DSME: Ways to manage your diabetes
First of two parts
EDITOR'S NOTE: November is National Diabetes Month and Certified Diabetes Educator and in 2016 Amy Aponick, wrote a two-part article discussing diabetes and the resources available for persons with diabetes. Amy assisted the GLOB Master on his journey from bordering on a diabetic coma to learning how to manage diabetes.
IT's IRONIC that we recognize November as Diabetes Awareness Month—it begins the day after a night filled with Halloween treats and marks the beginning of an approximate 2-month-long season of what many refer to as "holiday eating." Awkward coincidence? Not really. November 14 is recognized as World Diabetes Day each year, and we expand that awareness in our country to the entire month of November.
I think it's actually great timing because it allows us to see diabetes in the context of real life. It's an opportunity to recognize that diabetes is not a ticket to a life-long strict diet where yummy food and holiday treats are like kryptonite, but rather that it is a condition requiring some creativity in managing eating habits to promote ideal blood glucose control, that is, a level of glucose as close as possible to what the healthy body naturally maintains.
It's exciting that Gainesville's Lunch Out Blog has chosen to put diabetes in the limelight this month, and I am honored to be able to contribute to spreading diabetes awareness. GLOB Editor Mike Sanford's testimonies speak for themselves – He is a prime example of how diabetes doesn't have to control or define a person's life. Learning as much as possible about managing diabetes puts a person with diabetes in the driver's seat by creating the power to decide which direction to go in, even though the road may not always be smooth.
I am a Registered Dietitian and Nutritionist as well as a Certified Diabetes Educator at the UF Health Shands Diabetes Education Program and Nutrition Center. My coworkers and I are passionate about educating people with diabetes and their families on how a long and healthy life can be lived without letting diabetes get in the way. Our program is recognized by the American Diabetes Association (ADA), which means we uphold the highest standards in providing quality, evidenced-based, and up-to-date information on diabetes management. We provide Diabetes Self-Management Education (DSME) sessions either to individuals or to groups. We love seeing how patients grow in knowledge about diabetes and in understanding how to control it.
If you have diabetes—ask yourself how long it's been since you've had diabetes education. Diabetes can be complicated and confusing—it's important to be aware of current management guidelines because research on diabetes is continuously discovering new and improved ways to manage it. You might be following outdated guidelines and need a tune-up. Also, things you read online or hear on the news are not always accurate and may not apply to your unique situation. If you don't have diabetes but care about someone who does, it's a good idea for you also to update your understanding of diabetes management to be a good support person.
In addition to learning current guidelines, it's just as important to be aware of the psycho-social effects of diabetes. A great resource for people with diabetes and for their family, friends, and caregivers is The Behavioral Diabetes Institute, which focuses on the social and emotional barriers to living healthfully with diabetes and on how to provide support appropriately.
When I counsel patients, I typically begin by asking what is their main concern in managing diabetes. Almost always, the answer revolves around food, which is often assumed to be the culprit in poor diabetes management. While very important, food is actually just one piece of the complex--yet manageable-- puzzle of controlling blood glucose level. Therefore, the ADA recommends that DSME sessions be tailored to each individual as opposed to being generalized into "cookie cutter" advice for everyone. In addition to information on healthy eating, other puzzle pieces of diabetes that DSME addresses are monitoring blood glucose level, being physically active, using medications safely, preventing/detecting/treating acute and chronic complications, addressing psychosocial issues, and developing personal strategies to promote health.
However, since the GLOB is dedicated to enjoying food, let's focus on that. First, there is actually no "diet" for diabetes, rather it is more about gaining a better understanding of how foods affect blood glucose. In DSME sessions, a significant amount of time is spent detailing the best way to plan meals. Meal planning based on chydrate counting is one of those methods that can be very effective; however, explaining that is beyond the scope of this article. To learn more about it, check out information at the Food and Fitness section of the ADA's website: www.diabetes.org and talk to your healthcare provider about being referred for DSME. Also, something you can start doing right now is expand your understanding of the relationship between food and blood glucose. If you're not routinely getting blood glucose information, figuring out how to eat can be a mystery!
FOLLOW THE GLOB WEB LINKS BELOW for more information about the new epidemic of Type 2 Diabetes:
AMY APONICK HAS WRITTEN AN ARTICLE discussing diabetes and the resources available for persons with diabetes.
AMY APONICK EXPLAINS THE ROLE of meaningful blood glucose testing and diabetes self-management.