By Amy Freeman, RDN, LDN, CDE, ACE-HC Certified Diabetes Educator | Sodexo at Ocala Health
Meet Paul*. Paul woke up three weeks ago, had his eggs and bacon for breakfast, brushed his teeth, took a shower, put on his favorite and most comfortable shirt and shorts and drove to his doctor’s appointment. The nurse practitioner, Roberto, enters the exam room and informs Paul, “Your blood work shows that your blood sugars are still too high; you have type 2 diabetes.” Roberto continues to explain the medication Paul will need to take and how Paul will have to start using a glucometer to check his blood sugars at home, but all Paul can think about is “I have diabetes? I have the disease that killed my Dad?”
If you have recently been diagnosed with diabetes type 2, perhaps you are feeling overwhelmed or frightened. What will the future look like if you have to take insulin or monitor your blood sugars? Perhaps you have a family member like Paul who has had a devastating health event related to diabetes type 2. However, what if you were told diabetes is a manageable condition and with planning and forethought does not need to drastically impact your life?
Let’s continue our journey with Paul. Paul left his appointment with Roberto feeling upset, confused, and utterly frustrated. However, while leaving the appointment, Roberto gave him some information and phone numbers of a local support group and a local diabetes self-management education class. Paul called those numbers to find out what he could do to take control of his diabetes.
Diabetes type 2 is a condition of insulin resistance. Insulin resistance is the reduced response of cells in the body to the function of insulin. Insulin is a hormone, a chemical messenger, sent from the pancreas through the blood stream to the body’s cells. Insulin’s action allows the sugar in the blood to enter into the cells. Insulin resistance results in higher levels of sugar in the blood and over time to the diagnosis of diabetes type 2.
When the “fasting” blood sugar, also called “before breakfast” blood sugar, is above 125 mg/dl on two different blood draws, type 2 diabetes is diagnosed. Normal fasting blood sugar is less than 100 mg/dl. Another way to diagnose diabetes is with a blood test called hemoglobin A1C (referred to as A-1-C). Hemoglobin is the part of the blood cell that carries oxygen and nutrients in the blood stream. When too much sugar is attached to the blood cell, the level of detectable hemoglobin A1C increases. Diabetes is diagnosed with an A1C of 6.5% or higher, a normal level being less than 5.7%.
So, what happens after a diagnosis of diabetes? Remember Paul? Paul took the advice of his nurse practitioner, Roberto, and made a few phone calls to see what education opportunities were in his community. The same information can be found on the American Diabetes Association website, at diabetes.org. To find your local diabetes education classes, visit diabetes.org, select the “in my community” option and scroll down to “diabetes education in your area” (on the right side of the screen) and submit your zip code. The Villages area has four different diabetes education providers, they are all local teams providing programs recognized by the American Diabetes Association.
While your physician or nurse practitioner is a vital member of your diabetes management team, you are the primary manager of your diabetes. Below are some helpful ways to assist you in managing diabetes type 2:
1. Be aware of the risks
• The risk of low blood sugar – know how to recognize and treat low blood sugar
• The risk of high blood sugar – know what causes high blood sugar and how to stabilize your blood sugar
2. Be aware of the risk of ignorance
• Know what you need to do to improve your long-term health with diabetes such as:
• When to get your eyes examined
• When to get your feet examined by a physician and when you should examine your feet
• When to get routine blood work
• The side effects of your medications (not all diabetes medications work the same and some non-diabetes mediation can also impact your blood sugar)
• When to check your blood sugars at home, if your physician or nurse practitioner prescribed this for you
3. Be aware when you need to ask for help
Support is part of living with diabetes: friends, family, healthcare providers, on-line or face-to-face support groups can play an instrumental part in making your life with diabetes less stressful.
The final “risk” is the risk of being frightened. Yes, diabetes can be a scary place to be: new medications, perhaps a new eating plan and a new focus on being more active. That can be scary. You are encouraged to seek out the guidance and experience of your local certified diabetes educator and your local diabetes support group. Thirty million Americans, 9.4% of the population, is living with diabetes – you are not alone.
Let’s visit Paul one more time. Last Thursday Paul attended a local diabetes support group. There he met 12 other people living with type 2 diabetes who were once in Paul’s shoes. Paul made some new friends, joked with the group about how scared he was feeling, and left the support group feeling confident he could move forward with treating his diabetes type 2. This morning, Paul made an appointment with a certified diabetes educator at the local diabetes education program (even better, their office is just three miles from his home)!
*Please note that the client’s name has been changed to protect his privacy.