November is National Diabetes Month, and much government and media attention is focused on the need to slow the growing “epidemic” of diabetes and prediabetes in the United States. Efforts to this end include the American Diabetes Association’s Stop Diabetes campaign, which encourages people to take an online risk test to assess their personal risk of developing prediabetes or Type 2 diabetes and to see a doctor if their test results suggest a high risk.
But what if you already have diabetes? Is there anything in National Diabetes Month for you? Of course there is! For people who already have diabetes, it’s as good a time as any to take a look at your diabetes management and ask yourself how things are going. Are there areas that need improvement? Are you interested in connecting with other people who have diabetes? Would you like to participate in a diabetes fundraiser? Would you like to learn something new? Here are some suggestions for making the most of a month devoted to diabetes.
1. Commit to a new healthy habit for one month.
Many lifestyle habits — not just eating and exercising — can affect your general health and your diabetes management. Some may affect your blood glucose levels directly, and others may have a more indirect effect, enabling or preventing you from carrying out your daily routines, for example. Rather than choose something you feel you “should” do, pick something you feel able and willing to do. Here are some ideas:
Get more sleep. Not getting enough sleep can increase insulin resistance, meaning your body requires more insulin to get glucose into your cells. This can lead to higher blood glucose levels and is believed to have other negative health effects. Inadequate sleep also tends to leave you feeling fatigued during the day, which is likely to make it harder for you to exercise, eat right, think, remember, and cope with stress.
Most adults need between 7 1/2 and 9 hours of sleep a night. Start your efforts to sleep more by setting and sticking to a regular bedtime and making your bedroom as dark and quiet as possible. For more tips on getting more sleep, go to “Getting the Sleep You Need.”
Drink more water. Dehydration can make you feel tired and headachy, and because thirst is often mistaken for hunger, it can also cause you to eat more. Drinking more water can make you feel better and help your body function better. But even if you’re not dehydrated, drinking more water in place of caloric or alcoholic beverages will likely be good for your health. Calories consumed in liquids don’t tend to satisfy hunger the way calories in food do, so it’s easy to drink a lot of calories without really noticing them. Quench your thirst with water, then eat food if you’re hungry.
Inspect your feet every day. You’ll probably find nothing of great interest on your feet in a month of daily checking, but it’s never too early to familiarize yourself with what your feet normally look like. That way, if something changes, you will notice more quickly. When checking your feet, note how easily you can see the bottoms of your feet. If you find it’s a strain, consider getting a hand mirror (possibly a lighted or magnified one) that allows you to see them with less effort.
Floss once a day. Periodontal, or gum, disease can negatively affect your diabetes control. Practicing good oral hygiene, including daily brushing and flossing, can go a long way toward preventing periodontal disease. Even if you hate flossing, commit to it for a month, then see whether it’s become a less-dreaded, more easily accomplished part of your daily routine.
Start using a pedometer. Vowing to “exercise more” is a difficult resolution to carry out. Clipping a pedometer to your belt or waistband every morning, on the other hand, is easy, and at the end of each day, you have a numerical readout of how active you were during the day. You may be surprised at how few — or how many — steps you take each day, but at least you know where you stand. When you’re ready, you can take the next step of deciding whether to purposely increase your daily steps. Many people aim for 10,000 steps a day, which is about 5 miles.
Try a new fruit or vegetable. Fruits and vegetables offer numerous nutrition benefits, including fiber, potassium, and other vitamins and minerals. While the amounts of various nutrients vary from one fruit or vegetable to the next — with darker-colored produce usually containing more nutrients — consuming a variety is an excellent way to reap a full range of benefits.
2. Seek out a diabetes-related event or activity in your area.
Numerous organizations sponsor events such as walkathons, bike rides, support groups, health fairs, and other activities that are aimed at raising public awareness of diabetes, raising money for diabetes research, or offering education and support to people living with diabetes. Not all of these take place during November, but most will have information available on when and how to sign up for future events.
