SIDE EFFECTS OF DRUGS FOR DIABETES

In most cases, people with type 2 diabetes use oral medications to control their blood sugar. These drugs along with a plan of healthy eating and physical activity, help to keep diabetes under control. 

There are several types of medications available. Each works differently. Many people take two or three types of pills, as it has been found that in some cases, a combination of drugs works best, but that depends on the patient. Some people take a medicine that combines two types of drug in a tablet. In some cases it is necessary to take both pills and insulin administered.

Your doctor will probably ask you to try a type of pill to determine if you get results or not. Depending on the results it may be that:

You need to take more of the same medicine

You have to take two different drugs

Your doctor may prescribe a different medicine

Needed insulin

WARNING: IF YOUR DOCTOR PRESCRIPTION TE INSULIN DOES NOT MEAN THAT YOUR DIABETES IS WORSE.

Side Effects

You've probably heard this term and are worried or confused about whether your medications may cause a problem in your body. A side effect is a problem caused by a medicine. Most drugs brings adverse effects or discomfort from your intake, for example, some medicines for diabetes can cause nausea or upset stomach when a person starts to take them.

Usually, the side effects of medications for diabetes are not serious and not common, so if you feel bad at some point you can talk to your doctor about it to find a solution or another form of treatment.

IT IS IMPORTANT TO NOT LET YOU TAKE YOUR MEDICINE WITHOUT CONSULT YOUR PHYSICIAN BEFORE.

The side effects of oral medications for diabetes may include the following:

Nausea and vomiting

Diarrhea

Gas and bloating

Decreased appetite

Headache and muscle pain, or only the latter

Flu or cold-like symptoms

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Ways to Control Diabetes

There are different ways to control diabetes: drugs, care, diet, controls, etc. Effective treatment of diabetes depends largely on the daily management of the disease.

Living with diabetes requires you to take an active role in their health care. This includes carrying out daily checks of blood sugar, meal planning, and for some, applied insulin injections.

Control Blood Sugar

Controlling blood sugar should be done several times a day and is a key factor in diabetes management. The process is simple:

The patient takes a small drop of blood (usually fingertip pricked) and dropped onto a strip of special paper.

The paper changes color according to the amount of glucose that contains blood.

It is compared to a table on glucose levels.

To obtain a more accurate measurement, the drop of blood can be placed in a measuring blood sugar. The result appears on the monitor screen. Most diabetic supply stores have a variety of gauges.

Nobody enjoys to prick your finger four or five times a day, so researchers are trying to develop less painful ways to control blood sugar. New techniques include the use of ultrasound to measure the sugar without hurting the skin. Early clinical studies in this area have yielded promising results.

The Food of the United States and Drug Administration (FDA) has approved a device shaped wristwatch to measure blood sugar called GlucoWatch®. By electronic stimulation blood sugar extracted through the skin to measure. However, this device does not completely prevent the need for finger prick.

Care and Diet for Diabetes

Understand how accurately measured the levels of blood sugar is vital for the proper treatment of diabetes. Every three or four months you can make a glycosylated hemoglobin test. This test measures the efficiency with which the patient has controlled its own level of blood sugar over the past three months. If the results and events of the past few months (eg, stress, diet, alcohol consumption) review, you can create a program customized diabetes management for each patient.

Getting used to a diet for diabetes can be difficult. Because diabetes is a disorder of blood sugar, food is an important to keep diabetes under control factor. Consult a nutritionist to develop a diet that includes foods for diabetes. Read the labels of foodstuffs for the content of calories, fats and carbohydrates. Invest in a good cookbook for diabetics to help control food consumption.

How to Fight Diabetes

Insulin is a hormone produced in the pancreas, which is necessary for the cell to extract energy from sugar in the blood. Without it, the cells cannot produce energy and the body cannot regulate blood sugar levels.

For diabetics type 1 (insulin-dependent), injections provide this vital hormone and are available in different formats. Some brands of fast acting insulin, but only remain in the blood stream approximately one hour. The long-acting insulins may remain in the blood for 10 to 12 hours. Many people use more than one type of insulin as the body's needs.

