TakeCHARGE - Excellus BlueCross BlueShield

Transcription

TakeCHARGE
Community Health Reports
Personal actions for better health
Diabetes
A nonprofit independent licensee of the BlueCross BlueShield Association
Are we taking charge of our own health?
Most of us know that proper car maintenance is necessary to assure that our vehicle runs well and lasts a long time.
We take responsibility for that by periodically changing the oil, installing new filters and rotating the tires.
That same sense of responsibility applies to our own personal health. We know that routine “maintenance” –
including getting moderate exercise, eating a healthy, well-balanced diet and avoiding known health risks –
will keep our “engines” running well.
In 2004, Excellus BlueCross BlueShield introduced StepUp, an online tool to encourage upstate New Yorkers to
get daily physical exercise and eat healthy meals, the foundations for better health. Since then, StepUp has helped
64,000 registered users to log more than 18 million miles and 14 million servings of fruits and vegetables.
Many of us have health conditions – such as diabetes or heart disease – stemming from our genes, past behaviors
or other circumstances. If you do, your doctor will recommend steps you can take to manage the condition.
In addition to staying active and eating a well-balanced diet, other actions may be as simple as regularly taking
your medicines or scheduling more frequent medical appointments.
By taking those additional steps, we assume greater personal responsibility for staying as healthy as possible.
Actively managing our health can add years to our lives, improve our quality of life and save us the time, effort
and money that go with treating more serious health conditions that can be prevented. When we don’t take
responsibility, our overall health is likely to suffer, our lives may be shortened, and we may contribute to the billions
of dollars spent on health care that could be avoided.
Excellus BlueCross BlueShield has introduced this series of proactive health reports to examine various health
conditions and highlight surveys in which people indicate what they’re doing – and not doing – to take charge
of their health.
We recognize that when people respond to health surveys, some may report taking better care of themselves than
they really do. Similarly, physicians commonly report that some patients exaggerate how closely they follow their
doctors’ health advice. That’s why the survey-based measures reported here may overstate how well people actually
care for their health.
The goal of these reports is to help readers understand the important connection between personal actions and
better health. We want to encourage productive discussions within families, strengthen patient and physician bonds
and prompt initiatives for healthier workplaces, all of which can improve our community’s overall health.
About diabetes
• Diabetes (also called “sugar”) is a serious health condition where the body does not produce or properly use
insulin to digest sugar (glucose). As a result, one’s blood sugar level becomes too high.
• There are different kinds of diabetes. Type 2 diabetes, the most common kind, usually strikes after age 40 and
can be influenced more by lifestyle than type 1. Type 1 diabetes usually strikes children and young adults and
is less preventable than type 2 because it is mostly genetic (inherited).
• There is no single cause of diabetes. Known risks for getting type 2 diabetes include age, obesity, unhealthy diet,
physical inactivity, family history of diabetes or having diabetes when pregnant, and race/ethnicity.
• The diabetes rate in upstate New York has been rising. Between 2001 and 2009, the rate among upstate
New York adults rose by more than 30 percent, from 6.5 percent to 9.4 percent. As of 2009, about 359,000
upstate New York adults reported having been diagnosed with diabetes. An additional 222,000 people
(5.8 percent of upstate New York adults) stated that they had pre-diabetes or borderline diabetes, a condition
where blood sugar is above normal. People who have pre-diabetes are more likely to develop diabetes than
those who don’t have this condition.
• Almost one-third of upstate New York adults who reported having diabetes (29.4 percent) described their
condition as severe enough to require treatment with insulin.
•The aging of the population and an increase in lifestyle factors, such as poor diet, physical inactivity and
overweight/obesity are likely key contributors to increasing diabetes rates over the past decade.
• Diabetes causes severe health problems. Over time, high blood sugar levels damage many parts of the body,
such as the blood vessels, heart, eyes and kidneys:
– Heart disease and stroke (cardiovascular disease), our nation’s leading killer, affected 94,000 upstate
New York adults who reported having diabetes, four times the cardiovascular disease rate among those
who reported not having diabetes.
