Insulin is a hormone made in the pancreas that helps move sugar from your blood to your muscles and other cells so they have enough energy to function. COURTESY
If you have type 2 diabetes, it means your body isn’t using insulin the way it should. Insulin is a hormone made in the pancreas that helps move sugar from your blood to your muscles and other cells so they have enough energy to function. With type 2 diabetes, though, you need more insulin than usual to do this task. That means your pancreas has to do more work. It’s basically like it’s running on a treadmill trying to keep up. When doctors treat type 2 diabetes, we prescribe lifestyle changes and medications to patients with the goal of helping the pancreas do its job as well as possible for as long as possible. We tell patients to cut down on sugar intake, so the pancreas doesn’t have as much work to do, we give medications that help insulin work more effectively and we also often prescribe insulin to help do some of the pancreas’ job for it. There are different types of insulin; some is taken with meals, some is taken just once a day, and some is taken a few times a day. Your doctor will work with you to determine the best fit for you. Controlling diabetes means committing to a healthier overall lifestyle, as well as taking medication regularly, so I always share the following with my patients to keep them on track:
Understand what you’re putting into your body
It’s so important that patients know what foods they can eat without raising their blood sugar levels, and which foods they need to carefully portion. Many of my patients don’t realize fruit can be problematic with type 2 diabetes. Most patients think fruit is really healthy, and it is, but too much fruit can make your blood sugar levels very high because they’re full of natural sugar. A couple pieces of fruit each day is healthy for patients with diabetes, but it’s important to eat fruit, like everything, in moderation. I also encourage my patients to read nutrition facts labels and I teach them how to understand them. A lot of the marketing out there is very confusing—a label may say there’s no sugar added, so patients will think the product is sugar-free, but if it’s full of carbohydrates, it’s going to raise their blood sugar. Monitoring your carbohydrate intake is key. Carbohydrates include sugars, starches, and fiber, and affect your blood sugar more than other nutrients. It’s important that patients with diabetes learn to keep track of their carb intake and avoid overdoing it to keep blood sugar levels balanced.
Understand that diabetes is a lifelong disease
When you’re diagnosed with type 2 diabetes, you’re going to be managing it for the rest of your life. That can really overwhelm patients, and they often think they need to completely change their lives immediately. But to make permanent change, you’ve got to be realistic about what you’re capable of. Patients are often more successful when they make small changes, little by little, that they’ll be able to sustain for the rest of their lives. Try one new thing at a time and take advantage of your provider’s guidance and ask for help from nurses and certified diabetes educators. A big take-home message I try to teach patients is that diabetes is a self-managed disease, and it depends on choices: choosing to take their medications as prescribed, choosing to eat the right foods, choosing to consistently check their blood sugar, and more. It can be overwhelming to take on the big lifestyle changes needed to manage diabetes, but that’s why having a solid relationship with your diabetes doctor is so important—having a partner in the process makes it a whole lot easier.
It’s so important to find the right doctor
Because diabetes is a lifelong disease, it means you’ll be working with your diabetes doctor for many years to come. Find a provider who meets you where you are, who listens and understands the realistic barriers you face. Every patient with diabetes is different, with different sets of challenges. If you trust your provider and develop a strong relationship with him or her, you’re going to get better care and guidance, which will result in better management of the disease.
Be honest with your doctor
Once you find the right doctor, it’s so important to be honest with him or her. Don’t be afraid to tell your doctor what is and isn’t working for you, and always ask what you can do differently if your blood sugar levels aren’t ideal. When you give your provider accurate information, that allows him or her to better care for you—you might need more or different medications, or you might be eating or drinking something you are not aware raises your blood sugar so much. Don’t just blame yourself if you’re not getting your blood sugar in check; work with your doctor to get things under control.
Don’t give up
I think my biggest tip for both patients and caregivers would be to never give up. There is a recipe out there for every single patient, and it’s a combination of lifestyle changes and medication. If something isn’t effective, keep trying to find the recipe that works for you. You may have a lot to learn along the way, but you will get there—it can be done. I emphasize to patients that hitting one bump in the road doesn’t mean their journey is over and impossible. It just means we need to try something else. It’s also important for patients to understand they’re not alone—they’re not the only person going through this. Patients need a lot of support at home, but if they don’t have that, there are many type 2 diabetes support groups that can offer encouragement and guidance. Patients who are in control of their condition never forget about their diabetes, but they also understand nobody is perfect all the time. Don’t let the times when you “cheat” or make a mistake get you down. Your next choice can be a good one—don’t give up.
* Dr. Kristen Kulasa, Endocrinologist in University of California San Diego Health
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