TakeCHARGE. Diabetes. Community Health Reports. Personal actions for better health

Transcription

1 TakeCHARGE Community Health Reports Personal actions for better health Diabetes A nonprofit independent licensee of the BlueCross BlueShield Association

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3 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.

4 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.

5 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.

6 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: 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: 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: 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.

7 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%) Checked their blood sugar daily 65.8% Had an A1C* test at least twice within the last year 84.1% Had a dilated eye exam within the last year 80.9% Had a foot examination within the last year 71.2% Received formal diabetes education** 49.7% Smoked cigarettes (current smokers) 16.3% Engaged in moderate physical activity*** 20.1% Seen a health professional within the past year for their diabetes 87.9% Southern Tier Adults with diabetes: 36,000 (9.2%) Checked their blood sugar daily 68.8% Had an A1C* test at least twice within the last year 71.7% Had a dilated eye exam within the last year 69.8% Had a foot examination within the last year 57.1% Received formal diabetes education** 49.3% Smoked cigarettes (current smokers) 19.2% Engaged in moderate physical activity*** 10.5% Seen a health professional within the past year for their diabetes 80.9% Finger Lakes Adults with diabetes: 75,600 (9.3%) Checked their blood sugar daily 59.9% Had an A1C* test at least twice within the last year 66.3% Had a dilated eye exam within the last year 75.7% Had a foot examination within the last year 62.4% Received formal diabetes education** 48.0% Smoked cigarettes (current smokers) 11.4% Engaged in moderate physical activity*** 13.6% Seen a health professional within the past year for their diabetes 83.6% Western New York Adults with diabetes: 115,500 (9.7%) Checked their blood sugar daily 58.4% Had an A1C* test at least twice within the last year 65.1% Had a dilated eye exam within the last year 77.8% Had a foot examination within the last year 80.7% Received formal diabetes education** 55.4% Smoked cigarettes (current smokers) 15.8% Engaged in moderate physical activity*** 10.7% Seen a health professional within the past year for their diabetes 88.5% *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:

8 Self-monitoring your blood sugar every day One way to test your current blood sugar is by drawing a small amount of blood using a glucose meter. Self-testing and keeping a record of the results is very 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. Take charge of your diabetes, using your blood sugar measurements to make healthy management choices and changes throughout your day. Talk with your health provider about ways in which your diabetes treatment plan might be changed to improve daily blood sugar control.

9 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 Western New York Finger Lakes Upstate New York 56.7% 58.4% 59.9% 60.9% Central New York Southern Tier 65.8% 68.8% New York State United States 61.3% 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 , February WebMD: Diabetes Health Center How to Test Your Blood Sugar With Diabetes. American Diabetes Association: Living With Diabetes Checking Your Blood Glucose. American Diabetes Association: Living With Diabetes Diabetes 24/7: The American Diabetes Association s Online Diabetes Management Program Integrated with Microsoft s HealthVault. American Diabetes Association: Diabetes Forecast: A Healthy Living Magazine Consumer Guide Blood Glucose Meters. content=meters-checking&utm_campaign=df American Diabetes Association: Diabetes Forecast: A Healthy Living Magazine - Blood Glucose Journal. content=bgjournal&utm_campaign=df Mayo Clinic: Diabetes - Diabetes management: How lifestyle, daily routine affect blood sugar.

10 Measuring blood sugar longer-term The A1C (HBA1C) test, a second way to see how well your blood glucose is controlled, is a blood test done by your health provider. It shows what your average blood sugar levels have been over the previous two to 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: Allows your health provider to adjust your medications (if necessary), provide lifestyle advice and decide whether you should have this test more often to see if any changes that are made are working. 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.

