IN THIS CHAPTER
Taking control of your health
Managing your diabetes
Where do I begin? That’s a question many people with diabetes ask themselves. For some people, the question may come up as soon as they’re diagnosed with type 2 diabetes. For other people, the question may arise after noticing complications of their diabetes. And still others may face that question as they care for a loved one with diabetes.
It’s not easy to know how to start taking care of yourself and managing your diabetes. After all, the diagnosis may have been a total shock. And you may not have a clue about how diabetes will affect your body and your life.
Stay tuned because we’re here to help you figure out how to begin taking care of yourself. In this chapter, you discover why it’s important to take care of your diabetes on a daily basis and for years to come. You also find out about the basics of managing your diabetes.
You’re the person who will be responsible for making healthy choices each day. You’ll make these choices around food, exercise, medications, and even testing your blood glucose. So, let’s get started.
Taking Care of Yourself
Making yourself a priority is one of the best steps toward taking care of your diabetes. Yes, you are a priority. After all, only you can manage your diabetes. It’s not your endocrinologist or your wife or your son who is dealing with diabetes every day. It’s you.
Feel better most days
Start taking care of your diabetes so you can feel better most days. Perhaps leading up to your diagnosis of diabetes, you didn’t feel so great. You may have gained weight. Or you may have had symptoms of diabetes such as dehydration and blurry vision. Perhaps you were more irritable and out-of-sorts than usual.
In some ways, it may have felt like a relief to discover a cause for these issues. In other ways, it may have felt scary to find out that diabetes was the answer.
The good news is that you can feel great living with type 2 diabetes most days. Not every day is going to be a home run, but most days can be base hits. That’s because taking care of yourself and managing your diabetes can positively impact your daily life.
Keeping your blood glucose on target can improve your mood and give you more energy. High blood glucose happens when you have undiagnosed diabetes or when your blood glucose is not on target (see Chapter 1 for more about blood glucose). High blood glucose can make you feel tired, irritable, and thirsty. It may cause you to urinate a lot or blur your vision. Keeping your blood glucose on target with an A1C below 7 percent will reduce the chances of these symptoms.
Two ways to keep your blood glucose on target are to eat healthy foods and exercise regularly. You’ll find out more about these two topics in Chapters 11–13.
Exercise in and of itself is a mood booster. It can reduce stress, lessen symptoms of depression, and release those amazing brain chemicals called endorphins, which make you feel good. So even though you may be exercising to help manage your diabetes, you’ll have the bonus effect of improving your mood on a daily basis.
Reduce the risk of complications
In the long term, untreated diabetes can really take a toll on your body. Why? It goes back to that issue of high blood glucose we talk about in Chapter 1. With diabetes, glucose gets trapped in the blood because it can’t get inside cells to provide energy. When glucose builds up in blood vessels, it creates a recipe for disaster.
High blood glucose damages blood vessels. People with diabetes also have an increased risk of high blood pressure, which can make things worse; blood vessels can’t pump enough blood or nutrients to all the parts of your body, and they can die or become clogged.
Blood vessels are everywhere in your body. They’re in your heart, eyes, toes, penis or vagina, intestines, and brain. High blood glucose affects all these blood vessels. It is an equal-opportunity blood vessel destroyer.
Blood vessel problems fall into two categories:
- Microvascular: Your small blood vessels. Complications can include the following:
- Damage to small blood vessels in your eyes: This can lead to ruptures and unhealthy regrowth, which can cause vision impairment or blindness.
- Damage to small blood vessels in your kidneys: This affects their ability to filter. And overworked vessels can lead to kidney failure.
- Damage to capillaries throughout your body: This could affect how quickly wounds heal.
- Macrovascular: Your large blood vessels. Complications can include the following:
- Damage to the large blood vessels in your heart: This can lead to heart attacks, heart failure, and death.
- Damage to large blood vessels in your brain: This can cause strokes and death.
- Damage to large blood vessels in your legs: This causes peripheral artery disease, a painful condition that makes moving painful.
Now it’s easy to understand why diabetes affects so many parts of your body. Uncontrolled blood glucose increases your risk of heart disease, stroke, kidney failure, blindness, nerve loss, and even amputation. Find out more about complications and how to prevent them in Chapter 8.
Keeping your blood vessels healthy is one of the holy grails of managing your diabetes. It may not sound exciting: “I took a bike ride today and improved my blood vessels.” But it’s why it’s important to take care of yourself and manage your blood glucose and diabetes.
The UK Prospective Diabetes Study showed that improving blood glucose and/or blood pressure reduced complications of type 2 diabetes. In this 20-year landmark study, scientists learned that complications were not inevitable for people with type 2 diabetes.
Healthy pregnancy, healthy baby
Taking care of your diabetes is important if you’re thinking about becoming pregnant. Try to get your blood glucose under control before you become pregnant and avoid an unplanned pregnancy if you have type 2 diabetes.
