Diabetes Basics.
Last updated Thursday, February 10, 2005
CopingWhat are some strategies for coping with diabetes basics? Different people find different ways to cope with diabetes. Some people
find it helpful to join a support group. This can be found in most
communities by calling the local American Diabetes Association
office. Others prefer to volunteer at hospitals, diabetes clinics, or
camps for children with diabetes. For others, coping mechanisms require
talking to a professional such as a psychologist. For everyone, it is
important to relate feelings to both your family and your physician.Who can help patients and families cope with diabetes basics? There are many options for help in coping with diabetes. Support
groups, healthcare professionals, and clergy can all be of assistance.
Often, simply finding someone with experience living with diabetes can
be quite helpful. The American Diabetes Association is a good resource, and they have a variety of books dealing with this topic. The books can be found at www.diabetes.org.
In many communities, the clinical nurse specialist (CDE; see above) is the most knowledgeable about what resources are available for a particular location. What are some strategies for coping with diabetes basics on the job? Coping with diabetes at work has similarities to coping with it at
home. Of course, much of this depends on the type of work one does.
People with "desk jobs" who get very little physical activity at work
would do best by taking advantage of walking steps instead of riding
the elevator, or intentionally parking further away than necessary.
Even this moderate amount of additional exercise can improve glucose
levels and for many, improve stress.
For people who take insulin, it is important your supervisor knows
you need to eat at specific times. If this is not possible, you can
discuss with your physician different strategies to avoid problems.
With the newer insulins, there are many ways to be creative about this.
For everyone with diabetes, it is important not to "hide" your diabetes
from your co-workers. This is especially true if you take insulin.
Some people have difficulty discussing their diabetes with others.
Occasionally, this is such a problem that self-management tasks are not
performed (blood sugar testing for example). These fears need to be
addressed and occasionally require the help of a psychologist. What are some strategies for coping with the effects of diabetes basics on relationships with family and friends? Another important but complicated topic is the effect of diabetes on different types of relationships.
For children, diabetes can affect their relationships with parents,
siblings, and friends. Kids often feel "different" and this can create
significant problems--occasionally resulting in behavior changes. It is
important for parents to make sure their child with diabetes does not
feel "different." The most important example is to make sure a
different type of food is not served to the child with diabetes
compared to the rest of the family. Everyone should be served the same
food.
In teens with diabetes, issues pertaining to dating are often a
concern. Both girls and boys often have difficulty in dealing with
their diabetes when confronted with the opposite sex. Again, the key is
for the family to be supportive of an open discussion of any concerns
that the teen may have. This may include discussions about the effects
of alcohol on diabetes control.
Diabetes can affect relationships in adults as well. Issues an be
just as complicated: relationships at work, at church, and at the golf
course can all be affected by diabetes. Many of these problems are due
to others being uneducated about the diabetes. Explaining to others
about diabetes can be the most important solution to problems that may
arise. What are some adaptive aids or tools for coping with diabetes basics? There are a variety of different "adaptive aids" to help with the
various aspects of diabetes. Perhaps the most common one is the use of
the specialized shoes to protect the feet in people with severe
peripheral neuropathy. Feelings of sensation in the feet are lost, and
special protective shoes can protect these feet from developing an
ulcer. These ulcers often become infected and cause many problems, but
the special shoes can assist in preventing this. Similarly, the use of
"orthotics" for the feet help to redistribute the weight so that areas
that are prone to callus formation have a better opportunity to heal.
There are a variety of new aids for actual blood glucose management.
Home blood glucose meters have become quite simple to use, requiring
small amounts of blood. Several meters can use blood from the arm or
thigh so there is no more pain from the fingersticks, which tend to
cause more pain. We are also using more sophisticated software systems
to download the meters to help assess trends in blood glucose readings.
This is particularly helpful for people who test frequently, and most
of the meter software can be purchased directly from the company for
your PC.
Insulin pump use continues to grow. In the US there are over 120,000
people using pumps, and this is also growing in people with type 2
diabetes. The pump delivers small amounts of fast-acting
insulin--usually lispro (Humalog) or aspart (Novolog)-- continuously
around-the-clock, and a "bolus" of insulin is infused by pressing a
button before a meal. The amount of insulin to infuse is based on the
blood glucose reading at the time and the amount of anticipated
carbohydrate intake. Obviously, exercise also has an influence in how
much insulin to administer. In our experience at the University of
Washington with pumps, for 107 patients for a time period of 3 years we
saw a 74% reduction in hypoglycemia. What are some strategies for coping with stress related to diabetes basics? Stress can have a major impact on blood glucose control as it causes
an elevation of adrenalin (also called epinephrine) in addition to
other hormones. Adrenalin makes one more resistant to the effects of
insulin, so no matter if you have type 1 or type 2 diabetes stress can
raise the blood glucose levels. One recent study showed that if one can
relieve stress the HbA1c can decrease, on average, by 0.5%.
The best strategy for relieving stress is to learn how to avoid the
emotional upset that may occur. This is easier said then done as it
takes time to change the way one reacts to stress. For some people,
getting exercise works well. This is particularly helpful for people
with diabetes as the exercise directly works against insulin
resistance. For many, it also makes the stress less bothersome.
For others, the main problem is lack of sleep--the stress keeps
people awake and the next day the stressed-out person has difficulty
functioning due to lack of sleep. It would be important to discuss this
with your physician as there are safe medications that could be used
for a short period of time to help with this problem. For people with
type 2 diabetes there is a higher rate of sleep apnea (due to obesity).
If you snore and are exhausted during the day, also ask your doctor
about this possibility.
For many with overwhelming stress, it may be best to discuss with
your physician. Divorce, loss of a loved one, loss of a job are all
major "stressor events" which may require more formal treatment, either
by discussing with a psychologist or with anti-anxiety medication. What are some resources for people with diabetes basics? There are a variety of important resources for people with diabetes. The largest American organization is the American Diabetes Association (ADA).
Based in Alexandria, Virginia, the ADA funds diabetes research, has
extensive education programs for patients with diabetes and health-care
professionals, and manages camps for children with diabetes. They have
a monthly journal "Diabetes Forecast" and a regular e-newsletter for
important updates in relevant news. The ADA can be reached at
1-800-DIABETES or www.diabetes.org.
Other important resources include:
- Juvenile Diabetes Research Foundation: 1-800-533-CURE or www.jdf.org.
The JDRF is the world's leading nonprofit, nongovernmental funder of
diabetes research. JDRF is the only major diabetes organization focused
exclusively on research.
- Taking Control of Your Diabetes: www.tcoyd.org.
A nonprofit organization started by Dr. Steven Edelman at the
University of California in San Diego, this group strives to motivate
and improve the lives of everyone with diabetes. The programs this
group runs are tremendous and if one comes close to you please make
time to attend!
- American Association of Diabetes Educators: www.aadenet.org
- The Diabetes Mall: www.diabetesnet.com. Provides reviews of all of the latest research and new products.
- The Diabetes Monitor: www.diabetesmonitor.com. "Monitors everything about diabetes in cyberspace."
- Diabetes Self-Management: www.diabetes-self-mgmt.com. S comprehensive journal regarding all aspects of diabetes care.
- Diabetes Interview: www.diabetesworld.com. An excellent newspaper.
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