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Diabetes is About Numbers, Do You Know Yours
Dr. Kwabena Adubofour explains the important numbers that diabetic patients need to track to stay healthy.
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Learn more about Kwabena Adubofour, MD
Kwabena Adubofour, MD
Dr. Kwabena Adubofour, MD is an internal medicine specialist and has been practicing for 28 years. He specializes in internal medicine and family medicine.Learn more about Kwabena Adubofour, MD
Transcription:
Diabetes is About Numbers, Do You Know Yours
Bill Klaproth (Host): So, diabetes is about numbers. Proper diabetes management is about…numbers. Do you know your diabetes numbers, and what to look for, and what to understand about the numbers? So, let’s learn more with Dr. Kwabena Adubofour. Dr. Adubofour, thank you for your time. So, first off, can you tell us about the diabetes program at St. Joseph’s Hospital and Medical Center?
Kwabena Adubofour, MD (Guest): Thanks for doing this, Bill. Yes, we have a robust patient education program at St. Joseph’s Medical Center, and I really would want all the patients who are listening to this to avail themselves of the opportunity to learn as much as they can about the disease, especially if they have diabetes themselves or their loved ones have diabetes, and the easiest way to do this is to call our Diabetes Navigator, and the number there is 209-944-8355, and there are all sorts of programs that are geared towards making sure that patients enhance their knowledge of this disease.
Host: And, you know, and that’s really important. People need to educate themselves and be their own best health advocate, isn’t that right?
Dr. Adubofour: That’s a fantastic point, and when it comes to a chronic disease like diabetes, the more you know, the more powerful you are. What I always say is that diabetes, per se, does not cause blindness, does not cause heart disease, does not cause strokes, does not lead to loss of limb. What causes all of that is uncontrolled diabetes. So, the more you know, the more you are in control, the less the complications you’re going to have. That is why patient empowerment, patient education is absolutely crucial when you are managing a chronic disease such as this.
Host: That is such a great statement. So, it all comes down to control and managing your diabetes, so it doesn’t get out of control. So, let’s talk about—
Dr. Adubofour: There you go.
Host: Let’s talk about—
Dr. Adubofour: Right.
Host: How people can control this, and some of the things they need to know about. So, first off, let’s jump into some of the important factors like blood sugar numbers. What are the blood sugar numbers we should know?
Dr. Adubofour: There you go. So, the other point I always make is that diabetes is a numbers game, and I ask my patient, do you know your numbers? So, this is really, really important.
Host: Umm hmmm.
Dr. Adubofour: And the good news is that you have a disease where you can find out if you’re doing a good job with its management through blood sugar testing. So, the reason for testing is in order to enhance your diabetes management. At the end of the day, that’s what this disease is all about.
Host: Gotcha.
Dr. Adubofour: You can find out how well you’re doing. You can determine if the amount of food you’re eating is the right amount. You can determine the impact of exercise. More importantly, you can determine if you’re on the right medication for your type of diabetes. All that through the glucose testing that you’re doing. So, these are important numbers that one has to know, depending on age, depending on how long you’ve had the diabetes, depending on whether you have any co-morbid conditions associated with the disease process or not.
Host: So, it’s all a numbers game, and we need to learn how to—
Dr. Adubofour: Right.
Host: —manage those numbers.
Dr. Adubofour: Exactly.
Host: So, those numbers vary throughout the day. So, let’s talk about a normal day in the life of someone with say, Type II diabetes. What should we know about the numbers after someone wakes up?
Dr. Adubofour: It’s all an individualized number, and that is dependent on your age. It’s dependent on how long you’ve had the disease, and whether you’ve had any complications associated with that disease or not, but with your typical average patient, we really need you to wake up—anywhere between 80 and 120 milligrams per deciliter of your blood sugar, and again, if you’re dealing with someone who is a bit older, who lives all by themselves; they don’t have a friend or a neighbor or a relative coming to help them if their blood sugar goes down too low, your target for the morning may be different. They may be a little bit higher than a younger person who is capable of looking after themselves a little bit more. So, you have an 80-year-old—or—an 80-year old who lives by themselves. You’re not going to set the same targets as someone whose much younger than that individual. So, the patients need to talk to their clinicians to ensure that the target range they’ve set for both, what we call a fasting blood sugar and a prandial blood sugar, is appropriate for that individual, and this is really, really important.
