We Are Here to Help!
We understand this can be a frightening time for you. We want you to know we can help. We have some basic information here on this page and we have also created the Succeeding in Your First 30 Days With Type 2 Diabetes guide designed to help you navigate the essentials of diabetes self-management. This comprehensive guide will allow people with newly diagnosed type 2 diabetes as well as those that still have questions on proper control to take a fresh look at daily diabetes management. Written by certified diabetes educators, this guide helps you eat right, learn how to test your blood sugar, discusses medicines, teaches basic exercises, and even helps you deal with the emotional aspects of a diabetes diagnosis. You can find out more information about the guide here.
What is Diabetes?
A number of chronic diseases fall under the classification of Diabetes Mellitus. They all are metabolic disorders in which the body cannot properly metabolize carbohydrates, fats, and proteins because of defects in insulin secretion and or action. Diabetes develops when the body cannot produce or normally use insulin made by the body. Insulin is an essential hormone made in the pancreas. Insulin is necessary to move glucose (the key source of energy for metabolism) from the blood into most cells of your body. Exceptions include liver and brain cells, which are not insulin dependent.
When glucose builds up in the bloodstream, blood glucose (or blood sugar) rises, causing a condition known as hyperglycemia. When blood glucose gets high, people may experience a variety of symptoms.
Most common symptoms:
- Increased thirst
- Frequent urination
- Weight loss
- Increased hunger
- Blurred vision
- Tingling or numbness in the hands or feet
- Frequent skin, bladder or gum infections
- Wounds that do not heal
- Extreme fatigue
- Very dry skin
Potential signs of extremely high blood glucose:
- Breath with a fruity smelling odor
- Confusion and agitation
- Abdominal Pain
What Happens When You Have Diabetes?
When a person has type 2 diabetes, a number of systems may not be functioning normally. It sometimes takes up to 5-10 years for type 2 diabetes to develop. The following problems may happen over this time period:
- Beta cells in your pancreas may not be able to make enough insulin, or the insulin that is made is not as effective to control the blood glucose levels. Your fasting blood sugar slowly creeps up over the years (pre-diabetes) until the insulin can no longer keep the levels in check and then diabetes is diagnosed.
- Insulin resistance is when; the body makes insulin but the body is resistant to the insulin. This means it cannot use the insulin that is available effectively. In many cases the resistance/ occurs because of chronic inflammation related to excess weight and inactivity. There is also an increased demand for more insulin since it is less effective. When blood glucose is higher than normal but not high enough to diagnose diabetes the term for this is called impaired glucose tolerance or pre-diabetes.
- Hepatic glucose output—the liver, with its storage bank of glucose (called glycogen), will release extra glucose.. The result, fasting blood glucose rises.
It is extremely important to take charge of your diabetes management. Day to day, meal to meal, blood sugar checks, doctor appointments to lab tests, you are determining the outcome of your own health. But, you are not alone. You have an informed team to guide you—your doctor (maybe this includes an endocrinologist), dietitian, certified diabetes educator, physical therapist, pharmacist and others. You have a support system—family, friends, and your support group here at DiabetesCare.net. There are many resources available—to help you take appropriate care of yourself and your diabetes. Diabetes care is non-stop and it will help you to learn everything you can about your diabetes.
Diabetes healthcare has moved to place the “patient” in the center of the treatment model, not the doctor. You as a person with diabetes are the head of your healthcare team. Share information about your blood glucose tracking, carbohydrates you consumed and questions to your healthcare providers. Be pro-active and speak up if you need more information or referrals to a diabetes program or a specific health care professional to complement your medical care.
Diabetes Self-Management Education (DSME)
Programs are available for people diagnosed with diabetes through Medicare and many health insurance plans. You can be referred to group classes specially designed and approved to empower you with all the basic information to manage your diabetes. If you need one-on-one education due to a special condition, this usually is possible as well. Call your insurance company to see what is covered and if there are preferred providers. Check with your local hospital or ask your doctor for a recommendation and a referral (if necessary) to see a diabetes educator. You also may have insurance coverage for individual appointments with the diabetes educator for medication management, insulin injection training, and use of an insulin pump. Call your insurance first to learn what is covered and how much will be expected for you to pay out of pocket.
Medical nutrition therapy (MNT)
Also available through Medicare and most health insurance plans. You can meet with a Registered Dietitian (RD) who may also be a Certified Diabetes Educator (CDE) and have individualized instruction on meal planning and diabetes care. Call your health insurance plan for information on the steps you should take to obtain this care.
Coping with a Diabetes Diagnosis
When a person is first diagnosed with diabetes, it's natural to experience a range of emotions. These may include; anger, sadness, depression, denial, fear, frustration and stress. Discuss these feelings with your diabetes health team. Sometimes it is beneficial to see a psychologist. According to the American Psychological Association a psychologist can help you cope with stress. Successful management of stress can help to regulate blood glucose. They are also trained to help people accept their diagnosis if needed and help overcome feelings of depression. They can be part of your health care team along with your doctor, dietitian, certified diabetes educator nurse and if needed physical or occupational therapist. These health professionals can work with you to create a program that meets your needs and helps you cope with the changes in your life. Enlist the support of family and friends who can help you stay on track. You can also tap into many other sources of support to help you manage the physical and emotional effects of living with this disease. Check with your local hospital and/or health department for support groups or ask your physician.
