Back to Diabetes Basics – Part 1

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What You MayExperience After Diagnosis
Where to start is the question. First,if you have just been handed the diagnosis of type 2 diabetes, eitheryou had an idea because others in you family history have it, or thisis a complete shock as you can recall no history of diabetes in yourfamily. Granted, there could be other reasons that may have inducedtype 2 diabetes, but I will discuss them in another blog. You mustrealize that the symptoms are not what every person feels, but theyare the minority. The feelings may be of a different intensity andlength for each person.
The FirstStage – Shock!
Are you in shock, have anger, ortotally befuddled? I can understand this and even acknowledge thatyou feel this way. This is the first stage in the process you willeventually go through to come to grips with your diabetes diagnosis. My anger was short lived as I had a history of diabetes on mymother's side of the family. My anger was at the time directed at adoctor that kept calling me a liar for not knowing I had diabetes. Yes, he had some reason to be upset at me as I was diagnosed while onthe operating table for angina. Stent insertion plus ballooning ofseveral areas in my arteries was in process and they could not stop. On top of that, they had the problem of stopping the bleeding at thepoint of insertion when finished.
His constant calling me a liar for notknowing I had diabetes resulted in a bedpan being hurled in hisdirection and quite a scene as nurses came running. I said I wantedsome quiet time and the doctor was preventing it. Even my roommatesaid his actions were disturbing and agreed with having him removedfrom the room. He asked to have his doctor come to see him. Shortstory – this doctor was told to stay away from our room as long aseither of us was in the hospital.
Shock, anger, or being in a fog isexpected when you receive the diabetes diagnosis. How you handle thiswill be important, as you need to consider what you do next. It isnot expected that you will retain the information given to you theday of diagnosis. It is important that you be ready for the nextappointment and have your questions ready to ask the doctor.
I hope that your doctor will havetesting equipment available to give you, or give you a prescriptionfor a meter, lancing device, lancets, and test strips. Be aware thatif you are not offered a meter, lancing device, lancets, and teststrips, you need to ask the doctor for a prescription before youleave. If you forgot, go back to the office and insist on aprescription. Some doctors will not as they do not want you to knowwhat your blood glucose levels are or does not want you to becomedepressed by the readings. If you have one of these doctors,seriously consider finding a doctor that will give you aprescription. Your diabetes health can be better for it.
Some doctors will use certifieddiabetes educators (CDEs) that can give you answers to many questionsand should reinforce anything the doctor has time to tell you. Theycan cover many areas of teaching you about diabetes and how to handlemany aspects of the disease. Many doctors do not have CDEs availableor will not use them. Some doctors use registered dietitians (RDs)and some doctors do not. In some of the more rural areas, doctorsare using nutritionists and others with a nutrition degree becauseRDs are not available.
With the rapid increase in people withdiabetes and a snails pace growth in the number of CDEs and RDs,other resources are being explored by some doctors. A minority ofdoctors are using diabetes mentors or peer mentors. A few doctorseven use peer-to-peer groups. The last three are interesting as thisindicates that these doctors are making use of knowledgeable patientsthat can use personal experiences to relate to new patients. This isa measure to help new patients feel like they are not alone in theirstruggle with diabetes, help educate new patients, and be availableto answer some questions when needed. You should avail yourself ofany education you have available. Your doctor is not available 24/7;therefore, you need to educate yourself to manage diabetes.
Okay, I have gotten ahead of myself andcovered a few areas that should come a week to a month afterdiagnosis. Education about diabetes is important, but the first weekwill be very difficult for many people. If shock and anger don'ttake over for a few days, you are definitely in the minority. A fewpeople will take the diagnosis in stride and be ready for the nextstep of being educated. Even if you are in a state of shock, keepthe fog at bay long enough to learn that diabetes “is not yourfault.”
Many people falsely feel that if theyhad done this or done that, they would not have diabetes. Part ofthis may be true, but people that are genetically disposed todiabetes should not feel this is their fault. Yes, their actions mayhave helped make the diagnosis happen earlier, but by having thepredisposition for diabetes; most people have no control inpreventing diabetes, just the timing of the diagnosis. There arepossibly some people that are not genetically predisposed to diabetesthat are diagnosed, but there is little evidence to-date supportingthis happening in large numbers.
There is no advantage in dwelling onthe past. This was a hard lesson for me to learn, but I had a goodfriend tell me that diabetes is the here and now and I needed tolearn how to deal with it. Since this person did not have diabetes,it really stopped me and made me realize that unless I did just that,I might not be capable of managing my diabetes.
The SecondStage – Denial!
After the initial shock, anger, or whatyou want to call it, you may have denial. This is not necessarilythe order, but can happen early on or years later. Denial can wreckhavoc in diabetes management and make it difficult to recover. Denial is thinking you have mastered diabetes and don't have to doanymore to battle diabetes and just stop, or outright refusal torecognize that you have diabetes. Both are damaging to you and maymake future management of your diabetes more difficult. Diabetesburnout is very different and should not be confused with denial.
The ThirdStage – Acceptance!
The next stage is acceptance ofdiabetes and the desire to manage it to the best of your abilities. And yes, denial can happen after what may seem like acceptance, butgenerally does not. Acceptance means that you recognize diabetes iswhat you have and have decided to manage it as only you can do. Yes,you will rely on your doctor for guidance and assistance, but youhave accepted it as your diabetes and intend to do battle with it.
A PossibleFourth Stage – Depression!
Now that I have covered the main stagesthat most people encounter, I need to add a possible fourth stage. This stage does not generally happen to about one-third of peoplediagnosed with diabetes, but may happen to the other two-thirds. This is generally a minor depression and may happen at anytime fromdiagnosis to years later. Only about 19 percent of people developsevere depression. The risk is there and needs to be considered anddealt with when it happens.
I have had diabetes for eight plusyears and have had what I believe was depression only twice, the lastabout a month age. I was in a down mood or funk and had to forcemyself to continue to work on blogs and do my research, but therewere days I did not want to do anything. I don't know what happensto everyone, but unless you really are seriously depressed, take itin stride and work to overcome it. Seek professional help if youfeel the need. Some do have serious depression and need to seekprofessional help. This is normally the best route to follow and getthe help necessary.
The last item for this blog is astatement by William Polonsky, PhD, CDE, and director of TheBehavioral Diabetes Institute in San Diego, CA. He states that“diabetes does not cause anything.” That is right;diabetes causes nothing, no complications or related problems. Thismay surprise a few people, but the cause of the complications andsome other problems is the poor or lack of diabetes management. Youmay think that this is what diabetes does, but no, if you maintainblood glucose levels at or near normal, the complications areunlikely to happen. Old age may happen before diabetes complicationsand you will likely die from old age before diabetes or itscomplication take over if you accomplish excellent blood glucosemanagement.
This also puts to rest the first myth. Many believe that diabetes is progressive and continues to get worse. If diabetes is managed properly, progression will not happen andpeople may live a long, normal healthy life. The factor that addsreality and keeps this myth in front of people is that few peopleactually do what they are supposed to do to manage diabetes. Forthem diabetes is progressive and their quality of life is often injeopardy.
Series 1 of 12.