Host: Gotcha. Ok. So, then what about after eating because that’s got to affect it, right?
Dr. Adubofour: Exactly.
Host: So, what about after—
Dr. Adubofour: Right.
Host: —yeah, breakfast, lunch, dinner? What should we know about that?
Dr. Adubofour: That’s a fantastic question. That’s a great question. Those numbers are really important in order for you to judge whether your food portions and the medications you’re taking to control the disease are appropriate or not. So, typically, what the American Diabetes Association says is that if the amount of food that’s sitting in front of you combined with your medications are appropriate, then your blood sugar should not be more than 180 milligrams per deciliter two hours after you’ve eaten that food, and this is really important for patients to know because by checking around meals, putting down the type of meal you ate, you can go—I mean Bill and I can come and call you, let’s go to a buffet, and you can look at that spread of food and know precisely what amount of those foods you’re supposed to eat so that your blood sugars do not become too high, and it is what I emphasize to patients all the time, and usually, anywhere from two to four weeks those individuals who are diligent about really checking their blood sugars and knowing what they’re doing with their foods become masters of this craft, and become so much easier to manage the disease when you know what you’re doing—you know your numbers. So, this is really, really important.
Host: So, you are making this very easy for us to understand. When you know your numbers, you understand how food can affect that number. So, knowing that mash potatoes increases your number to this, or rice increases your number to that, really helps you manage. Plus, then, portion control—you really can dial in what you’re eating and understand how it’s going to affect your numbers.
Dr. Adubofour: That’s an excellent point because if you do not know those numbers, come Thanksgiving—
Host: (Sigh)
Dr. Adubofour: You’re guessing—
Host: (Sigh)
Dr. Adubofour: —and you cannot guess—
Host: That’s not the—
Dr. Adubofour: —with (laughs)—
Host: —and that’s not good at Thanksgiving.
Dr. Adubofour: (Laughs) That’s not good at Thanksgiving.
Host: (Laughs)
Dr. Adubofour: You cannot guess at Thanksgiving. You need to know precisely—leaving that table what’s going to happen two hours from the time the meal is served. So, it’s really, really important that patients understand this properly.
Host: Well, the more you know, the better you can manage this. So, that makes sense. So, can you explain to us what A1C is? We hear this in commercials all the time. What is A1C?
Dr. Adubofour: That’s another very important number as well. So, fortunately, we’re able to detect in your blood a process we refer to as glycosylation of your hemoglobin. So, the amount of blood sugar in your blood, you know, to put it in simple terms, gets attached to a portion of your hemoglobin, and that hemoglobin is referred to as the A1C. So, the higher the blood sugar in your blood over a period of three months, the higher your A1C is going to be. So, that number is used to determine how well you’ve been coping with the disease over the last three months—very important number.
Host: Well, thank you for explaining that to us—another important number to remember. So, let’s turn to testing. So, how long will people have to keep poking themselves to monitor their blood glucose levels? I know technology has made a really big impact in this area. Is that right?
Dr. Adubofour: That’s a wonderful question, and that technology is here, and I think that it’s definitely going to get cheaper to do it. Now, it’s called continuous glucose monitoring in which a sensor is placed under the skin, and the patients can have access even on their cell phones to just how the variation in blood glucose during the day is taking place. It’s a wonderful tool, but we may still have to poke ourselves one or two times a day just to calibrate the machine, but it definitely beats having to poke your fingers several times a day when you have this technology available.
Host: So true, and what a great tool to help someone manage this and really understand those numbers. Again, so Dr. Adubofour, with this disease, if you could wrap this up for us, it seems like lifestyle is a major factor in managing this as we’ve been talking about. So, how important is it that people take charge of their own health and become their own best advocate?
Dr. Adubofour: So, number one, the emphasis here is that you’re in charge. Diabetes does not cause complications when it’s managed appropriately. You only get complications when you have uncontrolled diabetes. Number two, 99.99% of this fight rests on you as a patient, and this is the reason why you need to really understand what you and your doctor are trying to achieve. If you know your numbers, you can go and complain if those numbers are not reaching the targets you’ve set.