In 2014, after paying your part B deductible, Original Medicare will help pay for the following:
- Diabetes screening, 80 percent of diabetes self-management training and education for 10 hours in the first year and up to 2 hours in the following years.
- They help pay for yearly glaucoma screenings carried out or supervised by a doctor that can do this in your state.
- May help with insulin used in a pump if the insulin comes from an approved provider.
- Medicare part B may also help with the cost of your blood glucose meter and strips as well as lancets and control solution. When using mail order you must use a national mail order contract supplier.
- Foot care by a specialist is partially covered every 6 months as long as you did not see a foot care specialist in-between visits. If you have diabetes foot disease, Medicare will help pay for one pair of shoes per year as long as you buy them from a Medicare approved podiatrist, orthotist, prosthetist, or pedorthist.
- If your doctor gives you a prescription for Medical Nutriton Therapy, you can get up to three hours of counseling by a Medicare approved registered dietitian. Each year after the first you can get an additional two hours with a doctor’s order. Contact Medicare at 800-Medicare or visit www.medicare.gov/supplier to see what providers can accept payment from Medicare.
- Medicare part D (for prescription drugs) helps pay for insulin if injected as well as other diabetes medications and the supplies needed to use the medication if on the formulary of your insurance plan.
- Medicare Advantage and other private insurers may also provide partial payment for the benefits mentioned above. Check with your plan and ask what benefits are covered for pre-diabetes or diabetes. Refer to the section on Medicare (see above) and ask if they also cover the benefit you are interested in. Insurances vary widely as to coverage. Some even cover more than Medicare.
- DiabetesCare.net provides online support groups that you are very welcome to join.
- Visit the DiabetesCare.net Forums section found right here on DiabetesCare.net.
- Living with diabetes is a challenge you didn't ask for, but it can be an opportunity to take a fresh look at your lifestyle and make positive changes. Exercise and diet play a major role in managing diabetes. You have the power to take control of your health and minimize diabetes' effects on your wellbeing.
Where to Get Support for a Diabetes Diagnosis
With 25.8 million Americans diagnosed with diabetes - eight percent of the population - many resources exist for managing the disease. Support groups exist, both in-person and online programs that deal with the practical and emotional aspects of the disease. Message boards and forums such as those available here on DiabetesCare.net give you a place to ask for advice about general or specific topics and benefit from the experiences of a community of others like yourself. There are many publications and products on the market that make diabetes management easier.
Simple Steps for Self-Testing
- It is best to read the instructions supplied with your home blood glucose meter. If you have specific questions, do not hesitate to call the manufacturer for assistance. General instructions for many meters are as follows:
- Wash your hands with soap and water and dry thoroughly.
- Put a test strip in the blood glucose meter.
- To draw blood from a finger you can massage your finger outward or shake your hand from the wrist. (To draw blood from alternative sites, follow the manufacturer’s instructions.)
- Poke the side of one of your fingers with the lancet. You may need to milk your finger a little for the droplet to form. Select a different finger each time. Remember to try to using the side of your finger rather than the tip as it is less painful
- Touch the drop of blood to the specific site on the test strip that accepts the blood.
- Wait for the result to display, and record the results in your log book.
Points to remember to care for your meter and for testing
- Read your meter pamphlet or call the manufacturer to find out the temperature limits of both your meter and test strips.
- Take care to keep your meter and supplies within this range
- Test your meter (if needed) with control solution as advised by your meter company
- Use your strips within the time period recommended by the manufacturer after opening. Do not use expired strips
- Use a new lancet at each testing and properly dispose of the old one. Never use a lancet after another person has used it
- It is recommended to test the fingers when hypoglycemia is suspected
- Bring your meter with you when you go for blood work. Test your blood glucose at the same time as your draw and match the numbers for accuracy. Call your manufacturer to see what the accepted level of error is for your meter
- If you feel the number that is shown on your meter is not correct, wash your hands again and test. If you still question the number, test with another meter if possible. Call formedical help if needed.
Frequently Asked Diabetes Questions
Can diabetes go away?
Currently no cure exists for diabetes. Type 1 diabetes is an autoimmune disease that destroys the ability of the pancreas to produce insulin. At this time injections or an insulin pump are necessary to sustain life. Type 2 diabetes is more common. In type 2 diabetes the pancreas can produce some insulin, it may not be enough and/or the insulin is present in adequate amounts but functions poorly due to insulin resistance. Research has shown that healthy lifestyle changes such as weight loss and exercise can decrease the need for medication for type 2 diabetes. Even with mild diabetes if symptoms diminish and blood glucose measures normal after weight loss and exercise, the disease will come back if you do not control your weight and continue to exercise.. Your risk of complications of diabetes is much lower if your blood glucose control is improved.
