General Health Guidelines

If you have diabetes, it is important to maintain your overall health. Even areas that seem unrelated, such as skin and dental care, are important. Here are some areas to consider:

Skin Care

Too much blood sugar makes the body lose fluid, so if you have diabetes, you are more likely than others to have dry and itchy skin. Sometimes, your  dry skin can become cracked. These cracks make it easier for germs that cause infections to get into your body.

Too much blood sugar can also cause nerve damage that decreases the amount of sweat your body makes. Sweat cools the body and  also helps keep your skin moist.

To keep your skin healthy:

• Drink plenty of water.
• Wash with a mild soap.
• Dry your skin well after showers and baths.
• Use a gentle moisturizing lotion after bathing, especially in the winter.
• Use lukewarm water because hot showers can dry the skin.
• Check your skin after bathing for areas that are dry, red, or sore.
• Call your doctor if you have a skin problem that doesn't seem to be going away.

Dental Care

High blood sugar makes it easier for bacteria that can damage your teeth and gums to grow, so if you have diabetes, you are at greater risk for dental problems than others. To keep your teeth and gums healthy:

• Keep your blood sugar in a healthy range.
• Brush your teeth at least twice a day.
• Use dental floss at least once a day. Floss removes germs that your toothbrush misses.
• Do not smoke. Smoking increases the risk of gum disease.
• If you wear false teeth, keep them clean.
• See your dentist at least twice a year for regular checkups and cleanings.

See your dentist if you have any of the following warning signs:

• Red, swollen, or bleeding gums
• Receeding gum line
• Tooth pain
• Loose tooth
• Bad breath
• Your bite feels different
• Your dentures do not fit right

Sick Days

Being sick with the cold, flu, or other illnesses puts your body under stress. That stress can raise your blood sugar to dangerous levels, so you will need to take extra precautions when you are sick. On sick days you should:

• Check your blood sugar every four hours. Keep track of your levels in a log or notebook.
• Drink plenty of water,at least eight ounces (one cup) every hour while you are awake.
• If you cannot eat like you normally do, try light foods such as soup and crackers. You can also drink juice or clear liquids that have sugar in them to keep your glucose in a normal range.
• Keep taking your medicines as you would if you were healthy. If you have trouble eating, ask your doctor or diabetes educator if you need to adjust your medication.
• Test your urine for ketones if your blood sugar is above 240 or you cannot keep food down. Contact your doctor immediately if your ketones are high.

Community Programs

At Mount Sinai, we believe it is important to be involved in our local community. We feel education is an important part of our job and we are involved with these programs:

Mount Sinai Green Market

We provide diabetes education every week at the local farmer’s market. In collaboration with East Harlem Health Outreach Partnership  and Mount Sinai Office of Community Affairs, diabetes educators from the Diabetes Center teach medical students to provide education and counseling on health and wellness. The weekly farmer’s market takes place at 100th Street and Madison Avenue.

Viva Fitness

Taking steps to get active and healthy can reduce your risk for type 2 diabetes, a chronic disease with potentially life-threatening complications. The Mount Sinai Diabetes Center and the YMCA of Greater New York, through its YMCA Diabetes Prevention Program (YDPP), offer a 16-week fitness and health-coaching program nai aimed at reducing the risk for type 2diabetes.

The program consists of two one-hour sessions per week. During these sessions, participants meet with a trained health coach from YDPP to learn about healthy eating, physical activity, overcoming stress, and staying motivated to meet your health goals in a comfortable group setting. You can also take part in Mount Sinai Diabetes Center’s Viva Fitness, a dance-inspired, light-exercise program. Sessions take place at the Mount Sinai Diabetes Center, located at 1428 Madison Avenue on the 4th floor of the Atran-Berg Building.

The program is based on research funded by the National Institutes of Health and the Centers for Disease Control and Prevention which shows that by eating healthier, increasing physical activity, and losing a small amount of weight, a person with prediabetes can prevent or delay the onset of type 2 diabetes by 58 percent.

To register, call: 212-912-2524. If possible, have your health care provider complete and fax this form.

Vision Voice Photography Exhibit and Documentary Film

Vision Voice is a multimedia community project that focuses on vision loss and managing diabetes in Harlem. This project seeks to bring attention to the importance of vision health in a community with high rates of diabetes and other chronic conditions that affect eyesight. We operate a traveling exhibit throughout Harlem that includes  a documentary film that further explores the women’s daily lives with diabetes and vision loss. The Vision Voice Project aims to reach Harlem residents, health care providers, and community leaders.  The film was selected for the 2012 East Harlem International Film Festival and will appear in numerous clinical waiting rooms, community-based organizations, faith-based organizations, and medical conferences in 2013.

For more information about Vision Voice or to view the documentary film, please contact Brett Ives, NP, CDE at brett.ives@mountsinai.org.

Emotional Health for Patients and Caregivers

At Mount Sinai, we recognize that a chronic illness such as diabetes can take a toll on your emotional health, as well as the wellbeing of your caregiver/s. We try to help you cope with the stress associated with diabetes and to identify signs of depression, so you can seek assistance if necessary.

Recognizing Depression

Everyone feels a little down from time to time, but feelings of sadness that do not go away or start to interfere with your daily activities may be signs of depression. This can affect both diabetes patients and caregivers. Symptoms of depression include:

• Changes in sleeping patterns
• Increase or decrease in appetite, often with weight gain or loss
• Fatigue and lack of energy
• Feelings of worthlessness or guilt
• Trouble concentrating
• Irritability or agitation
• Loss of interest in usual activities
• Feelings of hopelessness
• Thoughts of suicide or death

If you experience one or more of these symptoms for two weeks or longer, contact your doctor. The good news about depression is that we can treat it with medications, counseling, or a combination of both.

Sometimes you may anticipate depression. Before you get “too deep,” you can help avoid it by:

• Eating a balanced diet
• Exercising regularly
• Getting enough sleep
• Avoiding alcohol or, if you choose to drink, using alcohol in moderation
• Seeking support from friends, family, or counselors
• Finding ways to relax and do activities you enjoy

Coping with Caregiver Stress

Keeping your blood sugar levels in a healthy range is important for staying healthy and avoiding complications, but it can be stressful. The effort can affect not only patients, but also caregivers. You can reduce caregiver stress and avoid burnout by doing the following:

• Take care of your health. See your doctor regularly, eat a balanced diet, and exercise several times  week. Remember that to be able to care of your loved one, you must first take care of yourself.
• Do not go it alone. Friends, family members, and religious groups may be able to help you, so do not be shy about asking.
• Seek support. Consider becoming involved in support groups, either online or in your community, for caregivers and family members of people with diabetes. These  groups allow you to share your experiences, frustrations, and solutions with people who are dealing with similar issues.
• Find time for yourself. Spendan afternoon or an evening with friends or doing activities that you enjoy.
• Seek professional help. Respite care provides a short period of time off for caregivers so that you can take care of your own needs. Home health agencies can provide nurses and health aides to help take care of your loved one at home. Adult day care centers offer care outside of the home.