Host: Right.
Dr. Adubofour: Lifestyle—exercise is important. You need to know the impact of exercise on your blood sugars as well. So, combine all that with your diet, with the medications, to find out where you ought to be in order to prevent any of these complications from occurring. In other words, take control of your diabetes.
Host: You know, as you were saying this, you have explained this in such a crystal-clear way about how someone really has the power in their own hands to manage this. How many people have diseases where they don’t have that control—
Dr. Adubofour: Exactly.
Host: —and you know what I mean?
Dr. Adubofour: Great point.
Host: With this disease, you just said it, number one, you’re in charge. Number two, 99.9% of this rests on you. You can manage—
Dr. Adubofour: Right.
Host: —this and lead a pretty normal life with this—
Dr. Adubofour: Right.
Host: —with this condition, where someone with cancer—they’re kind of…oh boy, I don’t know what’s going to happen—
Dr. Adubofour: Um hmmm.
Host: —I’m going to try to do the right things—
Dr. Adubofour: Right.
Host: —but it’s kind of out of my hands. This one is in your hands, and then—
Dr. Adubofour: Right.
Host: —then number three, you said exercise is important. So, if you eat right, understand the numbers behind the food you’re eating, and you exercise and take care of yourself, you can manage this. You can live with this. You’ve got this. Right?
Dr. Adubofour: Bill. That was a wonderful summary of everything that we intended to get across today.
Host: Well, I—
Dr. Adubofour: Thank you.
Host: —learned it from you. I’m a good student.
Dr. Adubofour: (Laughs)
Host: (Laughs) You’re a good teacher.
Dr. Adubofour: Thank you so much. Thank you.
Host: Thank you, teacher. I appreciate it.
Dr. Adubofour: Thank you so much for doing this.
Host: Well, this has been great. It’s been my pleasure, Dr. Adubofour and thank you for your time. To learn more about community classes and support for those facing diabetes, please visit stjosephscares.org/diabetes, and if this podcast helped you out, please share it on your social channels. Let other people hear the important message from Dr. Adubofour and please check out the full podcast library for topics of interest to you. This is Hello Healthy, a Dignity Health Podcast. I'm Bill Klaproth. Thanks for listening.
Diabetes is About Numbers, Do You Know Yours
Bill Klaproth (Host): So, diabetes is about numbers. Proper diabetes management is about…numbers. Do you know your diabetes numbers, and what to look for, and what to understand about the numbers? So, let’s learn more with Dr. Kwabena Adubofour. Dr. Adubofour, thank you for your time. So, first off, can you tell us about the diabetes program at St. Joseph’s Hospital and Medical Center?
Kwabena Adubofour, MD (Guest): Thanks for doing this, Bill. Yes, we have a robust patient education program at St. Joseph’s Medical Center, and I really would want all the patients who are listening to this to avail themselves of the opportunity to learn as much as they can about the disease, especially if they have diabetes themselves or their loved ones have diabetes, and the easiest way to do this is to call our Diabetes Navigator, and the number there is 209-944-8355, and there are all sorts of programs that are geared towards making sure that patients enhance their knowledge of this disease.
Host: And, you know, and that’s really important. People need to educate themselves and be their own best health advocate, isn’t that right?
Dr. Adubofour: That’s a fantastic point, and when it comes to a chronic disease like diabetes, the more you know, the more powerful you are. What I always say is that diabetes, per se, does not cause blindness, does not cause heart disease, does not cause strokes, does not lead to loss of limb. What causes all of that is uncontrolled diabetes. So, the more you know, the more you are in control, the less the complications you’re going to have. That is why patient empowerment, patient education is absolutely crucial when you are managing a chronic disease such as this.
Host: That is such a great statement. So, it all comes down to control and managing your diabetes, so it doesn’t get out of control. So, let’s talk about—
Dr. Adubofour: There you go.
Host: Let’s talk about—
Dr. Adubofour: Right.
Host: How people can control this, and some of the things they need to know about. So, first off, let’s jump into some of the important factors like blood sugar numbers. What are the blood sugar numbers we should know?
