Diabetes is on the rise

Darlene Turner

Diabetes is a disease whose incidence is rising, like the rivers of Iowa this spring. Contributing to this flood of cases of diabetes are improved screening for the disease, decreased physical demands in our automated world, and easy access and low cost of unhealthy food. Over 30 million people in the US are diagnosed with diabetes, and many more have the disease but are yet unaware of it. Because it is a disease with a treatment plan that calls for lifestyle change, there are special challenges you face, actions you take, and results you want if you are living with diabetes.

There are challenges you face in diabetes. I do not have diabetes, but I see people with diabetes every day as I work to help them. I follow diabetes social media groups with members who rant and rave about all the frustrations they have with diabetes, and they echo the people sitting in my office. There is a stigma associated with diabetes, which makes the person feel guilty, as if it is their fault. They also sometimes sense disappointment from their family or even from healthcare workers. There is a financial price tag to this disease, with costs for healthier foods, diabetes testing supplies, and prescriptions for diabetes medications, insulins, and technology including insulin pumps and blood sugar sensors. Many times there is a related need for blood pressure and cholesterol medications to help prevent the related heart disease that is frequently coupled with high blood sugars. It is challenging to get time off work to come to appointments, and also challenging to take time out at work to test blood sugars and take medications.

Diabetes is such a complex disease that there are whole departments like our Diabetes Center with educators and dietitians to help people not only to understand the disease, but also how to plan meals, use technology to monitor their response to medications, and help cope with a diagnosis that does not go away.

There are actions you take in diabetes:

” First of all, know your blood sugar numbers. Get screened for diabetes so that if your numbers are trending upward, you can get help now to delay or prevent the actual diagnosis. Getting the diagnosis of prediabetes can be a blessing to your life if you implement changes that keep you from progressing to full-blown diabetes. The treatments for prevention of diabetes and the lifestyle changes for the disease are the same plan. Checking your blood sugars seems meaningless to you unless you know what you are looking for. Use your blood sugar checks to see whether your lifestyle changes and medications are improving your blood sugar control.

” Secondly, get physically active to help your body utilize the insulin from your pancreas to work better. Exercise can help reduce your weight, which reduces your insulin needs. Working out helps with mental health and coping abilities. It is the cheapest treatment in diabetes, since all it requires is comfortable shoes and a place to walk. Choose an activity you like to do. Start slowly and increase activity gradually.

” Thirdly, learn what foods to eat that you enjoy and will not make your blood sugars rise. There is a need to reduce carbohydrate intake. There is a need to control impulse eating, replacing it with healthy choices of snacks or having a glass of water and going on an extra walk to keep you on track in self-care. There are many resources available to help track your food or help count your carbohydrates. Simply writing down what you eat can help with your accountability and help improve your food plan.

In addition, with diabetes, you are also in need of regular medical care to monitor its progression. TV commercials try to convince us that there are medications that will magically make your diabetes be perfectly controlled. There is no diabetes medication that can control your diabetes without you doing your part in controlling your food intake and increasing your physical activity as much as you can. In Type 2 diabetes, there is a gradual reduction in how much insulin your body is making. In Type 1 diabetes, your pancreas suddenly stops making any insulin. There are differences in treatment, so find a medical provider you trust to help you in facing all the challenges above.

Finally, there are results you want in diabetes. Utilize diabetes education classes and materials to help you in caring for yourself. Bring family members to appointments and classes to learn how they can help support you. I sense a lot of fear from patients due to the complications of uncontrolled diabetes, including fear of heart disease, strokes, dialysis, and amputations. Who wouldn’t fear those things? While we cannot know your future, we know that letting your diabetes go uncontrolled for long periods of time, makes it harder to get it controlled down the road. Ignoring your diabetes does not make it go away, although many of my patients have tested that out. The results that you want are to live with your diabetes well controlled, which reduces the risk of complications, helps you to feel better, and increases your ability to enjoy your independence.

The waters of the rivers of Iowa have been receding. A lot of damage was done, and people in impacted cities are working to try to prevent those floods from happening again. The numbers of cases of diabetes are still rising, but if we work together in our communities to encourage healthy eating and activity choices, maybe we will live long enough to see changes in the future. When parents choose healthy lifestyles, it helps their children. When communities promote and provide safe and affordable places to exercise, it helps people renew their love of physical fitness. Let us all be working together to reduce the challenges of diabetes, be aware of the actions to treat diabetes, and help one another to see the results of those actions, in longer, healthier lives.

Darlene A. Turner, ARNP, CDE

UnityPoint Clinic Nephrology