11 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% Utica/Rome/North Country Western New York Finger Lakes Upstate New York Southern Tier 64.8% 65.1% 66.3% 69.3% 71.7% Central New York 84.1% New York State United States 64.2% 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). Take-charge resources: National Diabetes Education Program: Know Your Blood Sugar Numbers. NIH Publication No , February American Diabetes Association: Living With Diabetes A1C. American Diabetes Association: Living With Diabetes Checking Your Blood Glucose. American Diabetes Association: Living With Diabetes Diabetes 24/7: The American Diabetes Association s Online Diabetes Management Program Integrated with Microsoft s HealthVault. WebMD: Diabetes Health Center - The Hemoglobin A1c (HbA1c) Test for Diabetes, Importance of Hemoglobin A1c Test.

12 Protecting your eyesight Having too much blood sugar over a period of time can damage the tiny blood vessels leading to the retina (the inner lining of the back of the eye), causing them to swell, weaken and become clogged, reducing blood flow. This decreased blood flow can damage the retina (diabetic retinopathy). The damage can cause vision problems, including blindness. Other diabetic eye 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). 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), is essential to detecting and immediately treating any diabetic eye problems. This can prevent eye problems from worsening and possibly affecting your vision.

13 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 Utica/Rome/North Country Finger Lakes Upstate New York Western New York Central New York 69.8% 75.2% 75.7% 76.5% 77.8% 80.9% New York State United States 68.7% 74.5% 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 2020 target for this measure (58.7 percent). Take-charge resources: 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. National Institutes of Health, National Eye Institute: Facts About Diabetic Retinopathy. National Institutes of Health, National Eye Institute: Finding an Eye Care Professional. National Institutes of Health, National Eye Institute: Eye Health Organizations Database. New York State Department of Health: Diabetes Information and Resources - Impairment and Diabetes: 5 Key Messages.

14 Keeping your feet healthy High blood sugar over a period of time can cause poor blood flow to your legs and feet (peripheral vascular disease), making them prone to sores and infections that are slow to heal. You may not feel any pain or even know there s a problem developing because of the nerve damage diabetes can cause (diabetic neuropathy). Left alone, the result can be infection and, at worst, a need to remove (amputate) parts of the feet or legs. This is why it is important for people who have diabetes to examine their feet daily and have a foot exam by a health professional every year. The health professional can keep you informed about caring for your feet, the health of your nerves and blood flow to these areas. Most importantly, this exam allows the health professional to find and treat any problems early, before they become more serious.

15 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 Finger Lakes 57.1% 62.4% Central New York Upstate New York Utica/Rome/North Country Western New York 71.2% 71.4% 75.4% 80.7% New York State United States 69.8% 72.9% 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). Take-charge resources: American Diabetes Association: Living with Diabetes Foot Care. American Diabetes Association: Living with Diabetes Foot Complications. 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. FamilyDoctor.org: Diabetes: Foot Care.

16 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).

17 Percentage of adults with diagnosed diabetes who reported being current smokers Finger Lakes 11.4% Western New York Upstate New York Central New York 15.8.% 16.2% 16.3% Southern Tier 19.2% Utica/Rome/North Country 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). Take-charge resources: New York State Smokers Quitline: 1 (866) NY-QUITS ( ). American Lung Association: Freedom From Smoking Online. American Cancer Society: Stay Healthy: Healthy living information to help you stay well - Guide to Quitting Smoking. National Cancer Institute: smokefree.gov - Quit Smoking TODAY - we can help. Centers for Disease Control and Prevention: Smoking & Tobacco Use - How to Quit - Government Resources. 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. EX+FINAL pdf?MOD=AJPERES

18 Thinking about getting active Exercise is a healthy practice for most people. Those who have diabetes should not be sidelined just because they have this condition. Even moderate increases in activity levels can be beneficial. The numerous benefits of exercise that are particularly important for people who have diabetes include: Keeping blood sugar, blood pressure, blood cholesterol (fat) levels and weight in check. Strengthening the heart muscle and lowering the already higher-than-average chance of getting heart disease. Improving blood circulation, which is often below normal in people with diabetes. If you have diabetes, it is very important to talk to your doctor before starting an exercise program to find out what types of physical activity are appropriate for you (a select number of people who have diabetes should avoid exercise). Set realistic goals and track your progress. When exercising, people with diabetes should 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 exercise so you know how your body responds to physical activity. Then you can consult your health care provider about making any adjustments to your exercise program.

