Don’t Fear Diabetes! Straight Talk for the Newly Diagnosed

If you’ve recently been diagnosed with diabetes, you may be in shock for a bit…that’s normal. But if you’re afraid or panicked, try not to give in to those feelings or let your imagination run wild. It’s easy to jump to conclusions based on the worst outcomes you’ve heard about or seen within your family or friends, such as amputation and blindness—but the reality, with today’s know-how, is usually nothing like that.

Key insight: For most people with well-managed diabetes, the most common complication is…no complication at all! And even though you will have to make some lifestyle changes, you’re not doomed to a lifetime diet of no treats and no carbs.

As a diabetes educator, the first thing I do with new patients is to help them face their fears. Doing so not only helps them feel better but may motivate them to take the manageable small steps that will help in so many ways. Let’s get started…

WHAT’S GOOD ABOUT A DIAGNOSIS

Think of a diagnosis of type 2 diabetes as a bit of good fortune in one way. As many as 40% of people with type 2 diabetes are walking around unaware that they have it, which means the disease is doing damage to their bodies unchecked. With a diagnosis in hand, you’re a step ahead—and you can stay ahead by employing some smart management strategies.

Can you look at the glass-half-full side of your diagnosis? Here’s the first benefit: You can take action. I see people every day who amaze me in their ability to take control of their condition rather than the other way around.

This means managing your blood glucose…which in turn reduces your risk of getting many diabetes-related complications. And if you do have complications, taking action means tackling those problems head-on and early so they don’t progress. Your diagnosis also can be the inspiration you need to tweak some habits that may have needed it anyway, such as eating a healthier diet and exercising.

Though it’s normal to be overwhelmed at first, remember…knowledge is power. It’s also the best way to counter anxiety and remain in control. Ready to face your fears, one by one? Here are the top five worries that people newly diagnosed with diabetes ask me about, the reality behind them—and how you can take action.

FIVE COMMON DIABETES FEARS

1. I’ll need amputation. The thought of losing a foot or leg is terrifying. But there’s typically a long chain of events that would have to happen before you’d need an amputation, and most of them are avoidable. First, blood glucose would have to be very high for a number of years…think, a wildfire burning out of control. Next, you would need to injure your foot and not notice it and not get it treated. Finally, a rip-roaring infection would have to take hold.

Take action: The key to avoiding all diabetes complications, including the prospect of amputation, is doing your best to monitor and manage your blood glucose, blood pressure and cholesterol or “lipid” (blood fat) profile.

Why are all three important? Think of your blood vessels as like the plumbing in your house—it is a closed circuit. The water should stay in the pipes. If your water pressure is high (the analogy being high blood pressure) or filled with years of debris (think fat deposits built up along the inside of your arteries), then the water flow changes (think of blood circulation with less flow). Now add uncontrolled high levels of blood glucose, which can block the mechanisms that the body enlists to fight infections. If your blood is “sweet” and doesn’t flow well because it is under a constricted, high-pressure system and full of debris, that all combines to increase your risk for foot infections after an initial injury or small skin cut occurs.

Uncontrolled high glucose, blood pressure and cholesterol can also lead to a decreased sensitivity in your feet. If left unchecked, it can lead to damage of the nerves, called neuropathy. This is a significant factor for people with diabetes who are faced with an amputation. You might not even realize your foot has a cut if you can’t feel it. That is why you need to take good care of your feet! Check your tootsies daily for any cuts or scrapes, and protect them by wearing closed shoes. See a podiatrist if you have a problem, such as an ingrown toenail…don’t attempt “bathroom surgery.” If you get a pedicure, bring your own tools to avoid being exposed to bacteria from the shop’s tools.

2. I’ll go blind. While it’s true that the risk for blindness is higher in people with diabetes than in people who don’t have the disease, most people with diabetes don’t go blind…and even more modest vision loss, when it does occur, doesn’t happen overnight. It’s usually the result of a trifecta—unchecked high blood glucose, high blood pressure and high cholesterol. Here’s what happens: High blood glucose causes damage to the blood vessels in the retina. That in turn makes the tiny vessels in the eye prone to bleeding or leaking fluid. It is the tiny hemorrhages in the eye that over time can block vision. Unhealthy levels of cholesterol in your blood further gum up the works. And high blood pressure puts a lot of strain on the vessels in the back of the eye. Over time, and unchecked, these factors may lead to vision loss.

