By: Molly Boll
You’ve Been Diagnosed with Diabetes – What’s Next?
Diabetes is a serious, lifelong condition that touches every part of your life. If you’ve recently been diagnosed with diabetes, you should know that living with this disease is not easy. It’s going to take hard work and discipline to manage your diabetes.
But, the good news is that it can be done! You can enjoy a good life while having diabetes. There are a lot of things you can do to protect your health from this disease. By taking charge of your diabetes today, you can live a more healthy life in the years to come.
My Life with Diabetes
I would like to start by giving you a quick glance at my struggles with diabetes. As I look back to when I was first diagnosed some 27 years ago, I realize today the extent of my denial at that time. I did not even take my diabetes medications for the first two years after diagnosis. I thought I was invincible, and I felt fantastic! I had a college education and a very interesting and demanding career in the Alaskan seafood industry. Now, how could I have this disease called DIABETES? People who have diseases are sick, and I was not sick!
Little did I know at that time that my blood glucose levels were working hard on my internal organs to eventually cause many health complications. Fortunately, my mother steered me to one of the top endocrinologists in the United States, Dr. Irl Hirsch of the University of Washington Medical Center-Diabetes Clinic.
Over the years, and with Dr. Hirsch’s help, I have slowly learned how to manage this disease. It has been an ongoing process, and one in which I sometimes succeed and other times fail. But the important thing is that when I do fail, I pick myself up and start all over again in this process of managing my diabetes.
Yes, approximately 60% of people living with diabetes have denied having this disease at one time or another. Yet, diabetes is a disease that seldom goes away. It is always with us. We have to consistently monitor our blood glucose levels, take our medications, and watch our diets. You are certainly not alone if you find yourself denying that you have this disease. But it is vitally important for you to acknowledge that you have diabetes, and to be willing to pick yourself up and continue on your self-management program for good diabetes control.
You have diabetes. So what’s next?
It is paramount to understand that YOU, AND ONLY YOU, are in control of your diabetes; but you can manage this disease with the help of a strong team. I like to explain this by way of a triangle and a ship. You are the captain of your ship at the top of the triangle; your doctor is the chief engineer at the lower left point; and your nutritionist is the first mate at the lower right point of the triangle.
You ultimately run the ship, while your doctor is your chief advisor and your nutritionist gives you the fuel to run your ship. It takes a TEAM effort to manage your diabetes. So, the first thing to do is to find a well-qualified internal medicine doctor who is familiar with diabetes, or an endocrinologist, as well as a diabetic nutritionist.
Sailing towards a full and healthy life.
Now that you have this concept of a ship to help you with your diabetes control, your ship must have a destination. Ultimately, this destination is a full and healthy life where your diabetes is well under control. Here are some suggestions to get you started on your journey to your “diabetes destination.”
Assemble your diabetes medical team. It is important to find the right physician for your diabetes visits, whether that is an endocrinologist or an internal medicine doctor. After you find the doctor that’s the right fit for you, be sure to ask him or her for the names of recommended diabetic nutritionists, eye doctors, and foot doctors.
Enroll in a diabetes class. It is highly suggested that you enroll in a diabetes class to learn more about your disease. Knowledge is a powerful tool in diabetes self-management. You will also meet a supportive network of people who are facing the same challenges that you are.
Test your blood sugar. I’ve found this to be the absolute most important tool. How can you possibly manage this disease if you do not know the levels of your blood glucose? Your diabetes educator can teach you how to use one of the many blood glucose meters available, and your doctor can tell you how often to test. You might be instructed to take a fasting test before your breakfast and then one or two more tests before lunch or dinner. Bring your blood glucose machine with you to your doctor’s visits so that he or she can see trends in your readings.
Lose weight. Diabetes and heart disease go hand in hand with excess weight. Obesity strains your heart, raises your blood pressure, and raises your LDL (bad) cholesterol and triglyceride (blood fat) levels. It lowers HDL (good) cholesterol. Even losing ten pounds can help to decrease your heart disease risks by lowering blood pressure, insulin resistance, and body fat.
