although a lot of patients are apprehensive about their ability to change their entire lifestyle, Thigpen notes that it might not be as bad as they think.
"For people who don't come in with that 'silver lining,' we try to give it to them," she says.