Medications for Diabetes

In general, type 2 diabetics do not need injections. In many cases, diet and exercise are sufficient to achieve a level of proper blood sugar. Some type 2 diabetics need to take pills to help the body metabolize sugar. In more severe cases of type 2 diabetes, you may need insulin injections as the disease progresses.

If the doctor thinks your condition warrants it, you may be prescribed medication to help control high blood sugar. Rosiglitazone (Avandia tradename) drug, for example, reduces the insulin resistance. Avandia increases the sensitivity of cells to insulin. Thanks to this, the body use insulin more effectively available, and so the cycle is interrupted resistance.

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Diabetes Care

The diabetes care from the point of view of natural health emphasizes a diet with whole grains, no refined sugar products, although a little honey can be accepted.

According to natural medicine, the diabetic should eat 80% raw food for quick and complete recovery.

If you have diabetes you should know that it is important to avoid sugar spikes so it is recommended to stick as closely as possible to these dietary guidelines:

- Eat plenty of vegetables especially peas and beans that are rich in silicon and also rich in certain hormones that have an insulin-like performance.

- Eat cucumber, garlic and onion to reduce the level of blood sugar because they contain natural hormones needed by the pancreas to produce insulin.

- Eat Nopal, either cooked or raw as this cactus leaves contain organic natural insulin.

- Before breakfast take a daily liquefied nopal (half of a leaf or an entire sheet if the variety chambray) with a xoconostle (a type of tuna) and a glass of water, you can add the juice a lemon and a slice of apple or a slice of pineapple.

- Alfalfa is highly recommended either in smoothies, tea or supplement.

- It is also important to include celery, watercress, parsley and artichokes in your daily diet.

- Prefer to start the meal a hearty salad of raw vegetables.

- Contrary to what is usually recommended diabetic it can and should eat fruit because although carbohydrates are complex carbohydrates that contain fructose (fruit sugar) and insulin to metabolize not needed. You can even consume grapefruit and banana for its high content of potassium, essential for the diabetic.

- Diabetic person should do several small meals throughout the day (instead of the traditional 3 meals) at intervals not exceeding 3-4 hours to keep your sugar levels under control.

- Do not eat simple carbohydrates found in refined flour (such as cakes, sweet bread, flour tortillas, white bread, donuts, cookies, etc.).

- If you eat carbs, prefer cereals like oatmeal or whole wheat, legumes such as beans, peas and lentils especially.

- With each food take 3 almonds or walnut halves 3 natural.

- Avoid soda, coffee, alcohol and snuff.

Other complementary therapies recommended:

1. Start by doing daily exercise as much as your personal status permits and go increasing your fitness until you can do at least 1 hour of exercise that includes aerobic exercise (at least 30 minutes), stretching exercises (15 minutes) and 15 minutes of resistance exercise to build muscle mass.

2. Perform skin brushing dry for a few minutes before bath as in diabetic improve circulation is extremely important.

3. Every day if possible, take a steam bath or sun.

4. Perform a weekly intestinal wash for a month.

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Diabetes-Ignorance is Not Bliss

You would think that something as serious as diabetes would generate enough interest for folks to have just a little knowledge about it. Apparently not!

In a recent survey conducted by Harris Interactive for Medtronic, Inc., they found that 67 percent of people incorrectly believed a cure existed for type 1 diabetes. 

The survey also showed that nearly 80 percent of U.S. adults don't know the difference between type 1 and type 2 diabetes.

Type 1 Diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells that make insulin, a hormone that regulates blood glucose. About 1 million Americans with type 1 diabetes are insulin dependent for survival.

Only half (fifty-one percent) of the survey respondents knew there were two types of diabetes. Type 2 diabetes is non-insulin-dependent diabetes. It appears mostly in older adults, but it's on the rise in younger adults due to the exploding obesity rate in the United States. Type 2 diabetes accounts for 90-95% of all diabetes cases in the U.S.

This is particularly disturbing in light of the fact that 90 % of type 2 diabetes can be prevented or reversed but can only happen if people have the knowledge of how to do it.

In the information age it seems appalling to me that so many people are ignorant of this disease which ruins so many lives not only in the United States but throughout the world.

