Living with Diabetes
By Marcia Kyle, RD, LD, CDE, licensed registered dietitian and certified diabetes educator at the Pen Bay Diabetes and Nutrition Care Center.
Nearly 26 million children and adults in the United States live with diabetes, and another 79 million people are at risk. Diabetes continues to be the leading cause of blindness, heart disease, stroke, kidney failure and amputation. In Maine, diabetes is the 7th leading cause of death.
As a certified diabetes educator and registered dietitian, I see daily how diabetes affects not only the person with diabetes but how it reaches out to touch family, friends and the community.
November is American Diabetes Month, so let’s look at one day in the life of a person with diabetes.
You 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.
You check your blood sugar before eating or even before drinking your first cup of coffee if milk or sugar is added. This requires poking your finger with a lancet device to get a drop of blood to test.
You take your medication. If you're on insulin, you mathematically adjust the dosage based on the results of the blood glucose reading.
You eat within a prescribed time and within a set amount of carbohydrates, especially if you're on medication. A typical breakfast is 1 cup oatmeal, 1 cup skim milk and 1 serving fruit that has 60 grams of carbohydrates. Watch out at the office meeting when a well- meaning coworker brings in a bag of bagels or donuts. If you indulge or add another 30–60 grams – oops, now your blood sugar is too high!
You eat lunch on time within 4-6 hours of breakfast and test your blood glucose again – another poke -- before eating. If you're 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. You hope the meeting doesn’t run over or you will have to inconspicuously eat a snack!
You fit in 30 minutes of exercise, maybe it occurs during the 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 complications are prevented by consistently having blood sugars between 90 and 130 mg. before meals.
You eat dinner on time within 4-6 hours after lunch and test your blood glucose again before eating (no nibbling while cooking). You adjust your medication if your results are too high or too low depending on medication.
Before bed, you test your blood glucose one more time. It is the fourth poke of the day and you 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, are stuck in traffic, etc.
We would all understand the immediate effects of living with diabetes if each person who reads this article would for one day walk in the shoes of a person with diabetes. 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?
We can become 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 help them cope.
Employers can promote healthy lifestyles in the workplace to prevent type 2 diabetes and its complications, thereby improving the quality of life by saving companies thousands of dollars a year per person in health care costs and productivity.
The public can support research funding efforts for youth 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.
Marcia Kyle, RD, LD, CDE, is a licensed registered dietitian and certified diabetes educator at the Pen Bay Diabetes and Nutrition Care Center. She is specially trained in diabetes prevention and management. For more information, call 701-3999 or visit pbmc.org/diabetes.