In the last 10 years, the number of new cases of type 2 diabetes has far exceeded experts’ predictions. What used to be referred to as “adult-onset” diabetes—which primarily occurred in mid-to-later adulthood—is now being diagnosed in a much younger population, including children, adolescents, young adults, and women of childbearing age. Among older adults over the age of 65, 20% have type 2 diabetes.
Persons with type 2 diabetes who cannot keep their blood glucose (sugar) levels in a healthy range are at a higher risk for serious and frequently life-threatening complications. The triple threat of poorly managed diabetes, uncontrolled blood pressure, and high cholesterol levels places those individuals at high risk for heart attacks and strokes. Also, blindness, kidney failure, and nerve disease often occur in persons who have not learned to properly manage their diabetes.
But it doesn’t have to be that way. Diabetes complications can be prevented. Medical research has shown that by taking an active role in caring for your blood glucose levels, blood pressure, and cholesterol, you can potentially avoid these complications and live a full life.
You are the key member of your diabetes care team. Working closely with a team of health care professionals with expertise in medical care, dietary counseling, and teaching self-care skills is the best way to manage your diabetes and prevent complications from arising.
8 Weeks to Maximizing Diabetes Control combines current diabetes research with the authors’ shared experience of over 40 years as certified diabetes educators. This book will provide a comprehensive and practical resource as you move forward in the quest to keep your blood glucose under the best possible control.
As health care professionals committed to excellence in diabetes care, we encourage you to stay educated, maintain a positive outlook, and always keep the advice of your diabetes care team close to your heart—LITERALLY!
John V. Borders, MD, FACP,
Internal Medicine Specialist
Edward I. Galaid, MD, MPH,
Internal Medicine/Preventive Medicine Specialist
Patti B. Geil, MS, RD, FADA, CDE,
Diabetes Nutrition Educator
Stacy D. Griffin, PharmD,
Diabetes Education Specialist
Kristina D. Humphries, MD,
Endocrinology and Metabolism Specialist
Carol B. Peddicord, MD,
Internal Medicine Specialist
You can’t change a diagnosis of diabetes. You are not the first person to wish that you didn’t have diabetes, nor will you be the last. But the fact is, you do have diabetes and this chronic disease will be with you for the rest of your life. Life goes on…and the most important thing for you to do is learn how to get your blood glucose under control. The good news is that people with diabetes can learn to self-manage their disease. With type 2 diabetes, that generally means making some healthful changes in behavior to help control your blood glucose levels with the advice of your diabetes care team.
Whether you are newly diagnosed with type 2 diabetes or you have had it for several years, one thing is certain: Knowledge is power. The more you know about diabetes, the better equipped you are to make informed decisions about your health. You and your diabetes care team can work together to assure that you have the knowledge and skill that is necessary to help you attain and maintain the best possible blood glucose control. In addition, the ability problem solve and have effective coping strategies to deal with the ups and downs managing a chronic disease are necessary to achieve positive lifestyle behaviors. The American Association of Diabetes Educators developed framework of seven self-care behaviors that measure, monitor, and manage outcomes.
AADE 7 SELF-CARE BEHAVIORS
The following self-care behaviors are the framework for measuring, monitoring, and managing outcomes.
1. Healthy eating
2. Being active
3. Monitoring
4. Taking medication
5. Problem solving
6. Healthy coping
7. Reducing risks
American Association of Diabetes Educators, AADE Self-Care Behaviors. www.diabeteseducator.org. Accessed March 2007.
8 Weeks to Maximizing Diabetes Control offers suggestions and guidance for people with diabetes to help put into perspective these diabetes self-management tasks or self-care behaviors that, at times, can seem overwhelming. It may be helpful for you to think about these self-care behaviors as they relate to your personal diabetes health.
Taking each self-care behavior and dividing it into realistic goals may help you move forward. To help maximize your diabetes control, you may want to focus on one self-care behavior and make changes in that area. Or in some cases, it may benefit you more to make changes that will enhance more than one self-care behavior to positively impact your blood glucose control. The eight-week format that is introduced with self-care behaviors that are strategic in diabetes management can be evaluated with your A1C measurements. Although A1C is an index of average blood glucose for approximately 120 days, the preceding 30 days contribute more to the level of A1C than blood glucose levels 90–120 days prior.
AS significant new research in the area of diabetes is published and more and more tools and technology are available, it always remains important for you to be aware of and embrace the variety of recommendations to enhance your diabetes health.
All the best,
Laura Hieronymus, MSEd, APRN, BC-ADM, CDE
Christine Tobin, RN, MBA, CDE
Diabetes mellitus is a disorder of metabolism (or the breakdown of nutrients, primarily carbohydrates). Often just referred to as diabetes, it is characterized by higher than normal amounts of glucose (or sugar) in the bloodstream. The higher blood glucose levels are the result of the body’s lack of insulin production or the inability use the insulin that is present in the body. Insulin is a naturally occurring hormone that regulates the amount of glucose present your bloodstream. Insulin is produced by the pancreas, which about 6–10 inches in size and located in the body just behind the stomach. In a sense, diabetes is not a single disease, but rather group of conditions that includes type 1, type 2, and gestational diabetes. There is also a condition called pre-diabetes, which almost always occurs before type 2 diabetes.
Type 1
Type 1 occurs when the body no longer produces or produces very little insulin. Although type 1 can occur at any age, it is most common in children and young adults. The vast majority of type 1 cases are caused by the autoimmune destruction of the pancreatic beta cells, which results in the inability to produce insulin. It is characterized by the rapid onset of symptoms, including weight loss and increased thirst, urination, and hunger. Because of the lack of insulin production by the body, those with type 1 diabetes require insulin therapy as part of their diabetes treatment plan.
Type 2
Type 2 is the most common form of diabetes, occurring in about 95% those diagnosed with the disease. In type 2, the body typically produces insulin early on; however, your body has difficulty using the insulin properly. Type 2 diabetes is typically not diagnosed until complications appear, which is the reason nearly one-third of cases are undiagnosed.