– Eye disorders, including blindness, are much more common among people with diagnosed diabetes
compared to those who do not have this condition. About one in five upstate New York adults who reported
having diabetes (72,000 adults) also reported having been told that the disease had affected their eyes, or
that they had retinopathy (damage to the retina, the inner lining of the back of the eye). Retinopathy from
diabetes is the leading cause of blindness in American adults.
– Kidney damage can lead to the need for treatment with dialysis or kidney transplant.
– Nerve damage, combined with poor circulation, can lead to the loss of feet or limbs, a frequent
complication of diabetes.
– Dental problems, such as gum disease and tooth loss, often occur in people with diabetes. In 2009,
about 75 percent of upstate New York adults who reported having diabetes (270,000 adults) reported tooth
loss, compared to less than half of those who said that they did not have diabetes.
• Nationally, diabetes is the leading cause of new blindness, kidney disease and non-traumatic lower
limb amputations.
• For people with diabetes, the overall risk for dying is about twice that for people of similar age who do not have
this condition.
• Average yearly medical costs for people who have diabetes are about 2.3 times higher than they are for people
who don’t have diabetes. Those with type 2 diabetes complications incur costs that are about three times higher than
the average for people who don’t have diabetes. The costs associated with diabetes complications are not always
covered by insurance.
Managing your diabetes
If you have diabetes, your risk of having short- and long-term health problems (diabetic complications)
depends on how well you take responsibility for controlling your blood sugar and watching for complications.
You can do a lot to prevent or slow down diabetes problems. Among other actions, the National Institutes of
Health advises:
–
Asking your health provider for the A1C blood test (also called a “glycosylated hemoglobin” or
“HbA1C” test) at least twice yearly to show the average amount of sugar in your blood over the
previous two to three months. The target for most people is 7 percent or lower.
–
Getting a complete exam from an eye health professional each year, allowing the provider to see the
back of each eye by using drops that widen (dilate) your pupils (known as a dilated retinal exam). The
blood circulation problems that result from diabetes can permanently damage your eyes.
–
Having a health provider examine your feet for sores or irritations at least annually,
because you may not feel them yourself (due to the nerve damage that can be caused
by diabetes) and they are slow to heal (because of the poor circulation related to diabetes).
–
Getting formal diabetes self-management education to learn how to care for yourself.
Other recommendations for proactively managing diabetes include:
–
Taking your medications as directed by your health provider.
–
Checking your feet daily for sores or irritations.
–
Maintaining a healthy diet that is high in fruits, vegetables, whole grains and fiber,
and low in sugar, saturated fat and processed foods.
–
Controlling your blood pressure and cholesterol.
–
Staying physically active as approved by your physician (for example, getting at least
30 minutes of moderate physical activity on at least five days per week, if medically advised).
–
Brushing and flossing your teeth each day.
–
Avoiding smoking.
Data sources
The remainder of this report is based on a random-digit-dialed telephone survey of adults (conducted annually
by each U.S. state) that asks about key indicators of proactive diabetes control. Data for upstate New York
and New York state was obtained from the New York State Department of Health, Behavioral Risk Factor
Surveillance System (BRFSS), 2008 and 2009 combined (2008 only for dental care, as 2009 data are unavailable).
To request access: http://www.health.state.ny.us/nysdoh/brfss/
The BRFSS data for each U.S. state are compiled and reported by the Centers for Disease Control and Prevention
(U.S. Department of Health and Human Services). The national data reported here are from the 2009 survey. For
further information: http://www.cdc.gov/brfss/
Data for upstate New York, New York state and the U.S. are compared to national diabetes targets for the year
2020, published by the U.S. Department of Health and Human Services as part of the Healthy People 2020
initiative.* Healthy People is set of public health improvement objectives that are identified and tracked over
time through a data-driven process. Additional information can be found at: http://www.healthypeople.
gov/2020/about/default.aspx.
Since survey respondents may not remember past behaviors accurately and may report taking better care of themselves than they actually do, the survey information in this report likely overstates the extent of proactive diabetes
management. Health plan data from the Healthcare Effectiveness Data and Information Set (HEDIS) indicate lower
levels of compliance for comparable measures.