Particularly in the case of diabetes, knowledge is the key to controlling the disease and prevention and reversing the disease as well. The drug companies and medical community needs to step up and do a better job of educating our misinformed public.

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What is Glycemic Index?

Glycemic index (GI) is a measure that ranks carbohydrate foods how quickly and intensely they will affect your blood sugar when you eat these foods. The underlying concept of the glycemic index is that different foods take different times to break up in the digestive process and release sugar into the bloodstream; some foods are quick-absorbing and break up quickly, while others are slow-absorbing and take a longer time to be digested.

The foods that break up quickly as sugar into the bloodstream have a high and foods that absorb slowly have a lower GI. 

Generally, high GI foods raise blood sugar more quickly and more intensely than the low GI foods. Because carbohydrate is the only group of foods that causes maximum rise of blood sugar (protein and fat do not directly affect blood sugar), GI has been developed for carbohydrate foods only. 

Even different foods under the carbohydrate group have different ratings on the GI because they vary in the speed in which they release sugar into the bloodstream. Carbohydrate foods that are coarse, unrefined, and contain fiber have a lower GI than their refined varieties. 

A whole wheat bread, for example, has a lower GI than a white bread made of refined flour. Because fat slows down the absorption of food into the bloodstream, carbohydrate foods, containing high content of fat, take longer time to be absorbed in the blood and are stated to have a low GI. (But foods with high fat content may be harmful.) 

Diabetes- The Complications

As I said at the outset early on you may not even know you have the disease and if you do know it seems so trivial so it is easy to ignore. But diabetes affects nearly every vital organ in your body Once you have been diagnosed with diabetes your fight has just begun. Poor blood sugar control can lead to many nasty complications. Here are the most serious: • Male impotence- say goodbye to your love life. Impotency is almost a certainty. • Kidney damage- Diabetes is the leading cause of kidney disease because the kidneys are working overtime to stay on • Nerve damage especially in the extremities of hands and feet. You don't want them to go numb.   • Heart disease and stroke. Heart disease is the leading cause of death in diabetics. • High blood pressure • Eye trouble- Diabetes is the leading cause of new cases of blindness in adults 25-75 • Pregnancy problems- During the later stages of pregnancy out of control blood sugars can lead to birth problems for both mom and child. • Infections and other illnesses - high blood sugars make it more difficult to recover from infections and other illnesses. Do we have your attention yet as to the seriousness of this disease? Photo Credit : Flickr.com

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The Positive Impact of Exercise

Exercise is an important part of getting control of Diabetes-the goal of everyone with the disease. Exercise while important for everyone, doesn't have the same impact on type one diabetics as it does on type 2 diabetics. 20 minutes a day can do wonders. Over 90% of the 21 million Americans who have diabetes have type 2 Diabetes.  Type 2 Diabetes is characterized by the pancreas not producing enough insulin to control glucose levels. When a cell doesn't respond to insulin it is insulin resistance. When a patient is diagnosed with Type 2 Diabetes, weight loss and diet are the usual suspects to gain control of the problem. If that fails medication is usually prescribed.  Inactivity, being overweight or obese, hypertension, high cholesterol, and coronary artery disease are all markers pointing to diabetes. Inactivity as you may well imagine leads to being overweight. The image of a couch potato comes to mind. 20 minutes a day can do wonders. Exercise impacts diabetes in several ways. First, strenuous exercise leads to weight loss given all other things being equal. Exercise causes the body to process glucose faster which lowers blood sugars. Exercise helps build muscle tissue which burns calories even when you sleep. 20 minutes a day can do wonders. Exercise helps keep you limber which is very important as you grow older. Exercise helps lowering stress and increasing blood flow. Exercise will lower your cholesterol and blood pressure too. 20 minutes a day can do wonders. For anyone who doubts this try a good little workout in the morning and tell me how you feel. Weight training for me actually works best followed by a nice twenty minute walk.   But it doesn't have to be in a gym, housework, yard work, playing with your kids, washing the car, anything that gets your heart rate up. And it doesn't even have to be in one stretch, break it up into two ten minute sets. 20 minutes a day can do wonders. Everyone should check with their physician prior to an exercise program. If you're trying to lose weight, a combination of physical activity and wise food choices can help you reach your target weight and maintain it. All of these benefits can be yours even if you haven't been very active before. 20 minutes a day can do wonders.   Photo Credit : Flickr.com

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Research: Affect of alcohol on diabetes

Affects of alcohol, beer, wine, drinks on diabetes.

