Managing diabetes is more than just controlling blood sugar levels—it’s about preventing complications that can significantly impact quality of life.
For Chad Ricks, an experienced healthcare leader for WoundTech and interim Regional Medical Director for several states, the importance of early and proactive diabetes management is both a professional and personal mission. With over 32 years in critical care, emergency services, and hospital leadership, he has witnessed the far-reaching impacts of unmanaged diabetes, particularly in underserved communities.
Understanding the Importance of Early Prevention
Preventing complications like neuropathy, ulcers, and vascular diseases begins with awareness. Early detection and proactive measures are crucial because diabetes often progresses silently. For instance, individuals may have elevated blood sugar levels for years without noticeable symptoms, making routine screenings and health education essential.
“I didn’t know I had type 2 diabetes until routine blood work revealed an elevated A1C. Like many, I had no symptoms other than being overweight,” Dr. Ricks tells BlackDoctor.org
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The Cultural and Socioeconomic Impact
Diabetes disproportionately affects communities of color, particularly Black American, Latino, and Asian populations.
Dr. Ricks highlights a combination of cultural, socioeconomic, and historical factors contributing to this disparity:
1. Food Deserts and Limited Access
Many urban areas lack access to affordable, nutritious foods, leading families to rely on processed or fast foods high in sugar and unhealthy fats. Dr. Ricks notes, “People eat what they can afford, often preparing meals the way they were taught—quick, easy, and fried.”
2. Psychological and Emotional Factors
Food often serves as a comfort mechanism for those facing economic hardship or systemic inequities. This can result in unhealthy eating habits that increase the risk of obesity and diabetes.
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3. Lack of Health Literacy
In many communities, discussions about family medical history are minimal. Terms like “the sugar” are colloquial euphemisms for diabetes, which may delay recognition of the disease’s seriousness.
How Diabetes Progresses Without Intervention
Unmanaged diabetes creates a cascade of health issues:
- Pancreatic Overcompensation. The pancreas secretes excess insulin to process food in individuals with increasing body mass. Over time, this cycle exhausts the pancreas, leading to insulin resistance.
- Complications Arising from High Blood Sugar. Persistent high blood sugar damages blood vessels, leading to poor circulation, vision problems, and delayed wound healing. Dr. Ricks mentions seeing cases where unmanaged A1C levels—measuring three-month average blood sugar—soar above 14, significantly increasing the risk of ulcers, infections, and cardiovascular diseases.
One of the most concerning diabetes complications is its effect on vascular health.
“The blood vessels are meant to expand and contract, but high sugar content makes them stiff. This prevents proper blood flow, whether through the arteries or veins, leading to complications like ulcers and neuropathy,” Dr. Ricks adds.
When the body’s insulin is ineffective or when insulin resistance develops, blood sugar levels remain dangerously high. Over time, these high levels of sugar cause:
1. Neuropathy
Nerve damage from prolonged high glucose levels results in reduced sensation, especially in the extremities. This often leads to injuries going unnoticed.
“I’ve had patients come to the emergency room with a severe ulcer on the bottom of their foot, only realizing it was there because their sock was soaked in blood or fluid. They couldn’t feel the wound because of neuropathy,” Dr. Ricks notes.
2. Foot Ulcers and Wound Complications
Poor circulation due to vascular damage can prevent wounds from healing properly, increasing the risk of severe infections or even amputations.
“A diabetic foot ulcer can develop quickly and worsen before the patient even realizes it’s there. Routine foot checks and medical visits are critical to catching these problems early,” Dr. Ricks says.
3. Other Comorbidities
High blood sugar levels also strain the kidneys, eyes, and heart. Many patients discover their diabetes only after complications like vision loss, kidney failure, or heart attacks.
The Importance of Regular Medical Check-Ups
Dr. Ricks emphasizes the necessity of routine medical care. “Many people pay for insurance but don’t utilize it. Insurance won’t refund unused premiums, so make the most of it. Regular check-ups, especially for those over 45 or with known conditions like diabetes or hypertension, are vital,” he says.