*Healthy People 2020 targets for smoking, exercise and annual physician visits that are specifically for people with diabetes have not been published.
Diabetes: Upstate New York by the numbers
Percentage of adults with diagnosed diabetes who reported having:
utica/rome/north country Adults with diabetes: 56,700 (9.5%)
Checked their blood sugar daily
56.7%
Had an A1C* test at least twice within the last year
64.8%
Had a dilated eye exam within the last year
75.2%
Had a foot examination within the last year
75.4%
Received formal diabetes education**
48.8%
Smoked cigarettes (current smokers)
21.1%
Engaged in moderate physical activity***
14.5%
Seen a health professional within the past year for their diabetes 86.3%
Central New York Adults with diabetes: 75,600 (9.1%)
65.8%
84.1%
80.9%
71.2%
49.7%
16.3%
20.1%
Southern Tier Adults with diabetes: 36,000 (9.2%)
68.8%
71.7%
69.8%
57.1%
49.3%
19.2%
10.5%
Finger Lakes Adults with diabetes: 75,600 (9.3%)
59.9%
66.3%
75.7%
62.4%
48.0%
11.4%
13.6%
Western New York Adults with diabetes: 115,500 (9.7%)
58.4%
65.1%
77.8%
80.7%
55.4%
15.8%
10.7%
*A blood test that shows average blood sugar levels over the
previous two to three months.
**Survey respondents who answered “yes” to the question:
“Have you ever taken a course or class in how to manage your diabetes yourself?”
***Moderate physical activity for 30 minutes on at least five days
per week.
Note: Upstate New York refers to the New York counties highlighted in
the map above.
Figures are based on the New York State Department of Health’s
Behavioral Risk Factor Surveillance System, 2008 and 2009 combined:
http://www.health.state.ny.us/nysdoh/brfss/
Self-monitoring your blood sugar every day
One way to test your current blood sugar is by draw-
• Take charge of your diabetes, using your blood sugar
ing a small amount of blood using a glucose meter.
measurements to make healthy management choices
Self-testing and keeping a record of the results is very
and changes throughout your day.
important because it can help you:
• Learn and record how daily stress, food, activity and
medication may be affecting your blood glucose.
For better sugar control, adjustments to your lifestyle
and/or medication(s) can be made in collaboration
with your health provider.
• Talk with your health provider about ways in which
your diabetes treatment plan might be changed to
improve daily blood sugar control.
Percentage of adults with diagnosed diabetes who reported measuring their
blood sugar at least once daily
Healthy People
2020 Target
70.4%
Utica/Rome/North Country
56.7%
Western New York
58.4%
59.9%
Finger Lakes
Upstate New York
60.9%
65.8%
Central New York
68.8%
Southern Tier
New York State
61.3%
United States
61.6%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Of the 359,000 upstate New York adults with diagnosed diabetes, about 61 percent (219,000 adults)
reported that they self-check their blood sugar at least once daily, as did 61.3 percent of New York state
adults with diagnosed diabetes and 61.6 percent of American adults who reported having this condition.
The figures for upstate New York, New York state and U.S. adults were about 10 percentage points below
the Healthy People 2020 target for this measure (70.4 percent).
Take-charge resources:
National Diabetes Education Program: “Know Your Blood Sugar Numbers.” NIH Publication No. 11-4350, February 2011.
http://www.ndep.nih.gov/media/knownumbers_eng.pdf
WebMD: “Diabetes Health Center – How to Test Your Blood Sugar With Diabetes.”
http://diabetes.webmd.com/guide/how-test-blood-glucose
American Diabetes Association: “Living With Diabetes – Checking Your Blood Glucose.”
http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html
American Diabetes Association: “Living With Diabetes – Diabetes 24/7: The American Diabetes Association’s Online Diabetes
Management Program Integrated with Microsoft’s HealthVault.” http://www.diabetes.org/living-with-diabetes/treatment-andcare/247.html?utm_source=WWW&utmmedium=ContentPage&utm_content=BGC&utm_campaign=247
American Diabetes Association: “Diabetes Forecast: A Healthy Living Magazine - 2011 Consumer Guide – Blood Glucose Meters.”
