It’s one thing to know what you should do to prevent or control diabetes. It’s another thing to actually do it. For people with the disease, too often life seems to get in the way of healthy eating, physical activity, glucose testing, medication regimens and all those recommended doctor visits.
If managing diabetes seems like a full-time job, keep in mind it’s a task that can’t be taken lightly. Diabetes is the fifth-leading cause of death by disease in the United States. Without proper self-management, it often leads to serious complications, such as heart disease, stroke, high blood pressure, blindness, kidney disease and lower-limb amputations, to name a few.
“We need to recognize and acknowledge that the demands of taking care of diabetes are very time-consuming,” says Karmeen Kulkarni, R.D., CDE, from the American Diabetes Association (ADA). “Therefore, the person with diabetes needs to have the best possible information.”
Drawing on her more than 25 years of experience as a diabetes educator, Ms. Kulkarni offers solutions to these common barriers faced by diabetes patients.
Barrier 1: What's expected?
You’re just not sure what you should -- or shouldn’t -- be doing for yourself. Suppose you wake up hungry but your blood glucose levels are already elevated. Should you eat breakfast anyway? If so, what foods should you eat? Or, if you travel often on business, what exercise and healthy eating options are available to you? Is cutting back on your blood pressure medication really such a big deal? If you don’t know answers to questions like these, your health could be in jeopardy.
Solution: Seek out expert advice now. What you learn will serve you for a lifetime. Find out what you should be doing, why it’s good for you and just how to do it. Ask your doctor or diabetes educator to explain in simple language. If you don’t receive the answer you need, ask for a referral to another expert, whether it’s a registered dietitian, an eye doctor or an endocrinologist.
For additional personalized care, Ms. Kulkarni advises contacting a diabetes education center recognized by the ADA. To locate such a center in your area, call the ADA or visit http://www.diabetes.org/education/edustate2.asp.
Barrier 2: What about exercise?
Pick your excuse: You don't have time for exercise; you’re too out of shape; it’s too much of a bother; you don’t have the energy.
Solution: Look for a form of activity you enjoy, and then start with baby steps. You’ll be surprised how far those steps can take you.
Exercise is especially important if you have diabetes, because it can lower your blood sugar and improves your body's ability to use insulin, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Exercise also can lower your blood pressure and cholesterol level, lower your risk for heart disease and strokeand help you with weight management.
Talk to your health care provider before starting an exercise program. Your provider can offer suggestions on how to get started and how to monitor your blood sugar while you exercise.
Barrier 3: What about losing weight?
You may feel helpless about controlling your weight. Sticking with a diet seems too complex, unpleasant or downright undoable.
Solution: Begin with a reality check. Healthy weight loss actually doesn’t have to involve confusing diet plans, complex measurements or purchasing special dietary food products.
In fact, “there’s really no specific diabetes diet,” notes Ms. Kulkarni. “There’s just healthful eating as recommended for everyone.”
This basically means eating a balanced diet low in fat, cholesterol and sugar, and paying attention to portion sizes and total calories. At the same time, you should realize that food can be a critical, ongoing issue for people with diabetes.
If you keep having trouble with weight control, ask your doctor for a referral to a registered dietitian who can help you personalize an eating plan. And be sure to engage in regular physical activity to help burn the calories you’re taking in.
Barrier 4: What about blood sugar?
Your eating habits are causing problems with blood sugar control, but you aren’t prepared to change them. Either you don’t know what needs adjustment, or you lack motivation.
Solution: Follow your doctor’s advice for self-monitoring your blood glucose levels, Ms. Kulkarni suggests. When you can see more clearly how the foods you eat affect you, you’ll be able to gain far more control over your condition.
“For example, one of my patients was of Asian background and loved eating lots of rice, so she had high blood glucose levels after every meal. She was having a tough time cutting back. Making a change with a favorite food can only come from within, so I asked her to do a before-meal glucose check and again two hours after eating. By testing herself regularly, she came to realize how high her glucose levels actually soared after eating all that rice. Blood glucose testing is very important. It gives immediate feedback and really puts the patient in the driver’s seat,” says Ms. Kulkarni.
Barrier 5: What's important?
You’d rather ignore your diagnosis altogether. After all, who wants to deal with a serious chronic illness?
Solution: Shine light on your condition. By denying it, you may pay a stiff price later, and so may the people who care about you. Discuss your diabetes with your family or with others who have diabetes, and ask for their support.
“Sometimes,” Ms. Kulkarni adds, “it’s just a matter of deciding to do everything you can to stay healthy so you can be there for your children and grandchildren.”
Barrier 6: What's about medical costs?
You need to monitor your blood sugar and manage any medications you take. But to do this, you'll need to buy test strips, a glucose meter, and your diabetes drugs.
Solution: Health insurance usually covers the cost of diabetes supplies, the ADA says. To find out your health insurance options, visit the ADA website.