<<Diabetes Home
Diabetes Prevention and Control Program
275 East Main Street
Frankfort, KY 40621
(502) 564-7996
How Diabetes Is Managed
Living with diabetes requires effective self-management of the disease as well as quality care on an ongoing basis by a multidisciplinary health care team. The health care team may consist of a provider responsible for continuing care and skilled in its delivery, a diabetes educator, a dietitian, a pharmacist, and any other health care professionals that may be needed by an individual. The person with diabetes is the most important member of the team. Early detection of diabetes and/or any of its related problems, appropriate professional health care and better education for diabetes self-management can prevent or control diabetes complications.
Management of type 1 diabetes: People with type 1 diabetes need daily injections of insulin because their bodies no longer produce insulin. Treatment includes taking insulin shots or using an insulin pump, making wise food choices, exercising regularly, taking aspirin daily (for some), and controlling blood pressure and cholesterol.
Management of type 2 diabetes: Treatment for people with type 2 diabetes typically includes taking diabetes medicines (if prescribed), making wise food choices, exercising regularly, taking aspirin daily, and controlling blood pressure and cholesterol.
The goal of diabetes management is to keep blood glucose levels as close to a normal range as safely possible, while avoiding blood glucose levels that are too high (hyperglycemia) or too low (hypoglycemia). A 1993 study called the Diabetes Control and Complications Trial (DCCT), conclusively showed that intensive glucose control delayed the onset and progression of eye disease, kidney disease and nerve disease by "a range of 35 to more than 70 percent." In fact, it demonstrated that any sustained lowering of blood glucose helps, even if the person has a history of poor control. This study was conducted by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health.
Taking control of your diabetes can make you feel better and stay healthy.
Complications of Diabetes and
Preventive Care
Heart Disease, Stroke, and High Blood Pressure
Heart Disease is the leading cause of death in individuals with diabetes. Death rates from heart disease are about 2 to 4 times higher among adults with diabetes than adults without diabetes. The risk for stroke is 2 to 4 times higher among people with diabetes. About 73 percent of adults with diabetes have blood pressure that is equal to or higher than 130/80 or take prescription medication for high blood pressure. Studies have shown the importance of reducing cardiovascular risk factors (such as diabetes, high blood pressure, high cholesterol levels, smoking, a positive family history of early heart disease, and the presence of albumin in the urine) to prevent or slow heart disease.
Numbers to Know
| A1c (glucose average) |
Below 7* |
At least twice a year |
| Blood Pressure |
Below 130/80 |
At every visit |
| Cholesterol (LDL) |
Below 100 |
At least once a year |
*An A1C of 7 equals an average blood glucose of 150
Eye Disease and Blindness
Diabetes is the leading cause of blindness in adults aged 20-74 years. Research has shown that early detection and treatment can prevent 90 percent of this blindness. If all people with diabetes received recommended screening and follow-up for eye disease, the annual savings to the federal budget could exceed $470 million. Optimal blood glucose control & blood pressure control can reduce the risk & progression of diabetic eye disease called retinopathy. Diabetic Retinopathy causes 12,000 to 24, 000 new cases of blindness each year.
- Individuals with type 1 diabetes should have an initial dilated and comprehensive eye examination within 3-5 years after the onset of diabetes.
- Individuals with type 2 diabetes should have an initial dilated and comprehensive eye examination shortly after being diagnosed with diabetes.
- Examinations should be repeated annually.
Kidney Disease
Diabetes is the leading cause of end stage renal disease or kidney failure. In 2001, 42,813 people with diabetes began treatment for end stage renal disease. In 2001, a total of 142, 963 people with end-stage renal disease due to diabetes were living with chronic dialysis or with a kidney transplant. Optimal blood glucose control and blood pressure control can reduce the risk and/or slow the progression of diabetic kidney disease.
- Individuals with type 1 Diabetes for 5 years or more should have an annual test for kidney disease.
- Individuals with type 2 diabetes should have an annual test for kidney disease starting at diagnosis of diabetes.
Nervous System Disease
About 60% to 70 percent of people with diabetes have mild to severe forms of nervous system damage. The damage could include decrease sensation and/or pain in the feet or hands, problems with digestion, and other nerve problems. Severe forms of diabetic nerve disease are a major contributory cause of lower-extremity amputations.
- Individuals with diabetes should inspect their feet daily.
- Individuals with diabetes should have an annual comprehensive foot exam (including assessment of protective sensation) by their health care provider and a visual inspection at each routine visit.
Dental Disease
Gum disease is more common among people with diabetes. Young adults with diabetes have about twice the risk of gum disease as those without diabetes. Keeping blood glucose levels near normal may help prevent dental complications.
- Individuals with diabetes should see a dentist every 6 months (or more frequently if gum disease exists).
- Individuals with diabetes should routinely brush and floss teeth.
Complications of Pregnancy
Poorly controlled diabetes before conception and during the first trimester of pregnancy can cause major birth defects in 5-10 percent of pregnancies and spontaneous abortions in 15-20 percent of pregnancies. Poorly controlled diabetes during the second and third trimesters of pregnancy can result in excessively large babies, which poses a risk to both the mother and the baby.
- Women with diabetes should maintain average blood glucose levels (AIC levels) as close to normal as possible before pregnancy occurs.
- Women with diabetes planning a pregnancy should be assisted and treated if needed for diabetes complications such as eye, kidney, nerve, and heart disease.
Influenza and Pneumonia
Individuals with diabetes are at risk for problems resulting from influenza (flu) and pneumonia. The influenza vaccine has been shown to reduce diabetes-related admission to the hospital by about 79 percent.
- All individuals with diabetes 6 months of age or older should have an annual flu shot.
- People with diabetes (age 2 or more) should receive a pneumonia shot.
- A one-time revaccination for pneumonia may be recommended for people older than 65