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Keeping your teeth and gums healthy is very important if you have diabetes. High blood sugar will cause germs to grow and the sticky film that is on your teeth, called plaque (PLAK), will build up, letting even more germs grow. Your gums could become red and sore, and maybe even bleed when you brush your teeth. Smoking makes it more likely for you to develop gum disease, especially if you are 45 years or older and have diabetes.

Red, sore gums are the first sign of gum disease that can lead to periodontitis (PER-ee-oh-don-TYtis) which is an infection of the gums and the bone that holds your teeth in place. If the infection gets worse, your gums may pull away from your teeth, leaving them loose. If you have symptoms of gum disease, call your dentist right away.

To keep your teeth and gums healthy, maintain your blood glucose (sugar) levels as close to normal as possible. Use dental floss once a day. Brush your teeth after each meal and snack. Use a soft toothbrush. Have your teeth and gums cleaned by the dentist at least once a year. Be sure the dentist knows you have diabetes. If you wear false teeth, keep them clean.

Diabetes can affect every part of your body, including your skin. In fact, skin problems are often the first sign that a person has diabetes. The good news is that most skin conditions can be prevented or easily treated if caught early.

When a person has diabetes, he or she can develop bacterial infections, fungal infections, and itchy skin more frequently than people who do not have diabetes.

One of the main culprits in fungal infections is called Candida albicans, which is a yeast-like fungus.These infections often occur in the warm, moist folds of your skin such as between your toes, your armpits, and in the corners of your mouth. If you think you have a fungal infection, call your doctor. You will need a prescription medication to cure it.

Localized itching is often caused by diabetes. It can be the result of dry skin, a yeast infection, or poor blood circulation. You may be able to treat itching yourself by limiting how often you bathe when the humidity is low. Use mild soap with moisturizer, and apply skin lotion after you bathe.

Diabetic dermopathy is caused by changes in the small blood vessels. Dermopathy looks like light brown, scaly patches and are often mistaken for age spots. The patches do not hurt, itch, or open up and require no medical treatment.

Most often, they occur on the front of both legs. Ask your doctor to recommend a skin care regimen that’s right for you.

Your kidneys play an important role in staying healthy. They act as filters to clean your blood. When you have diabetes, there are many things you can do to prevent or slow down kidney damage, which can be the result of high glucose (sugar) levels in your blood.

First, ask your doctor what blood glucose numbers are healthy for you. With that information, you can keep your blood sugar as close to normal through your prescribed treatment plan.

Second, keep your blood pressure below 130/80. That will help prevent kidney damage. It will also slow damage to your heart, eyes, and blood vessels.

Third, have your doctor or dietitian draw up a healthy eating plan for you, and then follow it.

Fourth, have your doctor check your kidneys at least once a year, and have any kidney tests he or she thinks you might need.

Fifth, see your doctor right away if you think you may have a bladder or kidney infection.

Your doctor may prescribe an ACE inhibitor, which is a medicine that helps control blood pressure and prevents your kidneys from filtering out too much protein. Protein, also called albumin (al-BYOO-min), in large amounts is very damaging to the kidneys.

When people with diabetes first begin to have kidney problems, they have no symptoms.

In a person with diabetes, the heart often has to work harder because of high blood sugar. High blood pressure and smoking cigarettes can contribute to heart problems, along with having high cholesterol (fats in your blood) and being overweight. Your heart is a big muscle that circulates blood through your body. Your blood carries oxygen to all of your organs, something that is necessary for life.

How can you prevent heart problems?

• Keep your blood sugar and blood pressure as close to normal as possible.
• Keep your cholesterol and other blood fats as close to normal as possible.
• Take all medications as directed by your doctor. • Ask your doctor if you should take an aspirin every day to protect your heart.
• Eat a healthy diet. You may want to consult a registered dietitian to find out what foods are best for you.
• Don’t smoke. Ask your doctor for help in quitting if you find that you can’t stop on your own.
• Exercise for 30 minutes every day. Ask your doctor for an exercise program that is best for you.
• Tell your doctor right away if you have symptoms of heart problems including shortness of breath, dizziness, pain in your chest, arms or shoulder, trouble talking, or weakness in one arm or one leg.

If you have high blood pressure, your doctor may tell you to take medication to lower it. He or she may ask you to also lose weight, or make other lifestyle changes.

For a person with diabetes, keeping your feet healthy is very important. High blood glucose (sugar) can cause two different kinds of foot problems. One problem is nerve damage and the other is poor blood flow, or circulation.

With nerve damage, you may not feel pain, heat, or cold in your legs and feet. You may not know if you have a sore or a cut on your foot, because you cannot feel it. This lack of feeling is called diabetic neuropathy (ne-ROP-uh-thee) and can lead to serious infections.