Dr. Adubofour: There you go. So, the other point I always make is that diabetes is a numbers game, and I ask my patient, do you know your numbers? So, this is really, really important.
Host: Umm hmmm.
Dr. Adubofour: And the good news is that you have a disease where you can find out if you’re doing a good job with its management through blood sugar testing. So, the reason for testing is in order to enhance your diabetes management. At the end of the day, that’s what this disease is all about.
Host: Gotcha.
Dr. Adubofour: You can find out how well you’re doing. You can determine if the amount of food you’re eating is the right amount. You can determine the impact of exercise. More importantly, you can determine if you’re on the right medication for your type of diabetes. All that through the glucose testing that you’re doing. So, these are important numbers that one has to know, depending on age, depending on how long you’ve had the diabetes, depending on whether you have any co-morbid conditions associated with the disease process or not.
Host: So, it’s all a numbers game, and we need to learn how to—
Dr. Adubofour: Right.
Host: —manage those numbers.
Dr. Adubofour: Exactly.
Host: So, those numbers vary throughout the day. So, let’s talk about a normal day in the life of someone with say, Type II diabetes. What should we know about the numbers after someone wakes up?
Dr. Adubofour: It’s all an individualized number, and that is dependent on your age. It’s dependent on how long you’ve had the disease, and whether you’ve had any complications associated with that disease or not, but with your typical average patient, we really need you to wake up—anywhere between 80 and 120 milligrams per deciliter of your blood sugar, and again, if you’re dealing with someone who is a bit older, who lives all by themselves; they don’t have a friend or a neighbor or a relative coming to help them if their blood sugar goes down too low, your target for the morning may be different. They may be a little bit higher than a younger person who is capable of looking after themselves a little bit more. So, you have an 80-year-old—or—an 80-year old who lives by themselves. You’re not going to set the same targets as someone whose much younger than that individual. So, the patients need to talk to their clinicians to ensure that the target range they’ve set for both, what we call a fasting blood sugar and a prandial blood sugar, is appropriate for that individual, and this is really, really important.
Host: Gotcha. Ok. So, then what about after eating because that’s got to affect it, right?
Dr. Adubofour: Exactly.
Host: So, what about after—
Dr. Adubofour: Right.
Host: —yeah, breakfast, lunch, dinner? What should we know about that?
Dr. Adubofour: That’s a fantastic question. That’s a great question. Those numbers are really important in order for you to judge whether your food portions and the medications you’re taking to control the disease are appropriate or not. So, typically, what the American Diabetes Association says is that if the amount of food that’s sitting in front of you combined with your medications are appropriate, then your blood sugar should not be more than 180 milligrams per deciliter two hours after you’ve eaten that food, and this is really important for patients to know because by checking around meals, putting down the type of meal you ate, you can go—I mean Bill and I can come and call you, let’s go to a buffet, and you can look at that spread of food and know precisely what amount of those foods you’re supposed to eat so that your blood sugars do not become too high, and it is what I emphasize to patients all the time, and usually, anywhere from two to four weeks those individuals who are diligent about really checking their blood sugars and knowing what they’re doing with their foods become masters of this craft, and become so much easier to manage the disease when you know what you’re doing—you know your numbers. So, this is really, really important.
Host: So, you are making this very easy for us to understand. When you know your numbers, you understand how food can affect that number. So, knowing that mash potatoes increases your number to this, or rice increases your number to that, really helps you manage. Plus, then, portion control—you really can dial in what you’re eating and understand how it’s going to affect your numbers.
Dr. Adubofour: That’s an excellent point because if you do not know those numbers, come Thanksgiving—
Host: (Sigh)
Dr. Adubofour: You’re guessing—
Host: (Sigh)
Dr. Adubofour: —and you cannot guess—
Host: That’s not the—
Dr. Adubofour: —with (laughs)—
Host: —and that’s not good at Thanksgiving.
Dr. Adubofour: (Laughs) That’s not good at Thanksgiving.
Host: (Laughs)
Dr. Adubofour: You cannot guess at Thanksgiving. You need to know precisely—leaving that table what’s going to happen two hours from the time the meal is served. So, it’s really, really important that patients understand this properly.