http://forecast.diabetes.org/files/images/V64n1_Meters_Rev_1-3.pdf?utm_source=WWW&utm_medium=ContentPage&utm_
content=Meters-checking&utm_campaign=DF
American Diabetes Association: ”Diabetes Forecast: A Healthy Living Magazine - Blood Glucose Journal.”
http://forecast.diabetes.org/files/images/v62n04_p35BGjournal.pdf?utm_source=WWW&utm_medium=ContentPage&utm_
content=BGJournal&utm_campaign=DF
Mayo Clinic: “Diabetes - Diabetes management: How lifestyle, daily routine affect blood sugar.”
http://www.mayoclinic.com/health/diabetes-management/DA00005
Measuring blood sugar longer-term
The A1C (HBA1C) test, a second way to see how well
• Allows your health provider to adjust your
your blood glucose is controlled, is a blood test done
medications (if necessary), provide lifestyle advice and
by your health provider. It shows what your average
decide whether you should have this test more often
blood sugar levels have been over the previous two to
to see if any changes that are made are working.
three months, a good estimate of how well you have
managed your diabetes during this time. The closer
your A1C number is to 7 or below, the less likely you
are to have diabetic complications.
Having the A1C test at least twice a year is important to
monitor your risk for diabetic complications and:
• Along with your daily self-testing, gives your
physician a more complete picture of how your
diabetes treatment is going.
• Encourages working with your health provider to set
your individual A1C target and treatment program.
Percentage of adults with diagnosed diabetes who reported having had their A1C
measured at least twice within the previous year
Healthy People
2020 Target
71.1%
64.8%
Western New York
65.1%
66.3%
Finger Lakes
Upstate New York
69.3%
71.7%
Southern Tier
84.1%
Central New York
New York State
64.2%
United States
63.1%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
69.3 percent of upstate New York adults with diagnosed diabetes reported having had the
A1C test at least twice within the previous year, higher than the percentage of their counterparts
statewide (64.2 percent) and nationally (63.1 percent).
The percentages for upstate New York, New York state and U.S. adults were below the Healthy People
2020 target for this measure (71.1 percent).
National Diabetes Education Program: “Know Your Blood Sugar Numbers.” NIH Publication No. 11-4350, February 2011.
http://www.ndep.nih.gov/media/knownumbers_eng.pdf
American Diabetes Association: “Living With Diabetes – A1C.”
http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/a1c/
American Diabetes Association: “Living With Diabetes – Checking Your Blood Glucose.”
http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html
American Diabetes Association: “Living With Diabetes – Diabetes 24/7: The American Diabetes Association’s Online Diabetes
Management Program Integrated with Microsoft’s HealthVault.” http://www.diabetes.org/living-with-diabetes/treatment-andcare/247.html?utm_source=WWW&utm_medium=ContentPage&utm_content=BGC&utm_campaign=247
WebMD: “Diabetes Health Center - The Hemoglobin A1c (HbA1c) Test for Diabetes, Importance of Hemoglobin A1c Test.”
http://diabetes.webmd.com/guide/glycated-hemoglobin-test-hba1c
Protecting your eyesight
Having too much blood sugar over a period of time
Getting a complete exam from an eye health
can damage the tiny blood vessels leading to the retina
professional each year, allowing the provider to see the
(the inner lining of the back of the eye), causing them
back of each eye by using drops that widen (dilate) your
to swell, weaken and become clogged, reducing blood
pupils (known as a dilated retinal exam), is essential
flow. This decreased blood flow can damage the retina
to detecting and immediately treating any diabetic
(diabetic retinopathy). The damage can cause vision
eye problems. This can prevent eye problems from
problems, including blindness. Other diabetic eye
worsening and possibly affecting your vision.
diseases that can cause vision loss include cataracts
(a cloudy film over the eye lens) and glaucoma
(a build-up of pressure behind the eye).
