Responding to a Diabetes Diagnosis

You've just been diagnosed with type 2 diabetes and your mind is swirling with questions.

You’ve just been diagnosed with type 2 diabetes and your mind is swirling with questions.

How do I check my blood sugar? Must I give up french fries? Will I have to give myself shots? Can I just take pills to lower my blood sugar? This isn’t the “bad kind” of diabetes, right?

Little wonder that you begin to feel panicky when your doctor uses the word diabetes and begins to explain about your body’s insulin resistance that causes sugar to accumulate in your blood instead of being used for energy.

Diabetes is a chronic disease with serious consequences that can include heart disease, blindness, kidney damage, nerve damage, sexual dysfunction, loss of limb, and even death—but it’s also a disorder that can be managed. Use your diagnosis as a call to action. You may be able to prevent or delay the most serious consequences.

“I always tell people: The good news is you’re in control. The bad news is you’re in control,” says Molly Brown, a certified diabetes educator for United Health Care in Plano, Texas.

So shore up your determination. Here’s what you can do:

• Learn your ABCs. Ask your doctor for your diabetes ABC numbers, and compare yours with these optimal levels: A1c: Results of 7 percent or less for this test of average blood sugar Blood pressure: less than 130/80 Cholesterol: low-density lipoprotein (LDL) less than 100 If your numbers are high, “don’t be patient,” advises Dr. Larry Deeb, a pediatric endocrinologist in Tallahassee, Fla. The average person diagnosed with type 2 diabetes already has had it for five years. Another six months or year of living with high levels of fat and sugar in the blood while you try to lose weight and start exercising could bring irreversible damage. Your doctor should prescribe medicine to correct your blood sugar level within three months.

  Make sure your physician examines your feet and teaches you about daily foot care, tests your urine for kidney problems, and monitors your medications during each visit. You may be referred to an endocrinologist (hormone specialist), cardiologist (heart specialist) or a podiatrist (foot specialist) if needed.

• Call your insurance company. Many offer disease management programs, free videos and booklets, and sometimes even a free blood sugar testing device. Ask about medical services and prescription coverage.
• Find a coach. Resources are available to coach you both mentally and physically into a new lifestyle. Find a certified diabetes educator through the American Association of Diabetes Educators website, www.aadenet.org, and make an appointment immediately. Your educator can explain how to check your blood sugar, how often to check it, and what the numbers mean. Though medications will bring your numbers down, there are side effects. In addition, type 2 diabetes gets worse over time, so you’ll need to keep increasing your medications, and eventually you may need regular insulin injections. Through diet and exercise, you can slow the progression, lower your medications, and possibly even eliminate the need to take pills. Together, you and your coach can devise an effective plan.
• See a dietitian. Your educator can recommend a registered dietitian who specializes in diabetes and will review what you typically eat. Tell the truth! If you crave chocolate cake, onion rings or alcohol, your dietitian will help you determine how to incorporate a reasonable amount into your diet without causing havoc to your body. You will learn how to count carbohydrates, control food portions, reduce fat and add fiber.
• Get moving! If your physician gives the OK, start a daily exercise program immediately. “Get out and walk!” Deeb urges. Exercise helps you lose weight, build muscle, speed metabolism and reduce blood sugar levels.
• See an ophthalmologist. Even if you are not experiencing vision problems, it’s important to monitor your vision regularly to prevent diabetic blindness. An eye specialist will look at the tiny blood vessels at the back of your eyes and may be able to correct problems if they are minor.
• Quit smoking. Having diabetes makes you more than twice as likely to suffer a heart attack or stroke, and far less likely to survive it. Smoking also boosts your risk.
• See your dentist regularly. Diabetes affects teeth and gums.
• Find support. More than 20 million Americans are living with diabetes. Visit the ADA website, www.diabetes.org, for information and to chat with other diabetics through the “Recently Diagnosed Message Board.” Find a local support group.

“Patients involved in support groups do better in managing their diabetes,” says Tamara Johnson, a diabetes educator at Kettering Medical Center in Kettering, Ohio (pop. 57,501).

Amy Eskind is a writer in Nashivlle, Tenn.

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