ADA. The American Diabetes Association holds Step Out walkathons and Tour de Cure bike rides to raise money for educational outreach, advocacy efforts, and research. For the walk, participants are encouraged to raise as much money as possible; for the ride, a minimum dollar amount is required to participate. The ADA also puts on free, daylong diabetes Expos — with lectures, demonstrations, and other educational components — at convention centers around the United States each year. Information on all ADA events and contact information for local chapters can be found online or by calling.
JDRF. JDRF (formerly the Juvenile Diabetes Research Foundation International) organizes Walks to Cure Diabetes and Rides to Cure Diabetes (multiday bike rides). For the walks, participants are encouraged to raise as much money as possible; for the rides, a minimum dollar amount is required to participate. The JDRF also supports other types of community fund-raising events organized by individuals. (Anyone may register a community event.)
(888) 533-WALK (for information about walkathons)
(888) 533-9255 (to find your local chapter)
TCOYD. TCOYD, which stands for Taking Control of Your Diabetes, holds a dozen or so daylong educational conferences and health fairs at locations around the United States. The events include lectures, health screenings, informational exhibits, demonstrations of various types, and more for about $30.
(800) 99-TCOYD (8-2693)
3. Seek out special Diabetes Month sales or other offers.
Pharmacies and other stores or service providers often have sales or discounts on diabetes-related items during National Diabetes Month. You may find free or low-cost health services such as blood pressure checks or vision screenings, discounts on diabetes supplies, or discounts on coaching or other educational services.
To find such offers, keep an eye on flyers or other communications from the places where you usually buy your diabetes supplies.
4. Observe World Diabetes Day on November 14.
The United States is not the only part of the world affected by diabetes: World Diabetes Day was created in 1991 by the International Diabetes Federation and the World Health Organization to draw attention to the growing health threat posed by diabetes everywhere. In 2007, World Diabetes Day became an official United Nations Day.
To see what events and activities are planned for World Diabetes Day this year, check out the website of the International Diabetes Federation: www.idf.org
5. Learn something new about diabetes.
You no doubt already know a lot about diabetes, but why not observe National Diabetes Month by learning something new? Look up something you’ve been wondering about, or browse through a website or book or magazine on diabetes until something catches your eye. Here are some sources of diabetes information you might find interesting:
National Diabetes Education Program. The NDEP publishes brochures and fact sheets aimed at people of different ages, different types of diabetes, and different ethnic or racial backgrounds. The website has several ways of searching by topic or by personal characteristics to help users get to the publications they need more quickly. The Diabetes HealthSense section of the site has resources tailored to help you meet your diabetes management — or prevention — goals.
888-693-NDEP (6337) (to order publications)
Diaboogle. The search engine Diaboogle is a Google custom search engine developed by blogger Bernard Farrell to weed out the sales pitches and gimmicks and connect searchers with useful, authoritative diabetes information and support. Just type a word or phrase you’d like to search on in the search box, then refine your search by clicking on Prevention, Complications, Symptoms, or Products, if desired.
JDRF Toolkit for Adults with Type 1 diabetes. The JDRF has an Adult Type 1 Toolkit, and it also offers a “Newly Diagnosed” version. The Toolkit offers information about Type 1 diabetes and lists resources for further information and help. Both versions can be downloaded at no cost.
(800) 533-CURE (2873)
Make an appointment with a CDE. When you need information not just about diabetes in general but about your diabetes in particular, a one-on-one meeting with a certified diabetes educator may be the way to go. Ask your diabetes care provider for a recommendation, or look for one in your area using the search function on the website of the American Association of Diabetes Educators. Remember to write down any questions you have before your appointment, to bring a list of all of the medicines you are currently taking, and to bring your blood glucose monitoring log.
6. Get more from your monitoring.
Using a blood glucose meter is only helpful if you know how to respond to your numbers. While low blood glucose numbers (lower than 70 mg/dl) demand immediate attention, in general, it’s best to look for trends or patterns in your blood glucose numbers, rather than to focus on isolated numbers. You will inevitably see some variation in your numbers from one day to the next, but what’s important is whether your numbers are usually in your target range first thing in the morning, before and two hours after meals, at bedtime, etc. Patterns of out-of-range numbers mean that you need a change in some aspect of your diabetes regimen.