Percentage of adults with diagnosed diabetes who reported having had a dilated eye
exam within the previous year
Healthy People
2020 Target
58.7%
Southern Tier
69.8%
75.2%
75.7%
Finger Lakes
Upstate New York
76.5%
Western New York
77.8%
Central New York
80.9%
New York State
74.5%
United States
68.7%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
76.5 percent of upstate New York adults with diagnosed diabetes (275,000 adults) reported having had a
dilated eye exam within the previous year, higher than the percentage of their counterparts statewide (74.5
percent) and those nationally (68.7 percent).
The percentages for adults in upstate New York, New York state and the nation exceeded the Healthy People
U.S. Department Of Health And Human Services, National Institute of Diabetes and Digestive and Kidney Diseases of the
National Institutes of Health, National Diabetes Information Clearinghouse: “Prevent diabetes problems: Keep your eyes
healthy.” http://diabetes.niddk.nih.gov/dm/pubs/complications_eyes/
National Institutes of Health, National Eye Institute: “Facts About Diabetic Retinopathy.”
http://www.nei.nih.gov/health/diabetic/retinopathy.asp
National Institutes of Health, National Eye Institute: “Finding an Eye Care Professional.”
http://www.nei.nih.gov/health/findprofessional.asp
National Institutes of Health, National Eye Institute: “Eye Health Organizations Database.”
http://www.nei.nih.gov/health/resourceSearch.asp?Disp=1&strKey=Diabetic+Eye+Disease
New York State Department of Health: “Diabetes Information and Resources - Impairment and Diabetes: 5 Key Messages.”
http:www.nyhealth.gov/publications/0939/index.htm
Keeping your feet healthy
High blood sugar over a period of time can cause poor
This is why it is important for people who have diabetes
blood flow to your legs and feet (peripheral vascular
to examine their feet daily and have a foot exam by a
disease), making them prone to sores and infections
health professional every year. The health professional
that are slow to heal. You may not feel any pain or
can keep you informed about caring for your feet, the
even know there’s a problem developing because of the
health of your nerves and blood flow to these areas.
nerve damage diabetes can cause (diabetic neuropathy).
Most importantly, this exam allows the health profes-
Left alone, the result can be infection and, at worst, a
sional to find and treat any problems early, before they
need to remove (amputate) parts of the feet or legs.
become more serious.
Percentage of adults with diagnosed diabetes who reported having had a professional
foot exam within the previous year
Healthy People
2020 Target
74.8%
Southern Tier
57.1%
Finger Lakes
62.4%
Central New York
71.2%
Upstate New York
71.4%
75.4%
Western New York
80.7%
New York State
72.9%
United States
69.8%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
71.4 percent of upstate New York adults with diagnosed diabetes reported having had a foot exam by a health
professional within the previous year, lower than the percentage of their counterparts statewide (72.9 percent)
but higher than the percentage of their counterparts nationwide (69.8 percent).
The percentages for upstate New York, New York state and U.S adults fell below the Healthy People 2020
target for this measure (74.8 percent).
American Diabetes Association: “Living with Diabetes – Foot Care.”
http://www.diabetes.org/living-with-diabetes/complications/foot-care.html
American Diabetes Association: “Living with Diabetes – Foot Complications.”
http://www.diabetes.org/living-with-diabetes/complications/foot-complications.html
U.S. Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney Diseases of the
National Institutes of Health, National Diabetes Information Clearinghouse: “Prevent diabetes problems: Keep your feet and
skin healthy.” http://diabetes.niddk.nih.gov/dm/pubs/complications_feet/
FamilyDoctor.org: “Diabetes: Foot Care.”
http://familydoctor.org/online/famdocen/home/common/diabetes/living/352.html
Saying “No” to smoking
Most people know that for many reasons, smoking is
bad for your health. The combination of diabetes and
smoking is especially dangerous. Tobacco counteracts
the healthy effects of any efforts you make to control
blood sugar and prevent diabetes complications. It can:
• Increase your already higher-than-average risk of
dying from heart disease or stroke (cardiovascular
disease). Those who have diabetes and also smoke
are 11 times more likely than those who don’t have
diabetes to die from cardiovascular disease. Smoking
also makes it difficult to control diabetes, because it
lowers your ability to use insulin and increases your
blood sugar.
• Elevate your cholesterol, which raises your risk of
having a heart attack.
