“… it is completely manageable when you are armed with the right tools …” –Trish Patsaros, RN, MSN, CDE
“More than 18 million people live with diabetes,” says RWJ Hamilton Diabetes Program Coordinator, Trish Patsaros, APN, CDE. “What’s startling is that two-thirds of them are not controlling their diabetes even though it is completely manageable when you are armed with the right tools and information.”
While diabetes is a complex disease, it has some simple principles for successful management and treatment.
| Meet Joe Gurney of Monroe “At first, I was in denial,” says Joe Gurney, recalling when he was first diagnosed with type 2 diabetes in 2007. “Maybe I wasn’t ready to hear it. I played at it and didn’t take it seriously.” Then Joe’s friend enrolled in diabetes education at RWJ Hamilton and Joe seized the opportunity to also learn how to care for his body. “My friend passed away shortly thereafter. I realized I still had the chance to improve my life.” “There were a few years I didn’t take care of myself. I needed to learn new habits.” Now, Joe meets with a certified diabetes educator to learn how to manage a disease that will be with him for the rest of his life. “I needed the accountability. Each time I come here, we talk and I get tips on how to improve.” “I love a good potato chip, ice cream and Symphony candy bar. Now I substitute the chips for popcorn and I eat other things like fruit with peanut butter for a snack or sugar-free cake for dessert. I learned you don’t have to deprive yourself.” Joe’s educator taught him how to read labels, plan meals, control portions and count carbohydrates. He also learned how to monitor himself. “At first, I checked myself four times a day to see how I was reacting to what I was eating.” They also developed an activity plan that balances with food and medication. Now, tennis and diabetes education have Joe Gurney back in the game. |
Making appropriate food selections, understanding portion sizes and learning the best times to eat are key. Diabetes education teaches you about the effect of food on blood glucose, sources of carbohydrates and fat, and meal planning. Barriers, such as financial and cultural factors, also can be addressed.
TIP: When eating out, make healthy choices, such as starting with a salad or sharing an entree.
Being active
Exercise gives your body strength, flexibility and balance and it also helps with weight management. Consistent activity improves body mass index, control lipids and blood pressure, and reduces stress.
TIP: Set small goals to start exercising until you reach at least 30 minutes a day, five days a week.
Monitoring
Daily self-monitoring of blood glucose provides information to assess how food, physical activity and medications affect blood glucose levels.
“You also will need a hemoglobin A1c test a few times a year,” advises Patsaros. “This measures how well your blood sugar has been controlled over the last few months and whether you need to adjust your treatment.”
Expect that medications will often change during the course of the disease. “It’s really important to be knowledgeable about your medication, including how it works, side effects, when to administer it, and the effect of missed and delayed doses.”
TIP: Control the ABCs – as measured by the A1C test, Blood pressure, and Cholesterol – three of the major risk factors for heart disease and stroke.
Problem solving
A high or low blood glucose episode or a sick day will require you to make rapid, informed decisions about food, activity and medications. Problem solving is continuously put to use as the disease is progressive, complications emerge and life situations change.
TIP: Pack these items when you're on the go: snacks, juice, glucose tablets, monitoring supplies and medication.
Reducing risks
Diabetes also causes eye disease, kidney disease and nerve damage. An important part of self-care is preventive care, including smoking cessation and regular eye, foot and dental exams.
TIP: Ask how often you should have your feet checked, eyes examined and kidneys tested.
Healthy coping
Emotional distress or denial directly impacts your health and indirectly influences motivation to keep diabetes in control. “Individual counseling and support groups offer an opportunity to work through your feelings, says Valerie Brooks-Klein, Ph.D., a licensed psychologist.
“My patients ask ‘Why did this have to happen to me?’ or they think ‘This is too hard.” These are natural feelings but they are not insurmountable,” she says. Likewise, “When a patient says, ‘It’s not bad. I can cheat and use insulin to manage my weight,’ they’re not being honest with themselves.”
Brooks-Klein helps people understand how negative thoughts lead to difficulty managing their condition. “If someone is afraid of being different or they feel they don’t have control over their own behaviors, they probably won’t succeed. We counter these thoughts with more constructive coping strategies and focus on what they can do to make their lives better.”
TIP: Talk about your feelings. Learn what you can control and cope with what you cannot.
Knowledge Really is Power
Patsaros has designed RWJ Hamilton’s Diabetes Self-Management Education Program around these seven principles. “Some say ‘knowledge is power’ is just a cliché but in my work I see that knowledge can make the difference between life and death, or having a higher or lower quality of life,” she says.