Do I have to give up sugar?
Sugar is a carbohydrate, and all carbohydrates raise blood sugar. Everyone needs to eat carbohydrates as part of their meal plan but it needs to be measured and controlled. Nutrition standards of care recommended by the American Diabetes Association recommend people with diabetes need at least 130 grams of carbohydrate per day. The amount and type of carbohydrate, as well as what else you eat with it, will alter the rise of blood sugar in speed and level. The American Diabetes Associations recommendations to keep blood glucose between 70 and 130 mg/dl before meals for most non-pregnant adults and less than 180 mg/dl one-two hours after the first bite of a meal. A healthy balanced diet, portion control and blood glucose monitoring can help you achieve these goals while including most foods in your diet. Some people use the glycemic index of foods to better understand the effect of food on their blood glucose. Ask your dietitian for advice.
Do I have to take insulin?
People with type 1 diabetes must take insulin to sustain life. The islet cells in their pancreas no longer produce insulin. People with type 2 diabetes either produce inadequate insulin or have insulin resistance (which means the cells have difficulty using the insulin they make ) or both. Treatment for type 2 may begin with learning to modify ones diet and exercising as suggested by ones doctor.. Drugs such as Metformin may also be prescribed. When blood glucose is very high on diagnosis, other medications might be recommended (including insulin).
Does diabetes cause other complications?
If blood glucose is not kept in check, diabetes can lead to a number of serious complications, including heart attacks, strokes, kidney disease, blindness, blood vessel disease, amputations, nerve damage and impotence in men. However, a recent statistics in the United States show heart attack rates dropping by 70 percent, stoke rates and amputations dropping by 50 percent and death from diabetes related crisis dropping by 28 percent. This is attributed to good care and knowing and practicing good diabetes self-management.
How do I prepare for sudden illnesses?
When you are sick, the body releases hormones that can raise blood glucose and make it harder to keep in check. Discuss a “Sick Day Plan” with your doctor. If on insulin, continue to take it - as well as check your blood glucose more often. You should have urine strips to check your urine for ketones. Oral medications for diabetes may or may not be discontinued, depending on your doctor`s advice. Check your over-the-counter medications for sugar and be aware that other cold care products can raise or lower your blood sugar. Keep your blood sugar log handy so when you call the doctor, you can provide them with useful information.
How does my blood pressure affect diabetes?
High blood pressure poses a risk for strokes. Since people with diabetes have a higher risk for strokes, you should check your blood pressure twice a year. If your blood pressure is higher than 120/80, discuss your numbers with your doctor. If blood pressure remains high, consider treatment options such as a low-sodium diet, increased exercise and/or taking blood pressure medication.
How is diabetes diagnosed?
Diabetes is diagnosed when a blood glucose test measures more than 126 mg/dl (fasting) or 200 mg/dl (two hours after consuming a glucose drink) or random blood glucose test over 200 with other symptoms consistent with a diabetes diagnosis. Blood glucose tests should be repeated to confirm results. Some doctors may order a glucose tolerance test, in which you drink a glucose solution and have your blood sugar tested before and every hour after for four hours. The hemoglobin A1C test is now approved for diagnosing diabetes (now used for diabetes management). An “A 1C” of 6.5 percent or greater is an indication of diabetes. People with risk factors for diabetes - family history, excess weight, high LDL cholesterol, and high triglycerides - should be tested regularly.
How often should I check my blood glucose?
To be sure, ask your doctor how often you should check your blood glucose. If you are treating your diabetes through diet and exercise or oral medication, diet and exercise, you should probably check your blood glucose level at least twice daily. If you take insulin, check your blood glucose four times daily. This will help you assess how well your meal and exercise plan and medication are working to stabilize blood sugar. Blood glucose levels of 180 two hours after eating or above 140 before eating are considered high.
How should I take care of my eyes and feet?
As a person with diabetes, you have an increased risk off eye and foot problems, so check both regularly. In particular, it is critical that you get a yearly eye exam that includes dilating your pupils to detect signs of eye disease. Having diabetes increases your risk of eye complications, such as retinopathy, macular edema, and cataracts.
Your doctor should check your feet at least once a year. Symptoms of foot problems can include decreased feeling in the feet, cramps when walking, cuts and scratches that heal slowly, redness in the feet when sitting and whiteness when propped up, lack of hair growth on legs and feet and leg or feet pain. Doctors advise daily checks for cuts or injuries in order to prevent infection or other problems. Because of potential damage to nerves, it’s sometimes difficult for a person with diabetes to feel injuries to the feet.
What should my HemoglobinA1c (HgA1c or A1C) level be?
A1C is a measure of your average blood glucose levels over a two to three month period. Ideally, your A1c should measure below seven. If it measures above seven and closer to eight or above, you may need to make changes in your treatment plan. To track your progress, you should get your hemoglobin A1c tested two to four times per year.