• Decrease blood flow, cutting the supply of oxygen to
all parts of the body. This can lead to cardiovascular
disease and wound healing problems.
• Further increase your chances of developing related
complications (nerve damage, kidney disease, dental
disease and vision problems/blindness).
Percentage of adults with diagnosed diabetes who reported being current smokers
Finger Lakes
11.4%
Western New York
15.8.%
Upstate New York
16.2%
Central New York
16.3%
Southern Tier
19.2%
21.1%
New York State
16.9%
United States
15.0%
0%
5%
10%
15%
20%
25%
16.2 percent of upstate New York adults with diagnosed diabetes reported being current smokers
(58,000 adults), less than the percentage of their counterparts statewide (16.9 percent)
but above the percentage of their counterparts nationwide (15.0 percent).
New York State Smokers’ Quitline: 1 (866) NY-QUITS (1-866-697-8487). http://www.nysmokefree.com/
American Lung Association: “Freedom From Smoking Online.” http://www.ffsonline.org/
American Cancer Society: “Stay Healthy: Healthy living information to help you stay well - Guide to Quitting Smoking.”
http://www.cancer.org/Healthy/StayAwayfromTobacco/GuidetoQuittingSmoking/index
National Cancer Institute: “smokefree.gov - Quit Smoking TODAY - we can help.” http://www.smokefree.gov/
Centers for Disease Control and Prevention: “Smoking & Tobacco Use - How to Quit - Government Resources.”
http://www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm
For additional information on smoking in upstate New York, see Excellus BlueCross BlueShield’s report: “The Facts About
Cigarette Smoking Trends Among Upstate New York Adults.”
https://www.excellusbcbs.com/wps/wcm/connect/a6a4190045fe9ee482e0cb6f01e7bb4a/Smoking+FSEX+FINAL+2+16+11pdf?MOD=AJPERES
Thinking about getting active
Exercise is a healthy practice for most people. Those
If you have diabetes, it is very important to talk to
who have diabetes should not be sidelined just
your doctor before starting an exercise program to
because they have this condition. Even moderate
find out what types of physical activity are appropriate
increases in activity levels can be beneficial. The
for you (a select number of people who have diabetes
numerous benefits of exercise that are particularly
should avoid exercise). Set realistic goals and track your
important for people who have diabetes include:
progress. When exercising, people with diabetes should
• Keeping blood sugar, blood pressure, blood
cholesterol (fat) levels and weight in check.
always have a carbohydrate (complex sugar) source on
hand in case the activity causes blood sugar to become
too low. Check your blood sugar before and after
• Strengthening the heart muscle and lowering the
exercise so you know how your body responds to
already higher-than-average chance of getting
physical activity. Then you can consult your health
heart disease.
care provider about making any adjustments to your
exercise program.
• Improving blood circulation, which is often below
normal in people with diabetes.
Percentage of adults with diagnosed diabetes who reported regularly engaging in
moderate physical activity*
Southern Tier
10.5%
Western New York
10.7%
13.6%
Finger Lakes
Upstate New York
13.9%
14.5%
20.1%
Central New York
New York State
18.5%
United States
17.5%
0%
5%
10%
15%
20%
25%
*At least 30 minutes of moderate exercise five or more times per week.
13.9 percent of upstate New York adults with diagnosed diabetes reported exercising moderately
for at least 30 minutes on five or more days per week, below the percentage of their counterparts
statewide (18.5 percent) and nationally (17.5 percent).
American Diabetes Association: “Diabetes Basics - Physical Activity.”
http://www.diabetes.org/diabetes-basics/prevention/checkup-america/activity.html
DIABETES IN CONTROL.COM - News and Information for Medical Professionals: “Tool for Your Practice: Physical Activity Log.”
http://www.diabetesincontrol.com/images/issues/2010/0810/physical_activity_log.pdf
American Diabetes Association: “A Guide to Changing Habits.” Call 1 (800) DIABETES (342–2383) for a free copy.
