Living with diabetes

By Marcia Kyle | Nov 14, 2008

Approximately 21 million children and adults in the United States are living with diabetes, and another 54 million people are at risk. Around the world, diabetes affects 246 million people; especially hard hit are people in developing countries.

Here in Maine, nearly 100,000 people have been told by their doctor that they have diabetes. National data show that for every three people who have been diagnosed, there is another person who has diabetes but hasn't been diagnosed yet. In all, then, more than 10 percent of Maine's population has diabetes, whether they know it or not.

Diabetes continues to be the leading cause of blindness, heart disease, stroke, kidney failure and amputation.

As a certified diabetes educator and registered dietitian, I see daily how diabetes not only affects the person with diabetes but also reaches out to touch family, friends and community.

November is American Diabetes Month, so let's look at one day in the life of a person with diabetes.

Get up at about the same time every day -- even on the weekend -- because many diabetes medications need to be taken at consistent times to be most effective.

Check your blood sugar before eating or even before drinking that first cup of coffee if you take it with milk or sugar. This requires poking your finger with a lancet device to get a drop of blood to test.

Take your medication. If on insulin, mathematically adjust the dose based on the results of the blood glucose reading.

Eat within a prescribed time, especially if on medication, a set amount of carbohydrates. A typical breakfast of one cup of oatmeal, one cup of skim milk and one serving of fruit has 60 grams of carbohydrates. Watch out at the office meeting when a well-meaning co-worker brings in a bag of bagels or doughnuts, and if you indulge add another 30 to 60 grams. (Oops -- now your blood sugar is too high!)

Eat lunch on time within four to six hours of breakfast. Test blood glucose again – another poke -- before eating. If on diabetes medication, you may go too low and have to consume a fast-acting carbohydrate to bring your blood sugar back up to safe range. (Hope that meeting doesn't run over or you will have to inconspicuously eat a snack.)

Fit in 30 minutes of exercise (maybe during lunch break because you have to be at your child's school for a basketball game and won't have time to exercise at the end of the day). If you skip exercise, your blood sugar control won't be as good, and you know that complications are prevented by consistently having blood sugars between 90 and 130 milligrams before meals.

Eat dinner on time within four to six hours after lunch. Test blood glucose again before eating (no nibbling while cooking). Adjust medication if your results are too high or too low depending on medication.

Before bed, test blood glucose one more time (fourth poke of the day) and decide whether you can have a bedtime snack.

Imagine the adjustments that need to be made when you are sick, want to take a hike, eat a late night dinner with friends, go to a party, travel, get stuck in traffic.

If each person who reads this article would for one day walk in the shoes of a person with diabetes, we would all understand the immediate effects of living with diabetes. And we would recognize they are confronted every day with the long-term health complications that result if the daily routine described above is not followed diligently. There are no vacations from diabetes.

What can we all do to help? We can be aware of the challenges a person with diabetes confronts daily, and support funding for research, education and prevention of the disease.

Families can support a loved one with diabetes by recognizing their unique challenges and helping them cope.

Employers can promote healthy lifestyles in the workplace to prevent type 2 diabetes and its complications, saving companies thousands of dollars a year per person in health-care costs, and productivity, while improving the quality of life for employees.

The public can support research efforts for young people with type 1 diabetes, who have the most urgent need for care.

Diabetes is getting people's attention, and so it should. Let's raise awareness of diabetes not only during the month of November, but throughout the year.

We can make a difference. For more information about the Pen Bay Healthcare Diabetes and Nutrition Care Center, visit pbmc.org/diabetes.
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