Facing a new diagnosis of type 2 diabetes can be a difficult and confusing time. Many ask “why me?”, some may feel shame due to the stigma surrounding type 2, while others want to know what they can proactively do to better their health. I asked people living with type 2 diabetes what their initial questions were at diagnosis. Hopefully, this can help some of you who are learning how to live with this new condition.
1. What is type 2 diabetes?
Type 2 diabetes is the presence of excess sugar in your blood due to your body’s resistance to insulin and, in many cases, production of too little insulin. You can think of insulin as the key that opens cells and allows glucose (i.e. sugar) to enter your cells. If your body is insulin resistant, then it cannot use the insulin effectively enough to allow the correct amount of sugar to enter your cells. In this case, it builds up in the blood, causing high blood sugar levels.
2. Why did this happen to me?
We know that there are both environmental and genetic factors associated with a type 2 diagnosis. We also know that obesity can lead to diabetes, but not everyone who is obese winds up with type 2 diabetes. Age, ethnicity and numerous other factors also come into play. Try not to be discouraged by your diagnosis. Instead, use it as an opportunity to start or maintain a healthy lifestyle. This will help you to avoid issues down the road, and can help turn the diagnosis into a positive change in your life.
3. What should my blood sugars be?
The American Diabetes Association (ADA) recommends a fasting or before meal blood glucose of 80-130 mg/dL and 1-2 hours after the beginning of the meal (postprandial) of less than 180 mg/dL. There are of course factors related to food and insulin doses that can affect these numbers. Fasting numbers should ideally be under 100 mg/dL, but this will vary from person to person. Talk to your healthcare provider to learn what their specific recommendations are for your unique situation.
4. Are there alternative treatments?
While there are complementary and alternative treatment options available, they do not claim to cure diabetes. However, they may be beneficial in many ways that can indirectly improve your diabetes health. With that said, traditional medicine prescribed by your doctor should always be taken, and alternatives could be an addition to your regular treatment protocol.
One alternative approach that is a surefire way to help your overall health and improve your blood sugars is improving diet and exercise. Eating healthy — making sure you get plenty of protein and focus on unprocessed and nutritious foods, like plenty of vegetables — and making sure to stay active can help you to stay maintain optimal shape and blood sugars.
Other alternative treatments to consider are meditation and aromatherapy, both of which may help to alleviate stress, a contributor to high blood sugars. Also, be sure to explore acupuncture and acupressure if you have neuropathy-induced pain, as both of these are known to alleviate pain and improve circulation.
While some herbs and supplements may help prevent heart disease and have other health benefits, there is no evidence that they can actually help a person manage their diabetes. The ADA, in its 2017 Standard of Medical Care in Diabetes statement, stated the following, “There’s no evidence that taking supplements or vitamins benefits those with diabetes who do not have vitamin deficiencies.”
5. Will I have to go on insulin?
At diagnosis and in the early stages of type 2 diabetes, your doctor will likely advise you to incorporate lifestyle modifications, like diet and exercise, to help lower your blood sugar. If that doesn’t help, or if you are not diagnosed early on, then oral medication is often recommended. If your blood sugars aren’t at an optimal level, it is possible that your doctor may suggest going insulin.
While some people will think going on insulin means they failed at controlling their blood sugars on their own, that is not the case and oftentimes, people prefer to be on insulin as you can be more flexible with what you eat and when. Insulin may also help your pancreas to make insulin longer and has been shown to help control blood sugars better than oral medications alone. It doesn’t matter how, but that you maintain healthy blood sugars to avoid complications such as vision loss, nerve and kidney damage and heart disease.
6. What doctors should I see annually?
Living with diabetes could mean complications down the road so it is important to stay on top of your diabetes care so you can flag issues before they worsen. You should visit your eye doctor annually, such as an optometrist or ophthalmologist, to check for potentially serious conditions, such as: glaucoma, cataracts, diabetic retinopathy and diabetic macular edema.
Patients who have been living with type 2 diabetes for a long time are at a greater risk for kidney disease and may also need to be under a nephrologist’s care. They can also administer dialysis, for those patients undergoing dialysis treatment.
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Podiatrists are also important doctors to routinely visit as nerve damage can ensue over time for patients living with diabetes. People with diabetes can also be more susceptible to wounds not healing properly, and podiatrists can check for infections that could worsen and lead to gangrene and even amputation.
Other specialists to consider are a dietician and personal trainer, if you feel you need help with reaching your diet and fitness goals.
7. How much should I expect this disease to cost me?
Living with type two diabetes places a significant economic burden on the individual. Costs vary depending on what country you live in. A study conducted by the National Library of Medicine concluded that the average medical costs over someone’s lifetime were $85,200, of which 53% was due to treating diabetes complications, and 57% of the total attributed to macrovascular complications. Making sure to see your doctors regularly and staying on top of your diabetes management can result in long term savings in healthcare costs.
8. Can I manage it just through diet and exercise? Can it be reversed?
Remission of type 2 diabetes is possible.
While you can’t necessarily “reverse it” you can certainly control it and some can even put it into remission. This depends on the individual, their overall health, how far into the condition they are along with other factors such as beta-cell function and insulin resistance. However, with healthy eating and regular exercise, many are able to free themselves from medications, and maintain normal blood glucose levels, thus preventing complications.
Be wary of fad diets and gimmicks that promise to cure you of type 2 diabetes. Reversing and prolonging the progression of this disease is up to the individual and their dedication to a healthy lifestyle and numerous other health factors (like co-existing health conditions and access to the most appropriate and affordable healthcare) may help or hinder their efforts.
9. Does having diabetes lower my life expectancy?
Diabetes is historically known for shortening a person’s lifespan but the good news is that with medication, technology, and a little effort, this doesn’t have to be the case. According to the CDC, diabetes is the 7th most common cause of death in the United States. This statistic doesn’t distinguish type 1 from type 2 diabetes and it also doesn’t take into account all of the complications that could be the main cause for death.
If you are actively managing your diabetes, you are less likely to develop these issues that could lead to a shorter life span. And, on a positive note, many find that they are actually healthier once diagnosed, as it helps them to make better choices for a healthier lifestyle.
10. Are my children at risk?
While genetics do play a strong role, this only means you are more at risk of developing diabetes, not that you will necessarily be diagnosed. Many other factors come into play, and while diabetes runs in families, developing healthy habits, maintaining a healthy weight and keeping active can help stave off a diagnosis as well.
A diagnosis of type 2 diabetes doesn’t have to be a death sentence. With a little determination and support from your medical team and loved ones, you can manage this condition. Asking questions and staying on top of your diabetes care is key to maintaining long term success.
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