Excellus BlueCross BlueShield: “StepUp: Your guide to being active, eating right and staying healthy every day.”
https://www.excellusbcbs.com/wps/portal/xl/mbr/hnw/healthyliving/stepup/
Seeing a health professional for your diabetes
every year
A routine visit to a health professional at least yearly
(often more frequently) for diabetes is a critical part
of successful long-term management. These visits are
needed to find out whether current efforts to manage
your diabetes work well enough to control your blood
• Blood pressure screening.
• Body mass index measurement to see whether your
weight is within normal range for your height.
• Waist measurement (a waist measuring more than
sugar and to watch for any signs of complications, such
than 35 inches for a woman or more than 45 inches
as eye or kidney disease. Your primary care provider can
for a man increases the risk for health problems
also help you coordinate care from your diabetes team
linked to diabetes).
(such as diabetes specialists, nutritionists and eye
doctors), which is very important to maintaining a
good management program. Your routine visits likely
will include:
• A blood sample to check A1C, kidney function and
cholesterol levels.
• A urine test for protein, which if present, may signal
kidney problems.
• A foot exam to look for sores or irritations that may
need to be treated or carefully watched.
• Lifestyle counseling, such as information and advice
about quitting smoking, eating healthy and staying
physically active.
Percentage of adults with diagnosed diabetes who reported having seen a health
professional for their diabetes within the previous year
Southern Tier
80.9%
83.6%
Finger Lakes
Upstate New York
86.1%
86.3%
Central New York
87.9%
88.5%
Western New York
86.5%
New York State
United States
84.8%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
The majority (86.1 percent) of upstate New York adults with diagnosed diabetes reported having seen
a health professional for their diabetes within the previous year, almost on par with the percentage of their
counterparts statewide (86.5 percent) and higher than the percentage nationally (84.8 percent).
Excellus BlueCross BlueShield: “Find a Doctor.”
https://www.excellusbcbs.com/wps/portal/xl/mbr/fnd/doctor/upstateny/
New York City Department of Health and Mental Hygiene: “Health Bulletin: How to Find a Doctor.”
http://www.nyc.gov/html/doh/downloads/pdf/public/dohmhnews3-10.pdf
New York State: “Search for a Physician.” http://www.nydoctorprofile.com/search_parameters.jsp
Maintaining your healthy smile
Although anyone can have tooth and gum problems,
Your annual visit to the dentist’s office can help you in
people with diabetes have them more often than those
many ways by:
who don’t have this condition, because germs (bacteria)
in the mouth are fed by and grow from high sugar in
the blood. The build-up of germs can make your gums
prone to redness, swelling and bleeding – the first signs
of gum disease. The gums and the bones that hold your
• Routinely cleaning your teeth and gums to keep
germs in check.
• Teaching you how to properly care for your teeth
at home.
teeth in place can then become infected. Tooth loss can
result.
• Catching gum and tooth problems early and keeping
you informed of what you can do about them.
• Making sure that false teeth fit well.
Percentage of adults with diagnosed diabetes who reported having had a
visit to a dentist or dental clinic within the previous year*
Healthy People
2020 Target
61.2%
60.2%
Upstate New York
63.9%
New York State
United States
59.3%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
*Note: Regional figures not shown because data were available for 2008 only.
60.2 percent of upstate New York adults with diagnosed diabetes reported having visited a dentist
or dental clinic for a routine check-up within the previous year, lower than the percentage of their
counterparts statewide (63.9 percent), but higher than the percentage of their U.S. counterparts
(59.3 percent).
The percentages for upstate New York, New York state and U.S. adults were close to the Healthy
People 2020 target for this measure (61.2 percent).
American Dental Association: “Oral Health Topics – Diabetes.” http://www.ada.org/3069.aspx
American Dental Association: “Public Resources – Find a Dentist.” http://www.ada.org/public.aspx
Mayo Clinic: “Diabetes - Diabetes and dental care: Guide to a healthy mouth.”
http://www.mayoclinic.com/health/diabetes/DA00013
For additional information on oral health in upstate New York, see Excellus BlueCross BlueShield ’s report: “The Facts
About Oral Health in Upstate New York, 2006.”
http://www.excellusbcbs.com/wps/wcm/connect/693fd9804e8ee6e89007bfe420b83c88/DentalFactSheet1030.pdf?MOD=AJPERES
Getting to know your diabetes
To live well with your diabetes, you must learn to care
for yourself. Formal education about your condition
gives you the power of knowing how to best manage
your condition to lower your risk for complications and
boosts your ability to:
• Make informed decisions about your diabetes care
plan with set goals and ways to reach them.
