I Just Found Out I Have Diabetes – Now What?

By Renee Wickliff, RD, CDCES, BSN, RN

Maybe you are at your doctor’s office getting a yearly checkup when they tell you your lab work came back, and you have diabetes. Or maybe you are doing a health screening at work and the staff tells you to follow up with your doctor because your blood sugar is high. Perhaps you have been peeing a lot and are thirsty all the time, so you visit your doctor to get checked out.

No matter how you find out, you just heard these dreaded words: “You have diabetes”.

Ok, first, take a deep breath. Diabetes can be very overwhelming, but you are not alone. The Centers for Disease Control (CDC) estimates that 1 in 10 American’s have diabetes [1]. Diabetes has become one of the most common diseases amongst the majority.

Left unchecked, diabetes can wreak havoc on your body. But, by taking proactive steps including eating healthy, exercising, taking your medications, and checking your blood sugars, this disease can be managed. Your life is NOT over.

My doctor said I had prediabetes. What is that?

Prediabetes is when your blood sugar is higher than normal, but not high enough to be diagnosed with type 2 diabetes. The CDC estimates that 1 in 3 American’s have prediabetes [2]. Risk factors include being overweight, over 45 years old, inactivity, family history of type 2 diabetes, polycystic ovary syndrome, or gestational diabetes.

Think of prediabetes as a warning sign. Your current lifestyle is leading you to become a diabetic. By becoming more active and eating healthier, you may be able to avoid type 2 diabetes. The tips in this article and on MyDiabetesLifestyle will help you if have prediabetes.

There is also a program you can join called the National Diabetes Prevention Program (DPP). This intensive program can help prevent type 2 diabetes. Click the link to learn more about the DPP.

Check Your Health Plan

Once you find out you have diabetes (or prediabetes), ask your doctor about different resources available. I worked on a team as a registered dietitian to help diabetics learn about nutrition. We also had a pharmacist to help them manage their medications, a nurse to follow up, and a social worker to help with their mental health. Your healthcare provider may have a team to help you manage your diabetes. It never hurts to ask.

A ‘Certified Diabetes Care and Education Specialist’ (formally ‘Certified Diabetes Educator’) is a credential that indicates an individual has been trained to help you manage your diabetes. Read as much as you can about diabetes but it will be helpful to meet with someone too. 

Make a New Diet Plan

One of the best lifestyle changes you can make is modifying your diet plan. Ask your doctor to refer you to a registered dietician, who will help you design a new diet plan. A good dietitian will take your current lifestyle, schedule, favorite food(s), how much time you have to cook, and budget into account. Many diabetics worry that they will never be able to eat their favorite foods ever again. That is not true! A dietitian will help you work in your favorites.

It may be overwhelming to make many changes at once, so start with small steps. Here are a few ideas, but I would recommend only picking one for now. Once it becomes a habit, add in another change. Remember that the journey of 1,000 miles starts with 1 step.

Healthy Ideas to Try Today

  1. Swap out sugar sweetened beverages like juice, sweet tea, energy drinks, or pop with water. If you drink sugar sweetened beverages at all meals, just pick one meal and switch to water.
  2. If you normally buy a large or medium, try buying a small. This can work with sides such as French fries, sugar sweetened drinks, or desserts like ice cream and milkshakes. 
  3. Many sandwich shops offer the sandwich to be wrapped in lettuce instead of bread. You can also ask for whole grain instead of white bread.
  4. Buy fresh vegetables like baby carrots, baby tomatoes, or sugar snap peas to snack on instead of chips or pretzels. You can also buy and chop up celery, cauliflower, broccoli, or cucumber.
  5. “Hide” unhealthy foods in the garage or the top of the fridge while leaving healthy vegetables and fruit out on the counter or in the front of the fridge where you can see them.
  6. If you eat out, split the meal in half when it comes to the table. Put the other half in a to go box for a different meal or share with a friend. As a bonus this will save you money!
  7. Instead of eating out of the package, place the food in a small bowl and put the package away.
  8. Add a bag of steamed vegetables to a meal. Pick one with no added sauce or salt. Just pop the bag in the microwave and in a few minutes, you have a healthy side. You can throw the bag away so there is no clean up.
  9. Avoid eating in front of the TV or computer, which can cause mindless grazing and overeating.
  10. Find one healthy meal to cook at home. Double or triple the recipe so it lasts for several days.