Take action: Schedule an eye exam with dilation at least once a year to check for problems. If it is discovered that you have retinopathy, several treatments exist including injections in the early stages (Anti-VEGF therapy or corticosteroids) or laser surgery in the late stages.

3. Taking insulin is scary or dangerous. Plenty of people hate the very idea of sticking themselves with a needle, and that’s natural. Most believe, wrongly however, that insulin itself is somehow harmful. Insulin is simply a hormone your body is missing and that needs to be replaced. Some believe that going on insulin is a sign their disease has just become serious. The truth is that by the time most people get a type 2 diabetes diagnosis, they’ve already lost 50% to 80% of the function of insulin-producing beta cells, as well as some of the cells, in the pancreas.

Take action: Remember that diabetes is a progressive disease…nearly everyone who lives long enough with the disease eventually needs insulin. You might need it now, or you might not for a few years or even decades. Don’t think of it as a punishment or a sign of failure but as another step in managing your condition and living your life to the fullest. You haven’t failed—your pancreas has. Many patients end up saying, “I wish I had started insulin earlier because I feel so much better.” And if you fear needles…take heart. If you participate in a diabetes-management program, you’ll learn about the latest and greatest equipment, including insulin pens. These needles are really tiny—I can’t tell you how many times people trying them have said, “I didn’t even feel that.”

4. I’ll need dialysis. Dialysis is necessary when your kidneys can no longer do the job of filtering waste from your blood. While kidney problems are a known complication of diabetes, dialysis is not a given by any means. As long as you get the recommended screening tests, you’ll be warned of any potential kidney problems so you can take lifestyle steps—and if needed get appropriate medications—to help protect your kidneys.

Take action: All of the things that are good for your health in general—such as focusing on whole, fresh foods…watching your blood pressure and cholesterol…not smoking or being around second-hand smoke—are also good for your kidneys. The tiny blood vessels in the kidneys, just like the ones in your eyes, don’t do well if your blood glucose or blood pressure is high. Exposure to tobacco smoke also constricts vessels.

5. I won’t be able to eat anything fun. Hold on! The key to managing diabetes isn’t cutting out entire categories of foods, such as fat or carbs. It’s eating more mindfully and with more planning. You can still have some bread, pasta—even sugar. While no one food is “forbidden,” though, you do have to think about the timing of meals and snacks and how much you eat. You’ll also learn how to balance out carbs with protein and to figure out which foods have the biggest impact on your blood sugar.

Take action: Follow some basic rules, such as relying more on fresh, whole foods and less on packaged or processed items. Do a “food inventory” of your kitchen to see how you can better stock your fridge and cupboard for success. Discover what inspires you. Get the help of a registered dietitian who specializes in people with diabetes. You can ask your local hospital or search the website of the American Association of Diabetes Educators. With that expert help, you’ll learn diet strategies that work for you.

NOTES FOR THE JOURNEY

Taking small steps is the best advice for conquering any fears you have when you’re first diagnosed with diabetes. Letting yourself be consumed by stress can lead to burnout or fatalism. Start by realizing that this is a journey, not a destination, and that there are measures you’ll be taking daily to remain healthy. Get ready for bumps in the road—and for successes and opportunities.

A few final thoughts…

• Pay attention to your numbers—blood glucose, cholesterol, blood pressure and others. Knowing these stats helps you stack the deck in your own favor and avoid complications.
• Focus on overall health. If other health issues come up as a result of your diabetes, there are many things that can be done to minimize or stop their progression. It all starts with being aware, engaged and involved.
• Don’t rely only on one doctor. People with diabetes have better results with a health-care team that includes (ideally) an endocrinologist… and if that’s not possible, a primary care provider with a focus on diabetes. Your team should also include a diabetes educator, who may be a nurse or a registered dietitian, to whom you can turn with questions. You’ll also need an eye specialist, podiatrist and dentist—all part of ongoing maintenance to keep you tuned up.
• Don’t go it alone. You might also want to find a support group, either online or in person, to get and share tips from others in your shoes. That may be more meaningful than what the person in the white coat says! People with diabetes who participate in support groups have lower glucose levels, on average. You can find a community to connect with by searching the American Diabetes Association support community or the Diabetes Hands Foundation. You may also find it helpful to use an app for your phone like MySugr, which has more than a million users worldwide, or a new app called KingFit that offers free diabetes education from national experts.

Most important…try to focus on the positive. Swap negative thoughts (about what you have to stop doing) for positive ones (about changes that will be good for you). Having diabetes is a challenge, and your efforts are worth the energy it takes to maintain your health. You’ve got this!