One of the most fulfilling aspects of being a dietitian and certified diabetes educator is helping people with diabetes become enlightened and empowered to take charge of their diabetes and their health. It is so rewarding to help people and find solutions and discover ways to get support for their diabetes self-management goals. There’s such a “fear factor” when it comes to diabetes, but with some patience, troubleshooting and support, people with diabetes can break away from the fear and embrace steps toward better health. Since November is Diabetes Awareness Month, I’m sharing my Guilt-Free RD approach to diabetes management, along with my personal relationship with it.
According to the Centers for Disease Control and Prevention, approximately 1 out of 11 people currently has diabetes, and as many as 1 in 3 U.S. adults could have diabetes by the year 2050 if current trends continue. Of the 29.1 million people who currently have diabetes, about 1 out of 4 do not know they have it. And of the 86 million people (1 in 3 adults) who have prediabetes, 9 out of 10 don’t know they have it.
Let’s face it – if you don’t know you have diabetes, there’s not much you can do about it. That’s why it’s so important to make sure you’re seeing your doctor on a regular basis and getting the appropriate tests so you can catch diabetes as early as possible and delay or prevent complications.
Knowledge may be ‘power’, but tools and strategies are ’empowering’. By the time my late father was officially diagnosed with type 2 DM in his mid-60’s he’d already had it for quite some time. When he went in to meet with the diabetes educator for the first time, she showed him how to check his blood sugar with a glucose monitor and it was over 400 mg/dL. I can only imagine how he felt – physically and emotionally. I have been a diabetes educator for more than 15 years – long before my dad was diagnosed. And while the advanced knowledge and skills I possess were helpful to him, it was my Guilt-Free approach that resonated most with him (and with my mom who was his number one fan and supporter). I encouraged him to think about his blood sugar as merely feedback on what was working and what was not working in his management plan – not as “good” or “bad” – and to incorporate realistic checks and balances that he could live with, such as eating a snack before he drove home from work or making sure his low blood sugar treatment contained only carbs and not protein or fat. These things may seem simple, but incorporating them into your daily life is not exactly easy. Over time, my dad (with my mom’s support) was able to manage his blood sugars quite well and I was very proud of him for facing it and working on it every single day.
Helping my dad with type 2 DM was one thing. Finding out my teenage niece had type 1 DM was an entirely different thing. Here I was, a CDE with more than 15 years’ experience and yet I felt helpless. I wanted to be supportive but not intrusive. At the advice of a dear family friend, I sent my niece a care package….that had nothing to do with diabetes. I just wanted her to know that she is a sweet, special person and that I love her. Diabetes doesn’t have to define her. It’s been almost a year since her diagnosis and she’s been to summer diabetes camp, and has an insulin pump and a continuous glucose monitor! Even though she was less than thrilled about going to camp, she did it and came back feeling better about her diabetes because she made lots of friends and met people who gave her information about the insulin pump. She says it’s still hard to keep her sugars right but all of the tools she has helps. Because of my involvement in the “diabetes online community” (the DOC) I send her info from time to time on interesting blogs and other social media stuff she might want to check out. But I leave it up to her to decide when and how much info she wants and needs. And the fact that she’s embraced the pump and finds it so much easier than multiple daily injections makes me excited and happy for her.
If you or someone you love is managing diabetes every day, I want you to know that studies show that people who are more actively engaged in their diabetes management have better outcomes. Doctors, dietitians and diabetes educators can provide you with a roadmap, but you should be the one in the driver’s seat.
Here are some tips and tools to support you on your journey:
• Know the rules of the road: Check out the AADE7 Self-Care Behaviors handouts in English and Spanish.
• Get behind the wheel: You are the most important person on your healthcare team. Educate yourself about diabetes by reading books, magazines and websites from credible sources (such as registered dietitians, nurses, physicians and reputable diabetes organizations). Ask your healthcare provider questions about your treatment plan and be an active participant in the problem solving process.
• Fuel up: Eat more healthfully—more fiber, less fat, salt, and sugar. Lose weight if needed or maintain a healthy weight. For people with type 2 DM, even a small amount of weight loss can significantly improve blood sugar levels and some people can even decrease or go off their diabetes medications (with a doctor’s supervision, of course).
• Start your engines: Get physical activity every day. It can be as simple as a daily walk. Find what works for you and stick with it. Aerobic activity, such as walking or swimming, is best for heart health, but strength training can be very effective for weight control, too.
• Follow the directions: Take your medications as directed. This is a problem that often gets overlooked. There may be many barriers to taking medication, such as negative feelings about them, fear of side effects, or financial reasons. However, diabetes pills and/or insulin are often necessary to control blood sugars and should always be taken as prescribed.
• Check the speedometer: Monitor your blood glucose levels. Blood sugar results are your own personal “speedometer” and provide valuable information. Don’t view these numbers as “good” or “bad” but instead use the information to learn how food, exercise, stress and other factors affect your blood sugars. Then use that information to make changes in your habits.
• Put the brakes on smoking: Or at least cut down as much as possible. Every little bit helps toward healthier circulation which is important in preventing or delaying complications such as heart disease, stroke, and kidney or eye disease.
• Pay attention to detours ahead: Diabetes is a progressive disease so it is normal and expected that you may need to make frequent changes in your diet, medication and exercise plan. These changes can be upsetting if you’re not aware that adjustments to your care plan are normal and necessary to stay on top of the disease. In addition, learn how to deal with roadblocks: healthy coping strategies are just as important as diet and exercise.
• Perhaps the most important step you can take to better manage your diabetes is to work closely with your diabetes care team for guidance and support. Just remember, you are not alone and you are, in fact, in the driver’s seat. The more input you have in navigating your diabetes care plan, the better!
To find a diabetes educator near you visit the AADE website here. To find a registered dietitian near you visit the AND website here.
Remember, the goal is to make sure diabetes doesn’t take control of your life, so that you can live life to it’s fullest and enjoy your journey and your loved ones every day!
If YOU have a story to share or diabetes strategies that work for you, please post a comment below! I’d love to hear from you!
If you liked this post, check out my other Food for Thought posts and my Sound Bites podcast.