Change Your Physical Activity Plans

Exercise is important to manage your diabetes. When you exercise, your body will use any extra sugar in your bloodstream, lowering your blood sugar. It also helps improve insulin sensitivity.

You don’t need to spend hours of time working out to see benefits. One of the best exercises you can do is walking. You can also look up different workouts on YouTube for free. This lets you exercise in the comfort of your own home.

If you want to join a gym, ask if you can get a week free to try it out. They may even set you up with a free session with a trainer to help show you around. Many yoga or Pilates studios and fitness classes may offer free trials. This will let you shop around to find the best exercise program for you.

You May Need Medicines to Lower Blood Sugar Levels

               If your blood sugar is very high when you are diagnosed, your doctor may start you on a new medication. Most newly diagnosed patients are given metformin. Metformin is cheap and effective, although side effects include diarrhea and upset stomach. These side effects usually go away after a few weeks [see: Is Metformin Causing You an Upset Stomach https://www.mydiabeteslifestyle.com/2019/08/29/is-metformin-causing-you-an-upset-stomach-try-eating-a-banana/]. Taking a low dose of metformin or an extended release formulation can help you avoid the side effects.

You might need to increase the number of your medications if your blood sugars remain uncontrolled. The best way to control blood sugars is positive changes in your lifestyle. I worked with many patients who were able to make such changes. Some of them were even able to get off their medications!

Your Blood Sugar and Other Tests

Most primary care doctors will want to see their new diabetics frequently until they know the blood sugars are under control. They will want you to keep a blood sugar log. A blood sugar log can be helpful for you to see how diet/exercise effects blood sugar. When I was working with one diabetic, we could see how her blood sugar would jump into the 200’s after she ate too many cookies. As you tweak your new lifestyle, keep checking your sugars for progress.

In addition to checking your blood sugar, your doctor will want you to have yearly eye exams, labs for your kidney/heart, and check your feet. These tests let doctors catch problems early when they are easy to fix.

Mental Health

            The reactions I saw to a diabetes diagnosis were different for everyone. Some people didn’t think it was a big deal because they felt fine (these were the patients I was most worried about!). Others sobbed in my office afraid they were going to go blind. Whatever you feel is valid. If you need to find someone to talk to, that is normal and many patients find it helpful.

               I did notice that patients who ignored their diabetes diagnosis were more likely to end up in the hospital with health problems. When I worked as a nurse, we frequently had patients who required toe or foot amputations due to uncontrolled diabetes. Many of these patient’s told me they ignored their diabetes, never checked their blood sugars, didn’t take their medications, and ate whatever they wanted. Please know many of the complications of diabetes can be avoided by making changes to your lifestyle.

Conclusion

If you have diabetes, you need to make changes or face undesirable consequences. Use the resources on MyDiabetesLifestyle.com to follow your blood sugars and learn how to make healthy changes.  Remember you don’t need to be perfect; you just need to do better then you did yesterday.

References

[1] Centers for Disease Control, “Type 2 Diabetes,” Centers for Disease Control and Prevention, 30 May 2019. [Online]. Available: https://www.cdc.gov/diabetes/basics/type2.html.
[2] Centers for Disease Control, “Prediabetes: You Could Be That 1 in 3,” Centers for Disease Control and Prevention, 10 June 2019. [Online]. Available: https://www.cdc.gov/diabetes/library/features/prediabetes-1-in-3.html.

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