19 Percentage of adults with diagnosed diabetes who reported regularly engaging in moderate physical activity* Southern Tier Western New York 10.5% 10.7% Finger Lakes Upstate New York Utica/Rome/North Country 13.6% 13.9% 14.5% Central New York 20.1% New York State United States 17.5% 18.5% 0% 5% 10% 15% 20% 25% *At least 30 minutes of moderate exercise five or more times per week 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). Take-charge resources: American Diabetes Association: Diabetes Basics - Physical Activity. DIABETES IN CONTROL.COM - News and Information for Medical Professionals: Tool for Your Practice: Physical Activity Log. American Diabetes Association: A Guide to Changing Habits. Call 1 (800) DIABETES ( ) for a free copy. Excellus BlueCross BlueShield: StepUp: Your guide to being active, eating right and staying healthy every day.

20 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 sugar and to watch for any signs of complications, such as eye or kidney disease. Your primary care provider can also help you coordinate care from your diabetes team (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. 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 than 35 inches for a woman or more than 45 inches for a man increases the risk for health problems linked to diabetes). 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. A urine test for protein, which if present, may signal kidney problems.

21 Percentage of adults with diagnosed diabetes who reported having seen a health professional for their diabetes within the previous year Southern Tier Finger Lakes Upstate New York Utica/Rome/North Country Central New York Western New York 80.9% 83.6% 86.1% 86.3% 87.9% 88.5% New York State United States 86.5% 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). Take-charge resources: Excellus BlueCross BlueShield: Find a Doctor. New York City Department of Health and Mental Hygiene: Health Bulletin: How to Find a Doctor. New York State: Search for a Physician.

22 Maintaining your healthy smile Although anyone can have tooth and gum problems, people with diabetes have them more often than those 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 teeth in place can then become infected. Tooth loss can result. Your annual visit to the dentist s office can help you in many ways by: Routinely cleaning your teeth and gums to keep germs in check. Teaching you how to properly care for your teeth at home. Catching gum and tooth problems early and keeping you informed of what you can do about them. Making sure that false teeth fit well.

23 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% Upstate New York New York State 60.2% 63.9% 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 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). Take-charge resources: American Dental Association: Oral Health Topics Diabetes. American Dental Association: Public Resources Find a Dentist. Mayo Clinic: Diabetes - Diabetes and dental care: Guide to a healthy mouth. 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,

24 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. 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. Become more aware of lifestyle choices (diet, exercise, stress management) and how they can reduce your risk of complications.

25 Percentage of adults with diagnosed diabetes who reported having received formal diabetes education Healthy People 2020 Target 62.5% Finger Lakes Utica/Rome/North Country Southern Tier Central New York Upstate New York Western New York 48.0% 48.8% 49.3% 49.7% 50.9% 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 2020 target for this measure (62.5 percent). Take-charge resources: American Association of Diabetes Educators: Diabetes Teaching Center at the University of California, San Francisco: Diabetes Education Online. New York Diabetes Coalition, PDF Download Library: The NYDC Tools for Better Diabetes Care Tool Kit.

26 General take-charge resources: American Diabetes Association, 1701 North Beauregard Street, Alexandria, VA 22311, DIABETES. 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) National Diabetes Education Program, One Diabetes Way, Bethesda, MD 20814, 1 (800) American Association of Diabetes Educators, 200 W. Madison St., Suite 800, Chicago, IL 60606, 1 (800) 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. New York State Department of Health, The New York State Diabetes Prevention and Control Program, 150 Broadway Room 350, Albany NY 12204, (518) New York Online Access to Health: 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. Excellus BlueCross BlueShield: Research Health Topics: Diabetes. (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.)

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