By Wil Dubois, BS, AAS, CPT, TPT
So you’ve just been diagnosed with Type 2 diabetes? You’re probably freaking out, or in total shock, or both. Well, rest assured you’re not alone, medically or emotionally.
On the medical side, in the U.S. alone, more than 4,600 people were diagnosed with diabetes every day in 2014. And on the emotional front, research shows that a diagnosis of diabetes has the same impact as a heart attack.
You’re in shock, and no doubt you’re confused. There’s a lot to learn, so much that doesn’t make sense, and it’s all happening too fast! How do you move forward? What’s the first step, and what are the next steps?
This simple, nine-step quick-start guide for diabetes can help you through the first few weeks after diagnosis.
Many people believe they gave themselves diabetes by eating poorly or by being overweight. If you’re one of them, you need to let go of that guilt. It’s simply not true. No one gets diabetes by eating too many candy bars. Diabetes is a complex polygenic disease, meaning its roots are at the genetic level and the causes are embedded in multiple genes.
If being fat were all it took to get diabetes, there would be far more people with diabetes. Consider the math: Our national obesity rate is nearly 30%, while our diabetes rate is about 10%.
No doubt about it: Diabetes carries a fearsome reputation. It can make you go blind. You can lose your legs. Your kidneys can fail. Right?
Those are all myths. Diabetes doesn’t do any of those things. Well-controlled diabetes is the leading cause of absolutely nothing.
All of the feared “complications of diabetes” actually are complications of high blood sugar, which when left alone is worse than having battery acid circulating in your blood. As long as you control your blood sugar, you’ll live a long, happy, and healthy life. Let go of the fear; instead, use that energy to learn and do what is necessary to control your blood sugar.
Your doctor doesn’t speak the same language you do. Doctors use all kinds of unique technical terms, buzz words, and acronyms commonplace in their profession. On top of that, in all likelihood you didn’t hear one word your doctor said after, “You have diabetes.” Those three words pretty much blocked out the rest of the conversation.
You need to go back to your doctor and say, “I’m sorry doctor — that was such a shock last time that I don’t think I heard a single thing you told me afterwards.” Ask your doctor to recap the treatment plan. Take notes. Don’t hesitate to ask what technical terms mean or to write them down to look up later. You’ll hear strange terms like hyperglycemia, HbA1c, microalbumin and maybe all sorts of scary-sounding words that end in “-opathy,” like retinopathy, neuropathy, and nephropathy. Learn them all.
At a minimum, you’ll be given a small machine called a blood glucose monitor. It’s important to learn to use this machine both correctly and wisely.
It’s unlikely your doctor will have the time to show you how to operate it, but one of the nurses on staff might. Also, you can always ask your pharmacist for help. Most meters come with a quick-start guide like any other high-tech device and, unlike many consumer electronics, most meter companies have a 24-hour help line you can call to ensure you’re using the machine correctly.
To use the meter smartly, you simply need to have the right attitude. Being asked to poke your finger isn’t a punishment — it’s a gift. Being able to track your own blood sugar is the first step in taking control of your diabetes, and you should do it fearlessly and with great curiosity. Numbers higher than you’d like? Don’t let it get you down. You need to embrace the fact that high numbers aren’t bad; they’re just good information. Testing shows you if you’re succeeding or if you need to make adjustments. The meter is your best friend, not your enemy.
The best way to test is in pairs — checking before and after meals — to understand how different foods affect your blood sugar. In all likelihood, your insurance won’t cover enough test strips, but you should buy more out-of-pocket, because they’re the key to success and are worth the investment, especially at first.
Medications don’t end at your doctor’s prescription pad. Talk to your pharmacist about the proper way to take each medication and whether you should be aware of any possible side effects.
You’re adjusting to a whole new schedule. Don’t be afraid to create a battle plan and tape it to your bathroom mirror or refrigerator.
You’ll likely have to make some changes in how you eat. These changes might be minor, or they might be major — it depends on how high your blood sugar is, how you eat now, and your doctor’s philosophy. There’s no official “diabetes diet,” but liquid sugars such as sodas and bottled teas usually are banished and, in many cases, you may need to reduce the amount of high-carbohydrate foods you eat. High-carb foods are sometimes called white foods: products made with sugar, flour, potato, rice, and corn.
Don’t panic. White foods don’t need to be eliminated. You just may have to reduce your quantities and make sure you don’t eat too many white foods in a single meal. But regardless of what your health-care team asks you to do, realize that diet change is best done a little at a time. Radical change is traumatic, hard to deploy, and harder to sustain. If you take things one small step at a time, giving yourself time to adjust, you can do it.
Like changes in diet, increases in movement should be made a little at a time, both to make them sustainable and because the body needs to adjust to increases in activity. Going from couch potato to gym rat in one week is a guaranteed recipe for a pulled, torn, twisted, or broken something.
The fact is, you’re in this for the long haul, so there’s no harm in wading in slowly.
Your family doesn’t know it yet, but diabetes is a social disease. The changes you need to make will affect them, and if you all go into it with team spirit everyone will benefit. The changes in diet and exercise can improve everyone’s health.
Ask for your family’s support, but be prepared for the fact that some will be better about changing their routines than others. Many people newly diagnosed with diabetes find a support group helpful. Your doctor should have a list of support groups in your area.
Diabetes can be expensive, so plan for it. Recent estimates put the average out-of-pocket cost of having diabetes at a whopping $7,900 a year. You may need to make some adjustments to your family budget.
Depending on your health insurance, you may have co-pays for doctor, educator, dietitian, and specialist visits, as well as for medicines — perhaps as many as a dozen total to control blood sugar, blood pressure, cholesterol, and possibly depression (diabetes can cause depression on the biochemical level). Many of the best blood sugar control medications are covered only under the more expensive “tiers” of health plans, meaning they cost more per month than other drugs.
Some of your medical care may not be covered by your health insurance. For example, you’ll need regular eye and dental care — dental cleanings twice a year are proven to help keep blood sugar down. You’ll also need blood sugar testing equipment and supplies, possibly syringes or pen needles if you need insulin, and more. Switching to healthier foods also can be more expensive.
Having diabetes won’t change your life as much as you think it will. And as the days go by, you’ll start to feel better than you have in years. You can live a long, full, happy life. There’s still a lot to learn, but you don’t have to learn it all today.
Just start with those nine simple steps. Drop any guilt you are carrying and skip the fear. You didn’t do this to yourself, and you have the power to keep yourself safe from the side effects of high blood sugar. Take the time to learn a new language of sorts, but be fearless when it comes to communicating with your medical team. Make sure you understand what your team is telling you; ask, and ask again if you need to. Commit yourself to understanding your tools and your meds. Make changes to your diet and exercise in small steps so they will stick. Enlist your family to help you, and remember to plan ahead for unexpected costs.
You can do this. You’re off to a great start.
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