What’s the Bottom Line in Diabetes?

You guessed it – it is Blood Sugar Control

Getting good control of daily blood sugars isn’t as easy as it may seem.  Blood sugars are affected by medications, dietary input, physical activity, illness, traveling, stress, and day-to-day living.

We are never 100% in control of all these activities at the same time.  However, they are part of life that changes minute by minute.  People with diabetes are jugglers, needing to try to keep all these aspects of their lives in balance by constantly paying some attention to each of these areas at all times. 

We need to be off balance in juggling these aspects of our lives in order to grow, become more effective and find ways to manage our life more positively.  Making small adjustments one at a time is a way to make small changes that will affect all areas of your life.

For instance, when there is an illness in the family, additional responsibilities at work or unforeseen health issues, it affects everyone.  Our time schedule, eating habits and/or choices, ability to maintain our physical activity, etc are all affected. 

Some people thrive in these situations.  Others become paralyzed by change and uncertainty.

The disruption of your usual schedule can be difficult, or it can be challenging.   We need to look at change as a means to grow as a person and feel accomplished. 

Find a way around the obstacle by planning ahead or adjusting your usual schedule to accommodate the change.  If we can do a little to balance all these aspects of maintaining diabetes control, we will be able to maintain at least partial control.  We may find that the adjustments we make are better than our original schedule.  Prepparing for meals for the week by having everything ready to add to the meal when it is time to cook can help us maintain good eating habits.  Find a park on the way to an appointment and take a short walk.

A reminder of our goals in terms of diabetes:

  1. 1. Blood sugars 80-140 mg/dl all the time (or within reach of this range)
  2. 2. A1C < 6.5%
  3. 3. Blood Pressure < 140/90 mm Hg
  4. 4. Cholesterol <200;  LDL <100
  5. 5. Do some kind of physical activity daily
  6. 6. Annual eye exam
  7. 7. Annual foot exam
  8. 8. Have annual urine test (microalbumin)

Be encouraged to accept change and find a way around it.  Be creative to find a way that works for you.  Don’t lose sight of your goals as a person with diabetes to be in control.

Susan Smith, Ph.D., CDE, is a nationally Certified Diabetes Educator (CDE) and a specialist in the field of diabetes since 1988.  Since 2002 she has worked with patients individually through all of the physicians in internal medicine and family practice at Visalia Medical Clinic. 


Susan Smith, Ph.D., CDE, is a nationally Certified Diabetes Educator (CDE) and a specialist in the field of diabetes since 1988.

Since 2002 she has worked with patients individually through all of the internal medicine and family practice providers at Visalia Medical Clinic. 739-2087

Type 1 diabetes occurs most frequently in children and young adults, although it can occur at any age. Type 1 diabetes accounts for 5-10% of all diabetes in the United States. There does appear to be a genetic component to Type 1 diabetes, but the cause has yet to be identified.

Type 2 diabetes is much more common and accounts for 90-95% of all diabetes. Type 2 diabetes primarily affects adults, however recently Type 2 has begun developing in children. There is a strong correlation between Type 2 diabetes, physical inactivity and obesity. People with Type 2 diabetes may hear their condition described as “mild,” but Type 2 diabetes is not a “mild” medical condition.


Diabetes and foot care

Jeffrey Hagen, DPM, is Board-certified by the American Board of Foot and Ankle Surgery.  He is especially interested in running/athletic injuries, reconstructive foot and ankle surgery and prevention of diabetic complications.

Uncontrolled diabetes causes damage all over the body and can lead to nerve and circulatory damage to the feet and lower legs. In fact, about 73,000 amputations were performed in the U.S. in one year alone due to uncontrolled diabetes.

Dr. Hagen works closely with VMC’s certified diabetes educator Susan Smith, Ph.D. to help patients maintain healthy control of diabetes and avoid complications of the feet. Dr. Hagen is now accepting new patients.


What are the symptoms of diabetes?

  • Blurred vision
  • Unusual thirst
  • Frequent urination
  • Slow-healing cuts
  • Unexplained tiredness
  • Rapid weight loss (Type 1 diabetes)
  • Erectile dysfunction
  • Numbness or tingling in hands or feet

If you experience more than one of these symptoms, make an appointment with your primary care provider.

Symptoms may occur rapidly with Type 1 diabetes; however, with Type 2 diabetes the onset is more insidious and may not be noticed.

How is diabetes diagnosed?

Through a blood test measuring your blood glucose level. Usually these tests are repeated to confirm the diagnosis.

If you are diagnosed with diabetes, what should you do?

  • Request a referral to a certified diabetes educator and/or a dietitian
  • Obtain a prescription for a glucometer and testing supplies
  • Begin to make lifestyle changes
  • Begin an exercise program
  • Decrease portion size
  • Make healthy food choices
  • Limit your intake of concentrated sweets
  • Increase your fiber intake
  • Test your blood sugar at varying times of
    the day