• Problem-solve with your health care providers to
achieve your best possible health and quality of life.
• Become more aware of lifestyle choices (diet,
exercise, stress management) and how they
can reduce your risk of complications.
• Overcome barriers to taking care of yourself and
controlling your blood sugar.
• Become an active and responsible member of your
diabetes care team.
• Work with your health providers to set your individual
A1C target and treatment plan.
Your primary care provider or health plan can help you
find diabetes education resources.
Percentage of adults with diagnosed diabetes who reported having received formal
diabetes education
Healthy People
2020 Target
62.5%
Finger Lakes
48.0%
48.8%
Southern Tier
49.3%
Central New York
49.7%
50.9%
Upstate New York
Western New York
55.4%
New York State
41.4%
United States
55.0%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
50.9 percent of the 359,000 upstate New York adults with diagnosed diabetes (183,000 adults)
reported having had formal diabetes education, higher than the percentage of their counterparts statewide
(41.4 percent) but below the percentage of their U.S. counterparts (55.0 percent).
The percentages for upstate New York, New York state and U.S. adults fell short of the Healthy People
American Association of Diabetes Educators: http://www.diabeteseducator.org/
Diabetes Teaching Center at the University of California, San Francisco: “Diabetes Education Online.” http://dtc.ucsf.edu/
New York Diabetes Coalition, PDF Download Library: “The NYDC ‘Tools for Better Diabetes Care’ Tool Kit.”
http://www.nydc.org/pdf_lib.php
General take-charge resources:
American Diabetes Association, 1701 North Beauregard Street, Alexandria, VA 22311, 1-800-DIABETES.
http://www.diabetes.org/
National Diabetes Information Clearinghouse, A service of the National Institute of Diabetes and Digestive and Kidney
Diseases, National Institutes of Health, 1 Information Way, Bethesda, MD 20892, 1 (800) 860-8747.
http://diabetes.niddk.nih.gov/
National Diabetes Education Program, One Diabetes Way, Bethesda, MD 20814, 1 (800) 438-5383.
http://ndep.nih.gov/
American Association of Diabetes Educators, 200 W. Madison St., Suite 800, Chicago, IL 60606, 1 (800) 338-3633.
http://www.diabeteseducator.org/
Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion,
Diabetes Public Health Resource, 4770 Buford Highway NE, Mailstop K-40, Atlanta, GA 30341, 1 (800) CDC-INFO.
http://www.cdc.gov/chronicdisease/resources/publications/aag/ddt.htm
New York State Department of Health, The New York State Diabetes Prevention and Control Program, 150 Broadway –
Room 350, Albany NY 12204, (518) 408-0125.
http://www.health.state.ny.us/diseases/conditions/diabetes/index.htm
New York Online Access to Health: Diabetes.
http://www.noah-health.org/en/endocrine/diabetes/
For additional information about upstate New York adults with diagnosed diabetes, see Excellus BlueCross BlueShield’s report:
“The Facts About Upstate New York Adults With Diagnosed Type 1 and Type 2 Diabetes and Estimated Treatment Costs.”
https://www.excellusbcbs.com/wps/wcm/connect/005a9400419b084999759fb98df73816/Diabetes+FS-EX+FINAL1.pdf?MOD=AJPERES
Excellus BlueCross BlueShield: “Research Health Topics: Diabetes.”
https://www.healthwise.net/excellus/Content/CustDocument.aspx?Xml=stub.xml&Xsl=cd.FrontPage.xsl
(Access by clicking the link to “For Your Helath” and then selecting “6,000+ Health Topics” on the left side of the page and
typing “Diabetes” in the search field that appears.)
excellusbcbs.com
B-3684 / 5529-11CC

TakeCHARGE - Excellus BlueCross BlueShield

Transcription

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