Before you become pregnant, try to lose weight if you need to, and get active. Make sure your A1C is within your target range. Talk to your doctor about your plans and make sure you’ve had a complete checkup, including a dilated eye exam. Eye disease can progress rapidly during pregnancy for some women. All these steps will set you up for success once you conceive.
High blood glucose can harm your baby during the first few weeks after conception, even if you don’t know you’re pregnant yet. It can cause birth defects in the developing baby such as heart or brain problems.
During your pregnancy, you may need to take medications such as insulin to manage your blood glucose. You may also need to adjust the foods you eat. Your hormone levels change during pregnancy, and they can affect your blood glucose, so you may need to revamp your regimen. Keeping your blood glucose under control will help you prevent complications such as preeclampsia (involving high blood pressure) or having a large baby with injuries during birth.
Taking care of your blood glucose during your pregnancy (and before) will help keep you and your baby healthy. See Chapter 9 for more details about diabetes and pregnancy.
Managing Your Diabetes
You may have heard the terms diabetes self-management plan or diabetes care plan. Both of these terms refer to how you take care of or manage your diabetes. Your plan takes into account your big-picture goals and your nitty-gritty choices each day.
On the one hand, diabetes management is not a small endeavor. You’re the person most responsible for taking care of your diabetes 24 hours a day, 7 days a week, 365 days a year. It’s not your diabetes educator or endocrinologist or even your spouse who will carry the torch. It’s you, the person with diabetes.
On the other hand, it’s a well-trodden road. Many, many people just like you are learning to test their blood glucose, take new medications, and change the way they eat and exercise. There are millions of people in towns and cities across the United States managing their diabetes with successes and struggles. You can find them in your community hospital’s diabetes support group, and you can find them online on the American Diabetes Association’s message boards. You’re not alone — and there’s much to learn from your healthcare team and others with type 2 diabetes.
This book walks you through the basics of managing your diabetes, chapter by chapter and step by step. In the following sections, we give you an overview about putting together a healthcare team, taking medications, eating healthy foods, getting active, and finding support.
Assembling a healthcare team
One of the first steps you’ll take in managing your diabetes is to put together your healthcare team. At first, you may start with your diabetes care provider, who may be your family physician or nurse practitioner or an endocrinologist. You’ll probably see a certified diabetes educator (CDE), who is specially trained to help people manage their diabetes. These professionals will monitor your diabetes and any related complications, but also help you set goals and troubleshoot problems as they arise.
Other specialists you may see include dietitians, ophthalmologists, podiatrists, dermatologists, and others. Read more about your healthcare team and what to expect during checkups in Chapters 3 and 4.
Taking medications
You may be prescribed a medication, such as metformin, as soon as you’re diagnosed with diabetes. Or you may take a combination of medications or insulin injections. Taking your prescribed medications is an essential piece of managing your type 2 diabetes. It is a cornerstone of your care — and it’s important to do it at the correct times each day or each week.
Switching a medication, adding a medication, or taking insulin is a normal part of having diabetes. Your diabetes will change over time, and your medication needs may change, too. Find out more about the different types of diabetes medications and how they work in Chapter 6.
Checking blood glucose
Your healthcare provider will test your blood glucose using the A1C test during your checkups. As we explain in Chapter 1, an A1C test is a measure of your blood glucose over the previous three months. It gauges how well your medications work or whether you need to change your meals or physical activity.
You may also be asked to check your blood glucose on your own using a meter. You’ll prick your skin using a lancet to draw a drop of blood, press a test strip onto the blood, and then get a reading on your meter. We walk you through all these steps in Chapter 7.
Checking your blood glucose will help you see how different things like food, exercise, and medications affect your blood glucose. It’s a snapshot of your diabetes that can help you make informed decisions like choosing a smaller meal at lunchtime or walking an extra 20 minutes in the evening when you get home from work.
Eating healthy and staying active
Learning about wholesome, nutritious foods and how to incorporate them into meals is a critical part of managing your diabetes. You may not have thought much about the nutritional benefits of certain foods before you were diagnosed with type 2 diabetes. After all, we all eat foods because they taste good. That’s the fun part!
You don’t have to give up your favorite foods because you have diabetes. Instead, you may need to eat them in smaller portions or prepare them differently to reduce calories. You may also add a few new foods packed with nutritional punch like salmon, beets, and olive oil.
Exercising also helps manage your diabetes by moving glucose out of the bloodstream and making your cells more sensitive to insulin. It boosts your mood and distracts you from everyday worries. Read all about food and physical activity in Chapters 11–13.
Finding support
Perhaps it sounds touchy-feely, but finding support is another important part of managing your diabetes. Support can mean so many different things — from chatting with online buddies on a message board to attending a diabetes education class.
At some point, you may experience the very real feelings associated with diabetes distress, including fatigue, annoyance, and just plain burnout. Or you may experience more intense emotions of depression and/or an anxiety disorder.
Talk to your healthcare provider about your feelings and concerns and seek support from a mental health professional or others with type 2 diabetes. Get more tips for dealing with stress and getting in touch with yourself in Chapter 14.