Host: Well, the more you know, the better you can manage this. So, that makes sense. So, can you explain to us what A1C is? We hear this in commercials all the time. What is A1C?
Dr. Adubofour: That’s another very important number as well. So, fortunately, we’re able to detect in your blood a process we refer to as glycosylation of your hemoglobin. So, the amount of blood sugar in your blood, you know, to put it in simple terms, gets attached to a portion of your hemoglobin, and that hemoglobin is referred to as the A1C. So, the higher the blood sugar in your blood over a period of three months, the higher your A1C is going to be. So, that number is used to determine how well you’ve been coping with the disease over the last three months—very important number.
Host: Well, thank you for explaining that to us—another important number to remember. So, let’s turn to testing. So, how long will people have to keep poking themselves to monitor their blood glucose levels? I know technology has made a really big impact in this area. Is that right?
Dr. Adubofour: That’s a wonderful question, and that technology is here, and I think that it’s definitely going to get cheaper to do it. Now, it’s called continuous glucose monitoring in which a sensor is placed under the skin, and the patients can have access even on their cell phones to just how the variation in blood glucose during the day is taking place. It’s a wonderful tool, but we may still have to poke ourselves one or two times a day just to calibrate the machine, but it definitely beats having to poke your fingers several times a day when you have this technology available.
Host: So true, and what a great tool to help someone manage this and really understand those numbers. Again, so Dr. Adubofour, with this disease, if you could wrap this up for us, it seems like lifestyle is a major factor in managing this as we’ve been talking about. So, how important is it that people take charge of their own health and become their own best advocate?
Dr. Adubofour: So, number one, the emphasis here is that you’re in charge. Diabetes does not cause complications when it’s managed appropriately. You only get complications when you have uncontrolled diabetes. Number two, 99.99% of this fight rests on you as a patient, and this is the reason why you need to really understand what you and your doctor are trying to achieve. If you know your numbers, you can go and complain if those numbers are not reaching the targets you’ve set.
Host: Right.
Dr. Adubofour: Lifestyle—exercise is important. You need to know the impact of exercise on your blood sugars as well. So, combine all that with your diet, with the medications, to find out where you ought to be in order to prevent any of these complications from occurring. In other words, take control of your diabetes.
Host: You know, as you were saying this, you have explained this in such a crystal-clear way about how someone really has the power in their own hands to manage this. How many people have diseases where they don’t have that control—
Dr. Adubofour: Exactly.
Host: —and you know what I mean?
Dr. Adubofour: Great point.
Host: With this disease, you just said it, number one, you’re in charge. Number two, 99.9% of this rests on you. You can manage—
Dr. Adubofour: Right.
Host: —this and lead a pretty normal life with this—
Dr. Adubofour: Right.
Host: —with this condition, where someone with cancer—they’re kind of…oh boy, I don’t know what’s going to happen—
Dr. Adubofour: Um hmmm.
Host: —I’m going to try to do the right things—
Dr. Adubofour: Right.
Host: —but it’s kind of out of my hands. This one is in your hands, and then—
Dr. Adubofour: Right.
Host: —then number three, you said exercise is important. So, if you eat right, understand the numbers behind the food you’re eating, and you exercise and take care of yourself, you can manage this. You can live with this. You’ve got this. Right?
Dr. Adubofour: Bill. That was a wonderful summary of everything that we intended to get across today.
Host: Well, I—
Dr. Adubofour: Thank you.
Host: —learned it from you. I’m a good student.
Dr. Adubofour: (Laughs)
Host: (Laughs) You’re a good teacher.
Dr. Adubofour: Thank you so much. Thank you.
Host: Thank you, teacher. I appreciate it.
Dr. Adubofour: Thank you so much for doing this.
Host: Well, this has been great. It’s been my pleasure, Dr. Adubofour and thank you for your time. To learn more about community classes and support for those facing diabetes, please visit stjosephscares.org/diabetes, and if this podcast helped you out, please share it on your social channels. Let other people hear the important message from Dr. Adubofour and please check out the full podcast library for topics of interest to you. This is Hello Healthy, a Dignity Health Podcast. I'm Bill Klaproth. Thanks for listening.