Alcoholic drinks include distilled spirits: beer, brandy, gin, rum, vodka, whiskey, and wine. The alcoholic content of distilled spirits is expressed in “proofs”. One proof equals 0.5 percent of alcohol. The distilled spirits are usually in 80 proof strength, which is 40 percent alcohol. Excessive intake of alcohol, over time, increases the risks for heart disease, nerve, liver, heart, brain, and kidney damages, breast cancer, and birth defects during pregnancy. In addition, excessive intake of alcohol is a strong risk factor for high blood pressure. 

However, some modern studies have shown that moderate intake of alcohol reduces the number of deaths from heart disease and helps increase life expectancy. This gain is derived probably because alcohol intake raises HDL (good) cholesterol and decreases stickiness of blood platelets (clotting), thereby decreasing the risk for heart disease and stroke. 

One of the recent studies that found alcohol consumption beneficial for heart health has been published in the New England Journal of Medicine (January, 2003). Key findings of this study are:

Alcohol consumption lowers the risk for heart disease.

The heart health benefit of alcohol is linked to the frequency of drinking. As compared with men who consume alcohol less than once per week, men who consume alcohol 3-4 or 5-7 days per week have decreased risks of heart attack even if the amount of alcohol consumed per drink is small to moderate. (A single alcoholic beverage contains 11.0 to 14.0 grams of alcohol.)

Stickiness of blood particles, and the resulting risk of blood clotting decreases in moderate drinkers than those who do not drink.

Of all the alcoholic beverages, beer and liquor offer the maximum protection against heart attack. Consumption of red and white wine, on the other hand, shows weaker heart protective effect.(This finding is contrary to the previous belief that wine was superior in reducing the risk of heart disease.) 

Frequency of alcohol consumption is heart protective mainly in men 40 years or older, and women aged over 55 years.

Although the above study and other studies also found alcohol consumption heart protective, the fact remains that even a moderate use of alcohol may be risky for many people having some preexisting health problems such as liver damage and diabetes. In diabetes, in particular, alcohol consumption may lead to a severe fall in blood sugar that may become life-threatening:

When you drink alcohol, your blood sugar tends to fall. The reason is that alcohol is rapidly absorbed into the bloodstream and the liver becomes engaged in clearing it from the blood. During this process, the liver stops its normal activity of releasing sugar in the blood from its glucose reserve (glycogen). As a result, the amount of sugar in the blood decreases and it can fall to dangerously low levels if you take alcohol in a large amount or on an empty stomach. When your stomach is empty, your blood sugar may already be running low and drinking alcohol on the empty stomach may further drop your blood sugar level.

Alcohol consumption may lead to low blood sugar unawareness, a dangerous condition in which you may not even feel the symptoms when blood sugar is falling. Also, drinking alcohol in a large quantity during the peaking effect of your diabetes medication may lead to a severe fall in your blood sugar. Such a situation may end up in a coma.

Because alcohol takes time to be fully cleared from your system, the risk of low blood sugar continues long after you have taken an alcoholic drink.

In addition, if you already eat a healthy diet, you are likely to gain excess weight by consuming liquor that provides mere calories without nutrition. Unhealthy weight leads to increased risk for heart disease and stroke. 

Because the use of alcohol is linked to unpredictable risks, no person should start drinking or increase alcohol consumption. After all, as the Centers for Disease Control and Prevention (CDC) points out, 45 percent of adult Americans do not drink any alcohol at all, and compared to 50 years ago, fewer Americans drink alcohol today. 

The Dietary Guidelines for Americans, 2005, suggest that adults, if they choose to drink alcohol, may do so sensibly and only in moderation, which means one drink per day for women, and two drinks per day for men. One drink equals 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirit.

