Advice for Newbies

By David Mendosa

Sorry to hear that you have joined us! Type 2 diabetes is a lot to live with, but it really manageable! And if you are depressed, I can understand. Being depressed is pretty common with us, especially right after a diagnosis.

In fact, if you take care of yourself, you will be healthier and happier than you ever were. That paradox is something many of us experience.

“Learning about diabetes...
will give you...
power over the disease.”

Controlling diabetes may not be easy, but the list of things that you need to do is a short one:

1. Exercise daily. Most of us prefer to walk. But for people with leg problems, swimming may be the best alternative. You almost certainly have a nearby health club that you can join.

2. Eat less. Eating fewer calories improves our blood glucose even before we have any weight loss. And losing weight is usually a beneficial side effect of eating less. Almost everyone with type 2 diabetes (myself included) is overweight. I know how hard it is to get down to the right weight, but every pound you take off gives you better control over your diabetes.

3. While uncontrolled diabetes can affect every organ of your body, your mind is the organ that you can use to control your diabetes. When you control your stress, depression, and hostility, you can reduce your blood glucose level.

4. For most, but not all, of us this is still not enough. Take the medicine or insulin that the doctor prescribes. You may not have to take it all your life, once the effects of exercise and diet kick in. But your doctor will almost certainly prescribe it now to help you get your blood sugar in control.

The first steps after diagnosis are:
You need to get a good doctor, if possible an endocrinologist, a doctor who specializes in diabetes.

1. Have the doctor give you the tests that all of us with diabetes get, particularly the A1C, which measures your average blood glucose level over the past two or three months. Have you had that test yet? What was the number? Knowledge of these things will give you power over your diabetes and help to lift your spirits.

2. Have your doctor prescribe a blood glucose meter, test strips, a lancing device, and lancets. In most states, if you have a prescription for them they must be covered under your insurance policy. Test as often as the doctor says to — or even more if you can afford more strips. The more you test, the more knowledge you will gain. That will give you more knowledge and power.

Knowledge about diabetes is power:
Learning about diabetes on the Internet and through books will give you even more power over the disease. I picked my eight favorite diabetes Web sites, and one mailing list and newsgroup each a couple of years ago. See http://www.mendosa.com/amiratop10.htm. The Web sites are for information; think of the mailing list and newsgroup as primarily being for support.

You can see my favorite books about diabetes at http://www.mendosa.com/books.htm. One of these, Gretchen Becker’s The First Year—Type Two Diabetes is just what the subtitle says: “An Essential Guide for the Newly Diagnosed.”

Having diabetes means that your body doesn’t do a good job of using the food you eat because of a disturbance of carbohydrate metabolism. It’s those carbs that raise your blood glucose levels. You can reduce the carbs in your diet, especially restricting those carbs that have a faster acting — high glycemic — index. The concept of the glycemic index is one of the most important and exciting area of nutrition to learn about. The glycemic index is a scientific system of measuring how fast a carbohydrate triggers a rise in circulating blood glucose—the higher the number, the greater the blood glucose response. You can find the most complete list of glycemic indexes on my Web site at http://www.mendosa.com/gilists.htm. It may be even better to also follow a very low-carb diet.

We also need to limit the amount of fructose that we eat. For most people the two largest sources of fructose are high-fructose corn syrup and table sugar (sucrose), both of which are about is half fructose. The trouble with fructose is its impact on the liver, which almost exclusively metabolizes it. Consequently, the more fructose in our diet, the higher the subsequent triglyceride levels in our blood. Our triglyceride levels are even more important in terms of our risks for heart attacks than our cholesterol levels.

The other important dietary consideration is to limit our AGEs, which is shorthand for advanced glycation end products. They cause oxidative stress and inflammation, which has a special connection to diabetes. How we prepare our food, especially the amount and duration of exposure to heat and by the associated water loss, is most important. Methods such as frying or broiling greatly increase the AGE content of food.

That’s all there is to it. Go for it! 

This article originally appeared on mendosa.com on September 10, 2002.

Last modified: February 18, 2008

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