Elevate Your Health Colorado: Your Health Information Resource

Diabetes is a systemic condition that begins in the pancreas and has the potential to affect many other parts of the body – from eyes to heart to feet. Because the effects of diabetes can be far reaching, research shows a comprehensive disease management approach works best.

“A comprehensive approach helps patients gain greater control over their diabetes and helps prevent long-term complications,” says John Merenich, MD, FACP, board-certified internal medicine physician, endocrinologist, and co-director of population and prevention services with Kaiser Permanente Colorado. For example, patients may work with a dietitian to develop healthy eating habits, receive frequent blood pressure and cholesterol screenings, participate in smoking cessation classes, and get annual flu shots.

To take charge of diabetes before complications arise, Dr. Merenich recommends the following:

1. Eat better and exercise more. “I don’t recommend short-term diets, because they tend to offer short-term results,” Dr. Merenich says. Instead, he encourages long-term eating habits that emphasize natural foods, such as fruits and vegetables, and eliminate sweets, soft drinks, and highly processed foods, such as refined carbohydrates and fats. He also recommends at least 30 minutes of moderate exercise five times a week, which helps the body reduce blood pressure and respond better to insulin.

2. Live a “therapeutic lifestyle.” “Stress produces cortisol, a stress hormone that contributes to insulin resistance and increases glucose levels in the blood,” Dr. Merenich explains. He encourages people to learn to recognize and manage stressful situations positively. He also recommends a “therapeutic lifestyle,” which includes adequate sleep, eating three well-balanced meals a day, and making time for enjoyable activities.

3. Improve your numbers. According to the American Diabetes Association (ADA), consistently healthy levels for blood sugar, blood pressure, and cholesterol may result in these and other benefits for people with diabetes:

• Every percentage point drop in hemoglobin A1C levels may reduce the risk of eye, kidney and nerve disease by 40 percent.
• Good blood pressure control reduces the risk of heart disease and stroke by as much as 50 percent.
• Improved cholesterol (especially improving LDL levels) may reduce cardiovascular complications by up to 50 percent.

4. If you smoke, quit. Smoking is especially dangerous for those living with diabetes because it can damage the large blood vessels responsible for carrying blood to and from the heart as well as smaller vessels, which reach the kidneys, nerves, and eyes.

5. Focus on prevention. People living with diabetes should get an annual flu shot to guard themselves against illnesses that can cause dehydration, which can make them susceptible to dangerously high blood sugar levels. The ADA has also found the following benefits when kidney, vision, and foot damage is detected and treated early:

• Treating early diabetic kidney disease can reduce the decline in kidney function by 30 percent to 70 percent.
• Early detection and treatment of diabetic eye disease may reduce the risk of severe vision loss by about 50 percent to 60 percent.
• Diabetic foot care programs can reduce amputation rates by up to 85 percent.

“Over time, some patients may develop complications from diabetes that affect their cardiovascular system, nerves, kidneys, or eyes,” Dr. Merenich says. “Thanks to the comprehensive disease management program at Kaiser Permanente Colorado, we offer patients the necessary help to delay or prevent these complications. But should they occur, patients have access to any specialists they may need right here in our system. The entire team can also access patients’ electronic medical records, and communicate electronically with one another on patients’ behalf.”

Kaiser Permanente Colorado also uses the comprehensive program to offer outreach classes to help patients quit smoking, control cholesterol, lose weight, and manage blood sugar levels, even if they are currently free from complications. Online tools provide information about healthy eating and how to achieve a healthier weight.

To learn more about tips to manage your diabetes, visit KaiserPermanente.org. 

Dr. Merenich received his medical degree from Hahnemann University in Philadelphia and performed his residency and fellowship at Fitzsimons Army Medical Center. He is board certified in internal medicine with subspecialties in endocrinology and metabolism.