He advises:
- Annual Check-Ups for the Young and Healthy. Those under 35 with no known health issues should see a doctor at least once a year.
- Biannual or Quarterly Visits for Older Adults or Those with Health Conditions. Regular monitoring ensures conditions like diabetes are managed effectively, reducing the risk of severe complications.
The Power of Prevention
Proper education, access to healthcare, and proactive measures can significantly reduce the severity of diabetes and its complications.
“My father had type 2 diabetes but managed it well with diet, exercise, and medication. Despite his condition, he avoided many of the vascular complications because he stayed on top of his health,” Dr. Ricks shares.
Steps to Prevent and Manage Diabetes Complications
Managing diabetes effectively requires a multi-faceted approach:
1. Proper Medical Care
Regular doctor visits ensure early detection and management. Dr. Ricks stresses the importance of understanding A1C levels—a key marker of blood sugar control.
New medications, such as GLP-1 receptor agonists, offer hope for controlling A1C levels when combined with proper diet and exercise.
2. Dietary Changes
A focus on clean eating is crucial.
- Increase: Fruits, vegetables, and whole grains.
- Decrease: Carbohydrates like rice, bread, pasta, and processed foods.
- Avoid: Sugary drinks and snacks.
“In food deserts, access to quality food can be a challenge, but even small changes, like reducing soda intake and choosing fresh produce when possible, can make a difference,” Dr. Ricks notes.
3. Exercise
Incorporating regular physical activity helps control weight and improves insulin sensitivity.
Even light activities like walking or stretching can have a significant impact.
4. Foot Care and Monitoring
Dr. Ricks also highlights the importance of routine foot examinations for diabetics:
- Check for cuts, sores, or discoloration daily.
- Seek immediate care for any wounds or unusual changes.
“Diabetic foot ulcers often worsen because patients aren’t aware of them due to neuropathy. Catching these early can prevent severe outcomes.”
The Importance of Knowing Your Family History
Diabetes often runs in families, and knowing your family’s medical history can provide crucial insights into your own health risks. Unfortunately, this knowledge isn’t always accessible, especially in fragmented family structures.
“As someone who was adopted, I didn’t know my family history for most of my life. When doctors asked about it, I couldn’t answer, and it felt isolating. However, after reconnecting with my biological parents, I learned about my mother’s side having a history of strokes and cancer, while my father’s side had cardiovascular disease and diabetes. This information has been life-changing, not only for me but also for my children, as they now know what to watch for,” Dr. Ricks adds.
He emphasizes that understanding family history helps patients and doctors proactively address potential risks. For example, knowing that glaucoma runs in his family prompted him to request regular diabetic retinopathy scans during his eye exams.
“Even if your family history is incomplete, any information you can gather is a valuable tool for managing your health and catching issues early,” Dr. Ricks advises.
Final Advice for Newly Diagnosed Patients
For those newly diagnosed with diabetes, Dr. Ricks offers this advice:
- Learn as Much as You Can. Understand what diabetes is and how it affects your body. Education is key to managing the condition effectively.
- Build a Strong Healthcare Team. Find a trusted provider who listens to your concerns and works with you to create a personalized care plan.
- Be Proactive, Not Reactive. Don’t wait for complications to arise. Take control by monitoring your health, following a balanced diet, and staying active.
- Don’t Ignore Your Feet. Check them daily, wear appropriate footwear, and don’t hesitate to seek help for any unusual changes.
Diabetes may be a silent killer, but it doesn’t have to be a death sentence. Through education, access to care, and proactive management, you can significantly reduce the risk of severe complications.
“Knowledge is power,” Dr. Ricks concludes. “Whether it’s knowing your family history, understanding the importance of routine care, or making small changes in your diet and lifestyle, these steps can save lives. Diabetes is a battle we can win, one informed decision at a time.”
