I Have Diabetes. Now What?
I’ve got some bad news. I went to the doctor last week and found out I have Type 2 Diabetes and high blood pressure. I knew I was overweight, but when I heard the news I was shocked. Not even pre-diabetic, full-blown diabetes. I have to take medicine now for both things.
I work two jobs, so it’s hard finding time to exercise. A few years ago I worked with a trainer and lost 70 pounds, but I gained it all back. I don’t know how to keep it off. My work schedule is always changing. I work anytime between 7 a.m. and 10 p.m. Sometimes I’m so starving by the end of work I just go to 7-11 and eat whatever they have. My office has a break room and it’s always filled with junk food. It’s always someone’s birthday.
My doctor – he gave me a packet of information, but I’m so overwhelmed I haven’t read it. I know I should eat better and exercise but I don’t know where to begin. Can you help me?
That is bad news, and I’m sorry you have these health problems to deal with. Diabetes and high blood pressure are serious conditions that must be managed. The good news is that you have the power to control this. It requires lifestyle changes and self-discipline; both can be difficult but are essential to your health.
You mentioned you don’t know where to begin, so let’s begin here:
You must take full responsibility for your health. Right. Now.
A doctor can give you medicine, a trainer can show you exercises, but you alone decide how you live your life. Everyone is busy (but I will grant you that two jobs is a lot to handle.) Everyone feels social pressure to eat junk at parties, or feels too tired to cook or exercise after a long day. Those are excuses. You now have two serious medical conditions, and if you don’t take care of yourself, you could very well die from them.
It’s tough love, but that is the real beginning. Now let’s break this down into more manageable bits.
What is Type 2 Diabetes
Type 2 Diabetes, simply put, is when your body cannot properly digest sugar, (glucose). Glucose comes from food and your liver. Glucose is important because that is what fuels your brain and muscles. Your pancreas secretes insulin, which is a hormone that helps deliver the glucose to your cells. In Type 2 Diabetes, your body becomes resistant to insulin, and your pancreas become overwhelmed and can’t make enough insulin to handle all the extra sugar. So instead of being delivered to your cells, the sugar hangs out in your bloodstream. Genetics play a role and some people who are seemingly healthy develop Type 2 Diabetes as well. It is also strongly linked to obesity and inactivity.
If not properly managed, diabetes can lead to cardiovascular damage (like a heart attack), nerve damage that starts in your fingers and toes and can spread up your limbs, kidney damage, blindness, foot numbness and risk of infection that can lead to amputation, certain cancers, and Alzheimer’s disease. Clearly, you don’t want that. (Source: Mayo Clinic: Diabetes Basics.)
What is High Blood Pressure (Hypertension)
Blood pressure is the force of blood pushing against the walls of your arteries as the heart pumps blood. If this pressure rises and stays elevated it can lead to stroke, heart failure and kidney failure. (Source: National Heart Lung and Blood Institute.)
- Take an active role in the management of your conditions
- Work with your doctor to transition your diet to healthy whole foods instead of junk foods and processed foods
- Get clearance from your doctor to start exercising
I’ll go into more detail below.
Take an Active Role
It’s good you are seeing a doctor. I know he gave you some medicine and a packet of information, which you have not read yet. Let’s go back to the beginning: You must take full responsibility for your health. You should no longer have a passive relationship with your doctor; instead view this as a partnership.
Read the information he gave you! You don’t have to read it all at once. Read as much as you can and then take a break. Keep a notebook next to you as you read and jot down any questions you have. Call the office and schedule an appointment specifically to get all of your questions answered. Don’t feel pressured to race out of there because the office is busy. Ask a friend or family member to come with you to help you remember everything you were told.
Do you know what medications you are taking and why? Have you made an appointment to have your eyes checked, as diabetes can damage your eyes? Did your doctor explain the importance of checking your feet for blisters?
Your life depends upon understanding what you have and what you need to do to manage it.
What Do I Eat Now?
You mentioned you are 70 lbs overweight. This is something that must be addressed. Your doctor should be able to recommend to you a registered dietician (RD) who can design a meal plan specifically for you that will help you deal with high blood pressure and diabetes. Things like sugar and salt have to be carefully monitored. As you begin to lose weight, you will need to keep your doctor informed, as medications may have to be adjusted.