The format you use to write down your monitoring results can make it easier or more difficult to see patterns. Your diabetes educator may be able to recommend a particular format or logbook. Two monitoring logs that can be downloaded for free from the Internet are the Accu-Chek Testing in Pairs tool and the Accu-Chek 360° View tool. The Testing in Pairs tool is designed to help you see how meals, exercise, or other activities or events affect your blood glucose level over seven days. The 360° View tool shows how different meals affect your blood glucose level and energy level over three days. Both forms are intended to be discussed with a health-care provider after being filled out. To find the forms, go here:
www.accu-chek.com (Click on “Products,” then “Data Management,” then select your preferred tool.)
7. Start a conversation.
Is there something you’d like to tell someone in your life about your diabetes? Would you like to inform a family member, a friend, or your doctor about the challenges of managing your diabetes or the effects it is having on your lifestyle or body? Do you need to ask for help in some area?
No matter what the specifics of your desired communication, it can be hard to know how to start conversations of a personal nature, even — sometimes especially — with the people who are close to you.
It helps to think through what you want to say before you say it. It also helps to think about how, when, and where you will start this conversation. Would a phone call be best? Or would a face-to-face meeting work better? It’s often a good idea to let the other person know ahead of time that you’d like to have a conversation on a particular topic. That way he is not taken off guard and can truly set aside other concerns to focus on you.
Be aware of your own emotions connected to what you want to say, and be prepared for the other person to have an emotional response to your information — but don’t assume that you know what those emotions will be. Try to stay calm and nondefensive. After you’ve stated as clearly as possible what you want to say, give the other person time to absorb it and respond. Listen carefully, and watch for nonverbal cues to better understand what the person is saying and feeling. Be prepared to take a break and revisit the topic at a later date: It may take a while for your message to sink in, or for the other person to sort out his thoughts and emotions.
Communication is difficult. If your efforts to communicate feel fruitless, seek help. Working with a therapist is a good way to learn to communicate more effectively, but you can learn more on your own, too. Here are some resources:
www.helpguide.org (Click on “Topics A-Z,” then “Relationships” for articles on communication.)
http://locator.apa.org (to find a psychologist)
http://therapists.psychologytoday.com/rms (to find a therapist)
8. Knock something off your diabetes to-do list.
Whether your to-do list is in your head or written down, you probably have one. The more specific the items on your list are, the easier it is to do them. If your to-do list has things like “eat better” or “exercise more” on it, find some specific steps that you could easily implement that would bring you closer to these goals. For example, plan a week of healthy lunches and write out a shopping list, then put “go grocery shopping” on your to-do list. In case you don’t have a list, here are some ideas:
9. Seek out support.
Talking with other people who are facing the same challenges as you are can make your burden feel much lighter. Even if nothing actually changes on a practical level, feeling heard and understood has enormous psychological benefits. And it’s possible that the people you meet through an online social network or in-person support group will have information or resources that can have a practical effect.
To find a support group, try calling your local chapter of the ADA or JDRF, or contact the diabetes department at your local hospital. Hospitals or other medical offices that offer diabetes education classes sometimes also have support groups that you can join. Here are some other potential sources of support:
DiabetesSisters. DiabetesSisters organizes regular support group meetings (which they call PODS meetups) for women with diabetes and has a SisterMatch program to match up women for mutual support. They also hold occasional conferences and other events.
Divabetic. Divabetic holds monthly Divabetic Club meetings in various U.S. cities, as well as occasional other outreach programs. While Divabetic programs are aimed mainly at women with diabetes, men are welcome, too.
TypeOneNation. TypeOneNation is the JDRF’s online social network for people with Type 1 diabetes and their families and friends.
10. Reach out to someone else with diabetes or prediabetes.
There are lots of ways to reach out to others to share your knowledge, experience, and resources, offer a sympathetic ear, or simply open the door to conversation. Even sharing the questions you have about your diabetes with others can be helpful; someone else who needs the answer may not have even thought to ask the question. Here are some ways to reach out: