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Monday, Feb. 12, 2018

WHAT? I HAVE TYPE 2 DIABETES … NOW WHAT?

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The patient is a major player in management and control of disease

Shocking and scary words to hear for anyone who has been recently diagnosed with Type 2 Diabetes.

Don’t think that you are alone. The CDC reports that there are over 23.1 million people who have heard those very words. There are still 7.2 million people who have diabetes that have yet to be diagnosed, with an additional 84.1 million adults over the age of 18 that have the early stages of diabetes (pre-diabetes).

There are two main types of diabetes.

Type 1 Diabetes is a chronic condition where the pancreas makes little or no insulin at all. Type 1 develops usually at a young age. When diagnosed with Type 2 Diabetes, you have a chronic condition that affects the way the body processes blood sugar (glucose) either due to the pancreas producing inadequate amounts of insulin or your body not appropriately responding to the insulin being produced.

Diabetes is a chronic, lifelong disease resulting from your body’s inability to process a sugar called glucose. Your digestive system breaks down foods and beverages, resulting in a variety of nutrients, which include glucose. While a portion of glucose produced is stored in your liver, most enters your bloodstream and travels to cells to be used as fuel for energy.

Glucose needs the help of a hormone called insulin (produced by the pancreas) to enter your cells. Insulin is thought of as the “key” that unlocks the door and allows glucose to enter the cells, thus being used for energy. Glucose can’t enter the cells without insulin. When you have Type 2 Diabetes, the cells don’t respond well to the available insulin in your bloodstream, thus glucose can’t enter cells easily and builds up in your bloodstream. This is called insulin resistance and is associated with Type 2 Diabetes.

Diabetes is not a disease to take lightly.

High blood sugars damage both your large and small vessels, which can lead to complications for your entire body. Heart attacks, kidney damage, strokes, nerve damage, blindness and amputations are complications that can result from uncontrolled blood sugars. Managing your diabetes can and will help you reduce your risk of the above complications and not allow diabetes to manage or control you!

The diagnosis of Type 2 Diabetes can be overwhelming, but diabetes is one of a small number of diseases that can be managed and controlled by the diagnosed individual. Yes, it takes time; yes, it’s not always easy; and yes, you are going to have to make changes that you don’t want to make, but it is a rare gift that you, the patient, are a major player in the management and control of your diabetes.

You are not doing this alone. Your primary care physician (PCP) leads your diabetes care team. You need to work with your PCP, your certified diabetes educators (nurse and dietitian), your pharmacist, a psychologist and possibly an endocrinologist (MD who specializes in diabetes) to individualize your management plan to fit your lifestyle, work and family needs. If your plan is not individualized, you run the risk of not being able to live with or stick to your management plan – resulting in lack of control of your weight and your blood sugars. This is not a one-size-fitsall disease – your diabetes care team will help and support you, but the actual dayto-day management of your diabetes is up to you!

Your management plan needs to include individualized suggestions and education on the following topics: learning all you can about your type of diabetes; choosing when, how much, what and where to eat; taking prescribed medications as instructed; checking your blood sugar at planned intervals during your day; getting and understanding lab work ordered by your physician (every three to six months); becoming and staying physically active; understanding the signs, symptoms and treatment of low and high blood sugar; and dealing with the emotional and psychological impact of a diagnosis of diabetes.

That being said, most newly diagnosed people find that they now have a new job in life: making appropriate decisions and managing their diabetes. It can feel like information overload since diabetes affects and changes your daily life related to work, school, your home life and your relationships with those close to you.

Change is hard and not easily accepted by most. Some newly diagnosed patients fight the diagnosis and think it will just go away in time. Diabetes will not just go away – it needs your time and attention to learn how to manage it correctly. But you don’t have to accomplish everything immediately. For many, just conquering diet, exercise (lifestyle changes) and blood glucose testing will initially control diabetes.

You don’t have to be an expert in diabetes management immediately. But with practice and time, diabetes management can become a habit and part of your daily routine.

Lisa Stansbury, MS, LDN, RD, CDE is a licensed dietitian/nutritionist and a certified diabetes educator. She has been in practice since 1981. She runs the nutrition program for Freedom From Obesity.

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