You must take responsibility for what you eat. Start with the very basics by getting rid of the junk food in your house. Why tempt yourself, right?
Your RD will most likely tell you to eat whole, natural foods instead of processed foods. How can you tell the difference? Generally speaking, if it has a label on it, then it has been processed in some way, meaning the food manufacturers have added preservatives or other ingredients (many of them chemicals) to the food inside the package. Also added to many processed foods are sugar, salt and fat. The quick tip is to shop the perimeter of the store, to get things like vegetables and lean meats, like chicken and avoid the middle aisles where the cookies and TV dinners live.
Binging and Starving
You mentioned that you starve yourself for hours and then binge eat at 7-11. As a diabetic you really need to plan your meals so you don’t have an insulin crash. This means you will need to work with your RD to find foods that are nutritious and also incorporate your busy and changing schedule. This means you need to prepare your food in advance and eat consistently.
Here is a tip: Prep your food once a week. I like to do my food prep on Sundays. It takes about two hours from start to finish, but then I don’t have to think about it all week and I’m never without a healthy meal.
Speaking of work, I agree that it’s really hard to eat clean when you are surrounded by junk food in the break room. Here are some ideas to try: 1) Avoid the break room. Eat your lunch in your car, at your desk, or outside. 2) Talk to your co-workers. My guess is you are not the only one who doesn’t want to be tempted by junk food all day. Maybe everyone can agree to make the lunch room a junk-free zone.
You mentioned, “It’s always someone’s birthday.” Yes, it is. But that doesn’t mean you have to eat the cake! Say happy birthday and move on. Bring your own healthy food and eat it while everyone else is having the cake. Are people looking at you funny? WHO CARES!?! Is it worth going to the hospital over? Doubt it. If you feel really, really pressured, like your boss’ wife made the cake or something, take a slice of cake, sing happy birthday, and then throw it away at your desk. No one will know, you’ve appeared social, and still remained healthy.
Talk to your doctor before starting any exercise program. Some gyms will require doctor’s authorization if you want to work with a personal trainer. Aim to exercise 3-5 days per week for at least 30 minutes with a combination of cardio and strength training. This will help use up that stored sugar in your liver to level out your blood sugar levels. It also reduces stress, is good for your heart, and builds up endurance to do everyday things like walking up stairs.
Your schedule may change during the afternoons and evenings, so wake up earlier and get your exercise out of the way before you go to work.
Special considerations for exercising with diabetes (Source: National Academy of Sports Medicine):
- Check with your doctor before beginning any exercise program.
- Make sure you have appropriate footwear and check your feet for blisters or abnormal wear patterns
- Keep a snack (quick source of carbohydrate) during workouts to avoid sudden hypoglycemia
- Avoid excessive plyometric training due to foot concerns
- Avoid foam rollers, as you may have reduced feeling in your legs and feet.
Special considerations for exercising with high blood pressure (Source: National Academy of Sports Medicine):
- Check with your doctor before beginning any exercise program.
- Make sure you breathe normally during exercise. This means you should not lift excessively heavy weights where you might be prone to hold your breath.
- Do no tightly grip weights or clench fists when training – this can dramatically increase blood pressure.
- Monitor your heart rate throughout your workout
- Perform exercises in a standing or seated position. When you lie down (especially when your head is lower than your heart, like in a floor bridge) this can have an intense effect on your blood pressure, so avoid these types of exercises.
- Avoid foam rollers as they require you to lie down.
Remember that your life is in your own hands. Getting a diagnosis of diabetes and high blood pressure can be very shocking, but you have the power to mitigate these conditions. Work with your doctor, eat healthy and become active.
Get healthy, friend! You can do this.
Here are some websites for further reading:
This blog post is for information purposes only and in no way is meant to substitute the care of a physician.
Sheslosingit.com (c) 2014 Lisa Traugott. All rights reserved. No portion of this blog, including any text, photographs, and artwork, may be reproduced or copied without written permission.