#1. Ignoring the diagnosis. Very often, when a person is initially told that they have diabetes, there are two things that happen: (1) the patient ignores the whole idea, and that leads to (2) “denial.” There are some legitimate reasons for this. In most cases, when a doctor tells a patient that he has diabetes, the patient is surprised or shocked to hear the news as he may have no symptoms and feel perfectly fine. The biggest issue with finding out a person has type 2 diabetes is that there may NOT be any obvious symptoms. Patients do not feel “sick.” There is no pain involved—other than our normal creaky arthritic bones, there is no fever or nausea, vomiting or diarrhea, no obvious wounds or infections. I often will have patients tell me that their doctor tells them that they have diabetes, but they (the patients) do not believe it.
This leads right to DENIAL, which can last from a few weeks to a year or two. Meantime, there are, shall we say, “things” unattended to going on. Some new medication may be ordered, but never picked up or rarely taken, food habits do not change and the patient may go to the doctor LESS often as he does not want to hear what the doctor has to say.
Type 2 diabetes creeps up on us and things continue to happen inside our bodies that we are unaware of…until symptoms may become evident. It is not too late to do something about it at that point, however, precious time has been wasted and some damage has been done.
#2. “I just won’t eat sugar.” Often, with a new diagnosis of type 2 diabetes, the first thing that pops into our minds is to stop eating “sugar.” After that comes many trips to the grocery store to find anything and everything that does not contain “sugar.” Pretty soon you are buying all sorts of “sugar-free” foods, under the assumption that those are what you need to help you control your diabetes. Well, I have some good news for you. “Sugar” is NOT the issue in managing diabetes. Sugar, as we know it, is the white stuff in our sugar bowls that goes on and in many of the foods we enjoy. Many years ago, the American Diabetes Association recognized that “sugar” is not such a big issue. In fact, the majority of foods that we eat turn to “sugar” (or glucose) in our bodies, with or without the sugar bowl. This has led to a newer approach to avoiding “sugar” by looking at our total carbohydrate intake. All starchy foods, all fruit and juice, all vegetables as well as all sweets and desserts are carbohydrates and therefore turn into glucose when digested.
"The healthy diet that is recommended for the general population is the same diet a person with diabetes should be working with. "
Our bodies need the glucose in order to help make energy (something we all would like more of), but an excess of glucose from eating all sorts of carbohydrates WILL raise your blood sugar. This is NOT bad news at all. The trend now is to learn to count your carbohydrates and there is virtually no food that you cannot eat, including some small amounts of “sugar.”
#3. Getting TOO involved in your diet. I have seen this happen to the point where a person is SO involved in their diet—and it may not necessarily even be a “good” diet—that they are denying themselves many types of foods and driving their friends and family crazy with their obsession to avoid sugar or whole other food groups. Up until the early 1960s this was the general “diabetic diet” that people were encouraged to use. Thankfully, new research and study shows that eating a so-called healthy diet is what we all need, with or without diabetes. I often tell my patients that there is no such thing as a “diabetic” diet. The healthy diet that is recommended for the general population is the same diet a person with diabetes should be working with.
#4. Having only one doctor taking care of you. Long gone are the days when our family doctor was the one and only in our lives, especially after a diagnosis of diabetes. If you plan to really take good care of yourself, you need a team. Yes, your family doctor with always be your gatekeeper, however there are a number of specialists that should also be a part of your team. Most of them you might see once a year at the most, so do not feel discouraged. Your family physician will be the one to direct you to the other specialty doctors that can help you control your diabetes with minimal complications. Here is the list:
An endocrinologist is a doctor who specializes in diabetes–seen once or twice a year.
An ophthalmologist is a medical doctor who will assess your eyes and be sure you are not headed for problems (uncontrolled diabetes is the leading cause of blindness)—usually once a year is sufficient.
A podiatrist is a foot doctor, and taking really good care of your feet is imperative.
Some folks may develop kidney problems in which case you would see a nephrologist. It may surprise you, but be sure to let you dentist know that you have diabetes. Gum disease, tooth or gum infections are not only signs of possible diabetes, but the infection or inflammation process actually adversely affects your blood sugar. Some people may also have to see a cardiologist, a doctor who specializes in heart and blood pressure problems.
#5. Not getting educated about diabetes. This takes us back to #1, denial. Getting yourself educated about diabetes is one of the best things you can do for yourself and your family. Throughout the country, there are many centers and individual practitioners who are eligible to give you updated and correct information about how to manage your diabetes. Diabetes CAN be controlled and the term we use is SELF MANAGEMENT, which involves getting yourself to a program led by diabetes educators. The world of diabetes is ever changing with new medications, updated research and so on. Connecting with a diabetes educator is your best bet to keep updated. While not a requirement to be a good diabetes educator, there is a national organization of diabetes educators and the standards are pretty high to be a member. Doctors, nurses, pharmacists, podiatrists, dietitians and social workers are the primary professionals who become Certified Diabetes Educators. Don’t forget the American Diabetes Association; it has been around for many decades and supports not only people with diabetes, but also the professionals involved in education and medical care as well. The American Diabetes Association, as well as some other diabetes related companies, often offer wonderful publications you can subscribe to in order to stay updated. The internet is often a good source of information as well, but be cautious as to the credentials of the authors of the articles and statements. Old and inappropriate information abounds.