Who should not drink alcohol?

Alcohol, should not be consumed by:

• People who cannot resist excessive drinking
• Women of childbearing age who are or may become pregnant
• Breast-feeding women
• Children and adolescents
• People taking medications that can react with alcohol
• People with specific medical conditions that may become worse by alcohol intake

Alcohol critics point out that the heart protective benefits derived from alcohol consumption can be achieved by more preferable methods. HDL (good) cholesterol, for example, can be increased by regular exercise. And daily use of a baby aspirin, through its anti-clotting action, can dramatically cut the risk for heart attack in most people. 

Because the use of alcohol is linked to unpredictable risks, especially in people with diabetes, these people should drink alcohol only if they are allowed by their doctors.

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The Amazing Diet-Not for Diabetics Alone

I have actually known about this for a long time. Only today did it come to me as one of those 'AHA' moments you read and hear about. They feel so good. I am going to call it THE Amazing Diet-because it is. It is truly revolutionary.

I need some marketing help with it. Any volunteers? I am convinced it will make me famous, rich, and maybe even lose some weight. After all isn't that the idea of a diet?

Some background if you will. I knew someone who was a very big part of my life for 14 years. She had every diet book ever written and maybe some still on the drawing boards I don't know. On top of that she had probably 4-6 pieces of exercise equipment maybe more because when she ran out of room for them she would put them in storage.

She had very good intentions. That is where it ended. She hadn't even read most of the books. She barely used the exercise equipment-little or not at all. When I met her she was a big boned person who over the years gained weight like all Americans. A sedentary lifestyle and some bad habits will do that. 

She loved chocolate-don't we all? She loved her desserts daily. Other than that she ate a very healthy diet-fresh fruits, veggies, chicken, seafood-good stuff. But she ate and ate.

She couldn't understand why she gained weight. I told her my soon to be revealed secret diet, THE Amazing Diet. She laughed at me and told me I was nuts. I am not nuts. 

I am a diabetic and have been for the better part of 15 years or so. For diabetics and soon to be diabetics (you may or may not know who you are) being overweight and/or obesity is the number one risk factor for developing the disease which affects 21 plus million Americans and is fast becoming a worldwide epidemic.

For diabetics watching weight is a much more serious issue than how you look. It is about life and death-pure and simple. 

I have struggled with weight most of my life. I spent over half of it in the food biz and have weak will power. I have tried a few diets: Atkins, see food, popcorn etc. and none of them worked for me. Then it came to me one night years ago. Here it is revealed for the first time.

IF YOU BURN MORE CALORIES THAN YOU TAKE IN YOU WILL LOSE WEIGHT. 

Only today did I get the enormity of it all. THE Amazing Diet is born. Here are the principles of it.

1. EXERCISE 30 minutes a day at least 5 days a week. Walking is okay. Try the magic number of 10,000 steps. Check with your doc first.

2. WATCH what you eat. And I don't mean with one eye either. Low fat, high fiber, fresh fruits and vegetables. I love salmon. Chicken is good too. Just not KFC. I go off the wagon occasionally just to prove I am human.

3. DRINK lots of water. 8-10 8 oz glasses seems to be the consensus. I am going to invent a device like a backpack with a flexible straw that you can strap on your back and wear 24/7 just to get your daily allowance.

4. THROW all the diet books and diet pills away. THEY DON’T WORK AMERICA. Next to bottled water it is the biggest scam perpetrated on the public.

5. VERIFY this with your doctor. Don't take my word for it. Who am I to tell you how to lose weight? If he says yes then you can thank me and send money.

Follow this diet and you will lose weight and if you don't have diabetes you will avoid it. If you do have it you will be happily in control of it.

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Dizziness and Diabetic Retinopathy (complications with eyesight)

Dizziness and changes in vision (eyesight) are symptoms of diabetes complications

Dizziness from Low Blood Pressure. Contraction and expansion of the blood vessels regulate the flow of blood. When the autonomic nerves controlling contraction and expansion of the blood vessels are damaged, the blood does not flow as it should. 

In such a condition, if for example, you suddenly rise from a lying position to a standing position, the vessels will not contract with sufficient force to supply the added amount of blood you need on rising, and your blood pressure will fall causing dizziness. This is a form of low blood pressure called orthostatic hypotension which causes dizziness and can cause one to faint.

Diabetic Retinopathy (EyeSight Effected). The damage caused to the blood vessels in the retina due to diabetes is called diabetic retinopathy. It is a degenerative disease of the retina and the most frequently occurring eye disease in people with diabetes. More than 5.3 million adult Americans are affected by diabetic retinopathy.

Over time, raised blood sugar levels injure the blood vessels of almost all the organs in your body. When this damaging process occurs in the retina, the tiny vessels supplying blood to the retina become weak and tend to break. 

This process damages the retina and affects the eyesight. Almost all people with type 1, and more than 60 percent of people with type 2 diabetes have some degree of eye damage during the first 20 years of diabetes. Eye damage from diabetes is a leading cause of blindness in adult Americans, and it is estimated that it makes nearly 24,000 people blind every year in the United States. 

However, what is interesting is that about 90 percent of the cases of blindness related to diabetes can be prevented by timely diagnosis and treatment of diabetic retinopathy.

Diabetic retinopathy is of two forms: nonproliferative and proliferative.

Nonproliferative Diabetic Retinopathy (NPDR). When persistently raised blood sugar levels injure tiny blood vessels of the retina, the area around each injury on the tiny vessel swells like a pouch, which is called a micro aneurysm. These pouches fill with blood and fluid, a condition that may resolve over time, remain unchanged, or cause leakage in the retina. 

Leakage of blood (hemorrhage) and fluid (exudates) in the retina leads to blurring of vision (eyesight). Sight, however, is cleared in several weeks or months. When the doctor examines the affected eyes, the pouches will appear as tiny yellow patches and the hemorrhages look like dots and blots. 

However, NPDR, which is also called background retinopathy, is not sight threatening. For most people, retinopathy may not progress beyond the background stage. But when the leakages occur and collect in the macula, the macula swells. Swelling of the macula is called macular edema that may cause sight loss.

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Diabetes-Conventional Treatment

Controlling your blood sugar is the most important goal of any type of diabetic on any kind of treatment. It is essential to feeling healthy and avoiding long-term complications of Type 2 Diabetes. Some people are able to control their blood sugar with diet and exercise alone. Others may need to take medications, in addition to making lifestyle changes. In either case, monitoring your blood sugar is a key part of your treatment program. You may need to test your blood sugar levels only once a day or as little as twice a week. Remember that the amount of sugar in your blood is constantly changing. Self-monitoring keeps you on top of the problem and should be done regularly.  Factors that affect your blood sugar include: Food. Food raises your blood sugar level; what and how much you eat, and the time of day, also affect your blood sugar level.  Exercise and physical activity. The more active you are, the lower your blood sugar. Physical activity causes sugar to be transported to your cells, where it's used for energy. Medications. The purpose of oral diabetes medications is to lower your blood sugar. But medications you take for other conditions may affect glucose levels as well so consult your pharmacist or physician.  Illness. The physical stress of a cold or other illness causes your body to produce hormones that raise your blood sugar level. Monitor your blood sugar more frequently when ill. Alcohol. Alcohol drives blood sugar levels sky high. If you drink make sure you know how your body reacts to it. Diet. You already know the foods you like. You need to learn the foods that are good for you and that your body will tolerate. The easiest way is to consult with a dietitian at a local hospital or get a book at the library and follow the guidelines. Your dietitian may recommend developing your meal plan based on the dietary exchange system, carbohydrate counting or the glycemic index. Being consistent and being true to the principles of the diet are key. It doesn't have to be boring. Exercise. As with any exercise program always talk to your doctor before you begin. Walking, hiking, jogging, biking, tennis, cross-country skiing and swimming are all good choices for anyone especially diabetics. Combine your aerobic activity with stretching and strength training exercises and remember to start slowly and build up time and intensity. Healthy weight. Fat makes your cells more resistant to insulin. But when you lose weight, the process reverses and your cells become more receptive to insulin. For some people with type 2 diabetes, weight loss is all that's needed to restore blood sugar to normal. A modest weight loss of 10 to 20 pounds is often enough. Medications. If diet, exercise and maintaining a healthy weight aren't enough, you may need medication. Various drugs may be used to treat Type 2 Diabetes.  Glucose monitoring. Keep blood glucose levels as close to normal as possible. Eat healthy, exercise and monitor your blood sugars. Once you learn to measure your blood sugar and understand how important it is, you'll feel more comfortable with the procedure and more in control of your disease. Testing is crucial because it tells you whether you're keeping your glucose levels in the range you and your doctor have agreed on. The ideal target range before meals is 90 to 130 mg/dL, and below 180 mg/dL two hours after meals.

