What You Don't Know Can Hurt You: Learning to Help Yourself
Knowledge is power, and knowing your numbers can help you keep them as close to normal as possible
It's a whole new world out there when it comes to diabetes. Each month brings more exciting developments: more information about causes, treatments and cures; new medications for keeping blood sugar, fat and pressure levels as close to normal as possible, to prevent complications; new tools for monitoring blood sugar levels and delivering insulin.
It is truly amazing. Eighty years ago we didn't even have insulin. When my sister got diabetes more than 40 years ago she was given her insulin with glass syringes, and when my son was diagnosed 20 years later he took one shot of NPH insulin a day. Today they both use insulin pumps to deliver ultra-fast-acting human insulin throughout the day. Times have certainly changed, and my sister and son have changed too.
That's true of every aspect of their diabetes care. In 1959 we helped my sister meticulously weigh and measure every bite she ate, and we spent hours searching for those expensive, less than totally satisfying “dietetic” specialties that were her only legal treats. Today she knows she can eat a reasonable, healthy diet of foods she enjoys. She has to watch how much she eats and when, but she isn't nearly as rigid as she used to be, because she doesn't have to be. She has learned how to eat reasonably and keep her blood sugars where she wants them, at least most of the time.
The way we test sugar has changed, too. In the old days we had only urine tests at home (they told us what my sister's blood sugar was several hours earlier), and blood sugar tests done “fasting” several times a year when she saw her diabetes doctor. Things are so different today. The new fast, easy-to-use blood sugar monitors provide up-to-the-second blood sugar information, and some have features that make it easier to track patterns and make adjustments. Now the doctor's office blood sugar test of choice is not one that tells you what your blood sugar was at one moment, after not eating for 12 hours, but what the average level was for the prior three months.
When it comes to diabetes, knowledge is power, and knowing your numbers can help you keep them as close to normal as possible.
One thing people with type 2 diabetes need to know about is the range of new medications for lowering blood sugar levels. As recently as the early 1990s, only one class of diabetes pills was available in the U.S. Now health care providers can prescribe five different classes of these pills. What makes this variety important is the fact that each class lowers blood sugars in a different way, so some people can take pills from different classes and get the benefit of both. I know people who take as many as three different diabetes medications.
Do you want to do a better job managing your diabetes? Do you want to learn more about new diabetes developments including treatments, medications and tools that might be right for you?
If your answer to either of these questions was yes, consider participating in a diabetes education program. Look first for programs that are recognized by the American Diabetes Association (ADA). Recognized programs feature certain components and standards including:
- An initial assessment to identify what you want and need to learn;
- Comprehensive content, so whatever you need to learn (from healthy eating to foot care to coping skills) is available;
- Staff qualifications to assure the educators know their stuff; and
- A teaching approach that assures people get the kind of interactive, skill-building experience they need instead of lots of lectures.
If you can't find an ADA-recognized program in your area, look for another program that has the things I mentioned above. It is a plus if the educator is a Certified Diabetes Educator (C.D.E.).
A good diabetes education experience is a wonderful thing. I have been working with colleagues at the Johns Hopkins Diabetes Center education program for many years. People come in groups of six to 15 for five consecutive days to learn all they want and need to know about caring for their diabetes. The Center staff includes physicians, nurses, dietitians and mental health professionals. We cover all aspects of life with diabetes, drawing upon the personal experiences, needs and concerns of the group members. The goal is to provide people the information, tools and support they need to make wise decisions about their lives with diabetes.
It is always wonderful to see the change in many Diabetes Center participants from the time they come in the door on Monday morning and when they walk out after the last class on Friday: people tell us their commitment to taking better care of themselves has gone way up during the week, and that their ability to do it has as well.
Research we have published on outcomes of participating in the Diabetes Center program bear out these statements. Six months after completing the program, participants were significantly better off than they were just before they started the program.
