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You Can Manage Diabetes with the Right Attitude and Support of Others

November 2015

November is American Diabetes Month. Whether you have been diagnosed with diabetes or are at risk, you’re not alone. You can learn to manage diabetes with the support of others and lead an active, healthy life.

According to the Centers for Disease Control and Prevention, 29.1 million people have been diagnosed with diabetes, and one-third of the population has the disease but has not been diagnosed. Knowing one’s risk for diabetes can lead to early intervention and behavior changes that may prevent or delay the disease’s onset and complications.

Marina Litvin, MD, Washington University School of Medicine endocrinologist at Barnes-Jewish West County Hospital, treats patients with various endocrine disorders, including diabetes. Dr. Litvin shares what you should know about diabetes and how to care for yourself if you have been diagnosed.

What is type 2 diabetes?

Type 2 diabetes is a lifelong, serious disease of having too much glucose (sugar) in the blood. The disease involves the pancreas, an endocrine gland behind the stomach that is part of the digestive system. The pancreas’ main function is to make hormones; one of the main ones is called insulin. Insulin helps get glucose from the blood stream into the body cells. Body cells need glucose for energy.  

When you have type 2 diabetes, three things don’t work well:

  • The body has too much glucose in the blood and not enough in the cells. 
  • The pancreas makes too much insulin early in the disease, and later in the disease does not make enough.
  • The body does not use its own insulin well. This is called insulin resistance. 

Why is it important to take type 2 diabetes seriously?

Taking care of diabetes results in better health and preventing or delaying complications. Studies have shown that keeping blood sugars as close to normal as possible may prevent or reduce damage to your eyes, kidneys, blood vessels and heart, decreasing your risk for kidney disease, eye disease, poor wound healing, nerve damage, heart disease and stroke.

Who should you talk to about diabetes?

The most effective way to treat diabetes involves a multidisciplinary team. A primary care provider and/or endocrinologist will see you every three months to review your blood glucose (sugar) levels and monitor treatment. A certified diabetic educator (CDE) is usually a nurse who has received specialized training in assisting diabetes patients. Your CDE can help you learn about healthy eating, blood glucose monitoring, being active, taking medication, including insulin, problem-solving, reducing risk and healthy coping.

A dietitian is an expert who will help modify your diet to ensure it’s low in carbohydrates and fat, which can help control blood glucose levels and cholesterol, and may help with weight loss, while reducing your risk of low sugars (hypoglycemia). Others who provide specialized care include ophthalmologists, podiatrists, diabetic foot nurses, exercise physiologists, psychologists/ psychiatrists and cardiologists.

How important is support?

Studies indicate that one of the best predictors of how well someone takes care of their diabetes is the amount of support they get from family, friends and support groups. Family can help by participating along with the diabetes patient in lifestyle changes such as diet and exercise. Support groups are important because patients can share their experience, including what worked and did not work in their diabetes management, and can make new friends. Barnes-Jewish West County Hospital offers a Diabetes Self-Management Program consisting of individual and group classes.  Prior to your first appointment, your physician will need to fill out a Diabetes Self-Management Education/Training and Medical Nutrition Therapy Services Order Form.

Why is a healthy diet key?

An effective meal plan for diabetes should include foods that you like that also fit your schedule and eating habits. A healthy diet is low in processed foods, salty foods, carbohydrates and fats. Such diets usually include non-starchy vegetables, fruits such as berries that have lower sugar content, non-fat dairy products, beans and legumes, lean meats, and fish. Limit consumption of soda, juice and diet soda. Consulting with a CDE and/or dietitian can help adjust your meal plan to fit your schedule, diabetes medication regimen and exercise patterns. Meal plans should include portion control and awareness/counting of carbohydrates. The dietician and/or CDE also can assist with guidance on healthy caloric limitation to help with weight loss.

Are there other things that can help maintain a healthy lifestyle?

Following a healthy lifestyle will not only help control your diabetes or reduce your risk for diabetic complications, but can help control blood pressure, cholesterol and decrease heart disease risk. Maintain a healthy, well-balanced diet, limiting grains, starchy vegetables and fats. Limit alcohol consumption because it can affect blood sugars and blood cholesterol. Regular exercise will help with mood, weight maintenance or loss and help improve insulin sensitivity. It is imperative to discuss your exercise regimen with your physician before starting. Find healthy strategies to deal with stress.

Seven tips to help diabetic patients enjoy Thanksgiving, but not overdo it:

  1. Enjoy the holidays! Moderation is helpful to remember.
  2. Be careful of alcohol consumption.
  3. Continue to exercise.
  4. Holiday events and meals can affect diabetes management in many ways, including stress, eating too much and having time to monitor blood glucose levels closely.
  5. Plan ahead - if you are not sure if there will be a full meal at a party, eat at home and take your insulin. Then, you can select lower carb options for snacking or sip seltzer water.
  6. Keep adequately hydrated which may help you consume less food, give you more energy, and prevent dehydration that can occur with alcohol consumption.
  7. Make a healthy and delicious dessert - recipe for Basic Crustless Pumpkin Pie.

Anything else individuals living with diabetes should know? What about those who may be at risk for developing pre-diabetes and type 2 diabetes?

Talk to your physician about your risk. Regular screening can help identify individuals with pre-diabetes in whom lifestyle modifications can help prevent or delay progression to diabetes. If you have been diagnosed with diabetes, lifestyle modifications can help you stay healthy and happy. Talk to your physician about various diabetes therapies (medications, insulin, and non-insulin injectable) and work closely with him or her to optimize your diabetes control safely.

To schedule an appointment for with Dr. Marina Litvin or another specialist, call 314.542.WEST (9378) or toll-free 844.542.9378 or request a call for an appointment.

American Diabetes Association
American Association of Diabetes Educators
National Diabetes Education Program


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