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Diabetes-Who Is In Charge

Your health care team and you need a team of pros working together to provide support and professional advice, but it's up to you to follow through. As they say in the Navy "you have the con" or something like that. Make a commitment to managing your diabetes. Learn all you can about Type 2 Diabetes. Ask your health care team for help if your best efforts aren't enough to control your blood sugar.  Schedule a yearly physical. It's important to have a thorough physical exam every year in addition to your regular diabetes checkups. Check for complications of diabetes and screen for conditions such as cardiovascular and kidney diseases.  Schedule a yearly eye exam. Make sure your eye care specialist knows you have diabetes. He or she should check for signs of retinal damage and cataracts and test you for glaucoma.  Take good care of your teeth and gums. People with type 2 diabetes are prone to gum infections. Brush and floss your teeth at least twice a day, and schedule twice-a-year dental cleanings.  Keep your vaccinations current. Because high blood sugar can weaken your immune system, you may be more likely to get influenza or pneumonia. Get a yearly flu shot and vaccinations for pneumonia and hepatitis B.  Take care of your feet. Diabetes can damage nerves in your feet, which reduces your ability to feel pain. You may develop a cut or other injury without realizing it. And because diabetes reduces blood flow to your feet, it's harder for sores to heal. To help prevent foot problems, check your feet every day for blisters, cuts, and bruises, cracked or peeling skin, and redness or swelling. Don't smoke. People with diabetes who smoke are three times as likely to die of cardiovascular disease or stroke as are nonsmokers. Smoking also increases the risk of nerve damage and kidney disease. Talk to your doctor about ways to quit smoking.  Avoid alcohol. Alcohol prevents the release of glucose from your liver and can increase the risk of your blood sugar falling too low. If you drink alcoholic beverages, do so only in moderation. It also helps to eat first.  Take a daily aspirin. Taking an aspirin every day after age 40 may reduce your risk of heart attack. There are risks too so talk with your doctor to make sure aspirin is safe for you and, if so, which strength you should take.  Monitor your blood pressure. If you have diabetes, you're twice as likely to develop high blood pressure as you'd be if you didn't have the disease. The risk for blacks and Hispanics is even higher. The combination of diabetes and high blood pressure is serious because both conditions can damage your blood vessels, increasing your risk of heart attack, stroke and other life-threatening conditions. The blood pressure goal for most people with diabetes is less than 130/80 millimeters of mercury.  Monitor your cholesterol. Unhealthy levels of cholesterol and triglycerides can cause cardiovascular disease in anyone, with type 2 diabetes or without. But as with high blood pressure, the damage is usually worse and more rapid when you have diabetes. Your targets: LDL below 100 milligrams per deciliter (mg/dL) — perhaps as low as 70 mg/dL if you have other heart disease risk factors; HDL 60 mg/dL or above; triglycerides below 150 mg/dL. Learn to manage stress. Constantly dealing with stress can make it more difficult to take care of yourself and manage your diabetes. You may find yourself eating all the wrong foods or forgetting to exercise or take your medications. And prolonged stress can cause your blood sugar levels to rise even if you stick to your diet and medication plan. To manage stress, consider techniques such as yoga, meditation, tai chi or deep-breathing exercises.  Do your best to stay positive. Diabetes is a serious illness, but it can be controlled. If you're willing to do your part, you can continue to enjoy an active and healthy life.

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