You’ve Just Been Diagnosed: Now What?

"You have diabetes." Those are the words more than 1.5 million Americans will hear this year. If you're among them, you've just joined the company of roughly 10 million men or 9.1 million women in the U.S. who have type 2 diabetes, numbers that don't include the estimated 6.2 million people who are unaware that they have it.

Diabetes, especially when it isn't controlled, can put you at risk for heart disease, stroke, amputation, high blood pressure, blindness and kidney disease. It's natural to feel fearful, especially if you don't know much about it other than that your glucose levels are too high (126 mg/dl or higher) and your cells are not getting the insulin they need. When it comes to diabetes, however, you benefit by being an active partner in your medical care. Here are five things you can do:

1. Forget old myths
You may have images of injecting insulin daily and never eating sweets again. Relax. Many people with type 2 diabetes effectively control their condition through diet (and weight loss, if they're overweight). Research has shown that people with diabetes can include sweets or starches in moderation as part of their daily meals. Carbohydrate-counting is one of the key elements of diet modification for people with diabetes. Be sure to talk to your doctor and make an appointment with a registered dietitian to talk more about your diet.

2. Buy a good glucose meter
Because monitoring is one of the first things a person with diabetes needs to do, according to Vanessa Rein, MD, of the Hospital of the University of Pennsylvania's Penn Rodebaugh Diabetes Center, your meter will be a valuable tool in controlling diabetes. Your doctor can advise you on any specific features you may need. (We've described some new models in "New Choices in Blood Glucose Monitors," but be sure to talk to your doctor about choosing the best glucose monitor for you.)

"You'll need to check your blood sugar and maintain a log," Rein says. "The more you check, the better. If you don't, you have no way of knowing how you're doing." A bonus: Studies have shown that daily testing with a glucose monitor can help you lose weight for the very reason that keeping a food journal helps. Both make you pay closer attention to your food choices.

3. Make friends with your doctor
You'll need to bring your glucose-meter log to visits with your doctor, which just got a bit more regular. Typically, you'll have two to four visits a year, says Rein. The reason: to catch any changes early on, to detect high blood pressure or high cholesterol (these can add risks for stroke and heart disease) and to keep you on track. Also, mention any other health problems you are experiencing as they may also be linked to diabetes.

4. Build your medical team
In addition to your primary care doctor, you'll want to find a good dietitian, ophthalmologist and endocrinologist, says Leonid Poretsky, MD, codirector of the Friedman Diabetes Institute at Beth Israel Hospital in New York. "Your best bets are diabetes centers across the country that offer a team approach," he says. These centers have all the specialists you'll need for one-stop shopping. Your doctor can point you to the closest center, or check the Web or Yellow Pages for certified diabetes centers.

5. Build your personal team
Educate your family about type 2 diabetes and make sure they understand the support you'll need in maintaining any diet or lifestyle changes.

About the Writer
Brian Hickey is the managing editor of the Philadelphia City Paper and has written for Details, Men's Health and Philadelphia Magazine.

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