Be physically active. Regular exercise helps to lower blood glucose levels and lower insulin resistance. This means your body can use its own insulin more effectively. Walking, swimming, and biking are excellent forms of exercise.
Eat a healthy and balanced diet. Have your diabetic nutritionist assist you in putting together a good meal plan for your particular diabetes. One essential component of this plan is that you eat all of the food groups daily. We will be discussing healthy eating for those with diabetes in our next article, with recipes included.
Take your medications as prescribed by your doctor. You must follow your doctor’s recommendations about your diabetic medications. It is essential to blood glucose management that your medications are taken daily as per the instructions of your doctor.
Know about the ABC’s of diabetes.
The (A) stands for a Glycosylated hemoglobin test (A1C). The A1C test measures the amount of sugar that attaches to protein in your red blood cells. Your red blood cells live for about two to three months, so this test shows your average blood sugar levels during that time. The greater the amount of sugar in your blood and the longer it remains high, the more sugar that will attach to those red blood cells. It is suggested you have this test done at least every three to six months. The American College of Endocrinology (ACE) recommends a target A1C of less than 6.5%. To give you an example of what the A1C indicates in terms of blood sugar, if your A1C is 6, then your average blood sugar would be 135 mg/dl; if your A1C is 7, then your average blood sugar would be 170 mg/dl; and if your A1C is 9, then your average blood sugar would be 240 mg/dl. The ACE recommends the following goals:
Blood sugar before meals=less than 110 mg/dl.
Blood sugar 2 hrs after meals=less than 140 mg/dl.
A word of caution here: these levels apply to most people, but your individual levels may be higher or lower. Your healthcare team will help you set the blood sugar target range that is best for you. It is also suggested that you try to keep your blood sugar levels similar on a daily basis. Research has shown that “variable” blood sugar levels can cause diabetic complications.
The (B) stands for blood pressure. It is said that people with diabetes are as much as three times more likely to have high blood pressure than people without diabetes. For this reason, people with diabetes are at a greater risk for heart disease. High blood pressure increases your risk for heart disease and stroke, and is also a factor in diabetic kidney disease, and eye and nerve problems. About 71% of people with diabetes have high blood pressure/hypertension. There are two numbers associated with blood pressure levels: the systolic (the bigger number) which measures the pressure as your heart beats and pushes blood into the blood vessels; and the diastolic (the smaller number), which measures the pressure when your heart rests between beats. The American Diabetes Association recommends that your blood pressure be no more than 130 for systolic and 80 for diastolic. If you have high blood pressure, you can make a number of lifestyle changes to lower your numbers. Quitting smoking, exercising at least four times per week, lowering your sodium intake, and adopting a weight-loss program if you are overweight can help to lower your blood pressure. Many people also need medication to get their blood pressure into the target range. These could include ACE inhibitors, angiotension receptor blockers (ARBs), beta-blockers, or diuretics.
The (C) stands for Cholesterol. If your LDL (bad) cholesterol is higher than 100 mg/dl., your HDL (good) cholesterol is lower than 40 mg/dl., and your triglycerides (blood fat) are higher than 200 mg/dl., then you are at greater risk for cardiovascular disease, diabetes, and insulin resistance. To keep cholesterol within healthy limits, eat a diet low in saturated fat and low in cholesterol.
In summary, whether you have been recently diagnosed or you have had diabetes for years, but do not feel in control of the disease, it is highly suggested that you: get your diabetes health team together; register for a diabetes education class; test your blood sugars daily; begin a weight loss program if needed; stop smoking; exercise consistently; eat a healthy and balanced diet, take your medications as prescribed; and know the ABC’s of diabetes.
Our next diabetes article will focus entirely on exercise and good nutrition, and will include some delicious recipes that complement a healthy diabetic diet.
If you have any questions about diabetes, please feel free to email me at firstname.lastname@example.org and I will attempt to answer all of your questions.
GOOD LUCK WITH YOUR DIABETES SELF-MANAGEMENT PROGRAM! AND REMEMBER, “YOU CAN DO IT!”