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Your first step
It's not uncommon to be in denial immediately following a type 2 diabetes diagnosis, but the first step towards dealing with the disease is to get your head around it both intellectually and emotionally. "Telling a patient that they have diabetes doesn't mean that they've accepted it," says Dr. Cheng. "People should spend time [acknowledging the news]. Once you've accepted it, you can be proactive about treatments." Taking the diagnosis seriously, and agreeing to follow the plan set up by your medical team—your physician, nurse, dietitian and pharmacist—will help you feel better faster, and prevent further progression of the disease.
Knowledge is power
Learning about the disease and its treatment options can help you take control of your situation. Ask your doctor to refer you to a diabetes education centre. "They provide in-person diabetes education in a setting where you can ask questions and get feedback," says Dr. Cheng. While you wait to connect with a centre in your area, you can find relevant and accurate information about type 2 diabetes on the Canadian Diabetes Association (CDA) website (www.diabetes.ca), as well as the CDA's Clinical Practice Guidelines website (www.guidelines.diabetes.ca). Canadians should avoid American-based diabetes websites since they often refer to different measurements for monitoring glucose (sugar) levels. Confusing imperial with metric measurements could make you feel worse, and derail your management of the disease.
Make lifestyle adjustments
When someone who doesn't have diabetes eats a meal, a hormone from the pancreas called insulin breaks down the glucose content in the food. But for patients with type 2 diabetes, the pancreas doesn't produce sufficient insulin, leaving glucose amounts at organ-damaging levels. Lifestyle changes can help ease the pancreas' burden and keep sugar levels stable. "If someone doesn't make lifestyle adjustments and continues to give the pancreas more work, then the diabetes itself will likely progress faster," says Dr. Cheng. These tweaks to your routine won't cure the disease, but they can help you feel better, reduce your need for medications, and lower the chances of developing complications involving your eyes, kidneys, nerves and cardiovascular system. Being proactive about lifestyle changes can also aid your emotional well-being. "When people make lifestyle adjustments they're empowered," says Dr. Cheng. "It can give a sense of confidence, that I can handle this."
Dr. Cheng says that the first lifestyle adjustments should involve food choices, and physical activity. "From a food perspective, diabetes education is important," she says. A dietitian can help you understand portion sizes and guide you towards healthy choices. Vegetables, lean meat, fish, grains, starches, milk and fruit should be part of a balanced diet. The Canadian Diabetes Association recommends three regularly timed meals per day with a limit on foods high in sugar and fat such as pop, candies, jam, chips and fried foods. With physical activity, the first goal is to increase daily movement. "Park your car a little farther away and walk, and take the stairs when you can. As you start to feel better, you can ramp up the physical activity even more," says Dr. Cheng. Once you're used to being active, try a fitness class, or enlist friends for a long walk or bike ride.
If you're overweight, these diet and activity changes could result in weight loss. People who have diabetes but who are at a healthy weight tend to have better blood glucose levels, blood pressure readings, and fewer health complications than their overweight counterparts. The goal, however, is to lose weight slowly under supervision. "Losing one pound a week (2 to 4 pounds a month), is your safest way to do it," says Dr. Cheng. "A slow, realistic weight loss is more likely to stay off." Before you begin any new eating habits, check with your medical team for expert advice. Some diabetes medications in conjunction with low-carbohydrate diets can create extremely low blood glucose levels – a situation that can be detrimental to your well-being.
Reducing stress, attending doctor's appointments, properly monitoring your blood glucose levels, and taking prescribed medications such as insulin are also important tools for the management of diabetes. And don't forget your friends and family. Loved ones can offer valuable support and encouragement when they understand the dos and don'ts of living with type 2 diabetes. "When the household gets behind the person and adopts physical activity, and a healthy diet, it can make the change easier – and affect the whole family in a positive, healthy way," says Dr. Cheng.