Poor blood flow makes it very hard to heal from a sore or an infection. Not enough healthy blood reaches your feet, and this contributes to the lack of feeling.

25% of all hospital admissions for people with diabetes are foot related.

• By taking good care of your feet, you can prevent or manage foot problems. What should you do? The American Diabetes Association suggests you wash your feet in warm water every day, but first check the water with your elbow to make sure it isn’t too hot.
• Look at your feet carefully everyday and check for blisters, sores, redness, or other problems. If you cannot bend over easily, use a mirror.
• If your skin is dry, use lotion after you wash and dry your feet. Never put lotion between your toes.
• Cut your toenails once a week, cutting straight across the top, being careful not to cut the skin. If you cannot cut your own nails, visit a foot doctor. Sharp nails can cause sores and infections.
• Wear shoes that fit well. There are special therapeutic shoes available for people with diabetes. Ask your doctor if you should wear them. Medicare and other health insurance plans may pay for therapeutic shoes.
• Take only the medications your doctor tells you to take.
• Always tell your doctor right away if you start to have foot problems, and have your feet checked at each doctor visit.

There are four different parts to the human eye.

• The Retina (REH-ti-nuh) is the lining at the back of your eye that senses light.
• The Vitreous (VIH-tree-us) is a jelly-like fluid that fills the back of the eye.
• The Lens is at the front of the eye and focuses light on the retina.
• The Optic Nerve is the eye’s main nerve to the brain. High blood sugar causes the blood to “thicken” and makes it harder to push through the tiny blood vessels in your retinas. The blood vessels swell and weaken, and some might become clogged and fail to let enough blood through.

Diabetic retinopathy is the medical term for eye problems. As retina problems get worse, new blood vessels grow in the eyes, but they are weak and leak blood into the vitreous of your eye. The leaking blood keeps light from getting to the retina, and you may see floating spots, or total darkness.

Over time, the swollen and weak blood vessels can pull the retina away from the back of the eye causing you to see floating spots or flashing lights. A detached retina can cause you to loose some or all of your sight. If you think you may have a detached retina, see your doctor right away.

To prevent or slow eye problems, keep your blood sugar and blood pressure as close to normal as possible. Your doctor will tell you what the numbers should be, and if you need to make a change in your treatment plan.

Before having an alcoholic beverage, a person with diabetes should ask three simple questions:

• Is my blood glucose (sugar) under control?
• Does my doctor agree that I am free from health problems that alcohol could make worse?
• Do I know how alcohol will affect my diabetes?

If the answer to all three questions is “Yes,” then it’s okay to have an occasional drink. The American Diabetes Association suggests that you have no more than two drinks that contain alcohol a day if you are a man, and no more than one drink a day if you are a woman.

The reason is that alcohol is a toxin that your liver wants to quickly clear out of your body and your liver won’t release glucose until it’s finished working on the alcohol. The result is LOW blood sugar, also called hypoglycemia.

If you drink more than your liver can process over a period of time, the excess alcohol enters your blood stream and can make you feel very weak, dizzy, or sick. If you take insulin, or oral diabetes pills, the medication is also working to clear glucose from your blood, which is another potential cause of low blood sugar.

Everyone knows the harmful effects that smoking has, but for a person with diabetes it is especially important not to smoke. The good news for those who do smoke is that no matter how long you’ve smoked, your health will improve after you’ve quit.

Smoking damages and constricts blood vessels, and that can lead to foot ulcers, blood vessel disease, and leg and foot infections. It also raises your blood sugar levels which makes it harder to control diabetes. Another good reason to quit is that smoking raises blood pressure and can lead to heart disease. In fact, according to the American Diabetes Association, people with diabetes who smoke are three times more likely to die of cardiovascular disease than are other people with diabetes.

Because nicotine is so addictive, you may want to ask your doctor for help in quitting. There are many methods you can try that will assist you in quitting, and the outcome will be well worthwhile.

What is the HbA1c test, and why is it important in the management of diabetes? The HbA1c test (also called a hemoglobin A1c test) is a simple finger stick blood test that will tell you what your blood glucose (sugar) levels have averaged over the past 2 – 3 months. Daily blood glucose monitoring is also very important, but average blood glucose levels are not affected by the time of day or food you’ve most recently eaten. They give you an overall picture of your glucose control and will tell you and your doctor if you should make changes in your treatment plan.

Your HbA1c test results are reported as a percentage. It is the percentage of hemoglobin in your blood that has sugar attached. The higher the percentage, the higher your average blood glucose level has been for the past 2 –3 months. According to the American Association of Clinical Endocrinologists (AACE), the target HbA1c level for most people with diabetes should be as close to 7% as possible. The problems associated with diabetes are greatly reduced for those who maintain an HbA1c of 7% or less.1, 2 If your result is 8% or higher, your doctor may want to change your treatment plan so that you can have better blood glucose control.