Tag Archives: Type 2 Diabetes

How managing your A1c can help you reach healthy blood sugars

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When it comes to healthy blood sugar control, the A1C is a vital measuring tool. A1c is the short name for glycosylated hemoglobin. Now, this may sound like a mouthful. It is abbreviated to the A1C to make it easier to understand.

The A1c calculated as a percentage point. Blood glucose attaches to the proteins in the red blood cells. The A1C measures the amount of sugars attached to the red blood cells. This is a normal process that occurs in both people with diabetes as well as non-diabetics.

The average red blood cell last about 120 days, the A1c can measure the blood sugar levels over the prior 6- 8 weeks.

When it comes to managing Type 2 diabetes, the A1c can is used in two ways:

To diagnose Type 2 diabetes or pre-diabetes:

  • An A1c over 6.5% on at least two separate occasions confirms a diagnosis of Type 2 diabetes mellitus
  • An A1c between 5.7- 6.4% on at least two different times is indicative of pre-diabetes
  • An A1c of less than 5.7% is normal

The A1c can also be used to measure blood sugar control:

The A1c is commonly used to monitor overall blood sugar control. It is important to know what your A1c is. I cannot tell you how many times I have been taken aback by patients who have no idea what their A1c is.

 If you are on a mission to THRIVE despite being diagnosed with Type 2 diabetes, you need to not only knowing what your A1c but also getting it under control.

What should be the target A1c in someone living with Type 2 diabetes?

About 20 years ago, there was a landmark study on people with Type 1 diabetes.  The research found that when diabetes was detected early and blood sugars well controlled, this helped to reduce the complications associated with type 2 diabetes.

To learn more about the complications associated with type 2 diabetes, and other information, you can download this free e-book, which is the first three chapters of my award-winning book.  

According to recommendations by the American Diabetes Association, the target goal for A1c should be less than 7.0%. An A1C of less than 7% correlates with sugars on average less than 140 mg/dl.

For every percentage above 7%, the blood sugars go up about 30 mg/dL. The higher the A1c, the higher the blood sugars. The higher the blood sugars, the greater the risk of complications.

So the goal for most people is to keep the A1c less than 7%

Now there may be some caveats to these recommendations-

For instance, if you over 80 years of age, then tighter blood sugar control may not be a reasonable goal. So have a discussion with your healthcare provider about what a reasonable goal should be at that point. Perhaps an A1c between 7-8% may be a more reasonable goal.

What are some factors that may affect getting the A1c to goal?

 For some suggestions on how to achieve healthy blood sugars, I recently put together a mini-course series which is a collation of prior blog articles on just that topic. To learn more click here.  

In summary, the A1c is a percentage measure of the amount of blood glucose that is attached to the red blood cells. The less the blood glucose attached to the red blood cells, the better the A1c. So we need to focus on what we need to do to achieve healthy blood sugars.

How to tell the difference between type 1 and type 2 diabetes in adults

A lot of times, I come across patients who have to use insulin and aren’t quite sure whether they have Type 1 or type 2 diabetes.

I hope to be able to clarify the difference between the two, especially in an adult.

Type 1 diabetes

Type 1 diabetes is commonly called ‘juvenile onset diabetes.’ Type 1 diabetes is usually diagnosed in young children, often under the age of 5 years. Type 1 diabetes is an auto-immune disease. An auto-immune disease is when the body forms antibodies against itself.

In the case of type 1 diabetes, the body develops antibodies against the cells in the pancreas responsible for producing insulin. These are called the beta cells. When the beta cells are attacked and destroyed, the result is a rise in blood sugars. Someone with type 1 diabetes requires insulin.

During community talks as well and media appearances, I take the time to emphasize the difference between type 1 and type 2 diabetes.

It is fairly common for people to flippantly state that “Diabetes is a disease of lifestyle” without differentiating between the two.

Type 1 diabetes is not a disease of lifestyle.

Type 2 diabetes

Type 2 diabetes is different. It is not caused by a lack of insulin; instead, it is caused by a condition called insulin resistance. With insulin resistance, the cells of the body do not respond to insulin efficiently. In my book, I compare insulin resistance to the landlord changing the locks on the door to your apartment so that the key no longer works. The beta cells have to put out more insulin to overcome the resistant cells.

When someone with type 2 diabetes starts using insulin, does that mean they now have type 1 diabetes?

No. It is possible that with the ‘natural progression’ of type 2 diabetes, some people may need to start using insulin. They may also have a condition called late auto-immune diabetes of adulthood (LADA).

Individuals with LADA have a slower progression toward needing insulin than someone with type 1 diabetes.

There are also other scenarios where someone newly diagnosed with type 2 diabetes needs to be started on insulin right away. This still does not make them a type 1 diabetic.

What can happen with type 2 diabetes is that with time, the beta cells (the cells that produce insulin in the pancreas) may begin to degenerate and so cannot keep up with the production of insulin. It may be necessary to start insulin to keep blood glucose levels within the normal range and reduce the complications of diabetes.

How can you tell the difference between LADA, and Type 2 diabetes?

There are several blood tests that your healthcare provider can perform to help tell the difference between LADA and type 2 diabetes. This is particularly important as the treatments are different.

So it’s important to be pro-active when it comes to your overall health and wellbeing. Do not be afraid to ask questions.

I’ll be sharing more details in my upcoming online course, “What your doctor does not tell you about type 2 diabetes’. For more information about Type 2 diabetes, you can download a free copy of the first three chapters of my award-winning book, “Dr. Eno’s A-to-Z Guide to Thriving with Type 2 Diabetes”, by clicking here.

To your health and wellbeing,

Health Awareness Topic- Is your metabolic health up to par?

According to a recent published study by the National Health and Nutrition Examination survey between 2009-2016, only 12% of Americans have good metabolic health. This means that 7 out of every 8 Americans do not have good metabolic health. These are pretty dismal numbers by all accounts.

What was concerning with this study was that even people with so called normal body weight may not have good metabolic health!  The paper goes on to warn that these implications pose a high concern for public health.

In today’s article we’ll go over what metabolic health is. Why we need to be concerned about metabolic health. How this is different from other health parameters. How we can quickly assess our metabolic health. Why we need to be concerned about it and finally what are some of the measures we can start taking to improve our metabolic health.  

What is Metabolic health?

Metabolic health is a term that is used to identify a cluster of measurements that could increase the risk of developing cardiometabolic diseases such as type 2 diabetes, heart disease, and strokes.   

Metabolic health looks at five measurements. The parenthesis show the normal range.

  • Triglycerides (normal less than 150 mg/dL)
  • Waist circumference (women less than 35 inches; men less than 40 inches)
  • Fasting blood sugars (less than 100 mg/dL; or A1c less than 5.7%)
  • Blood pressure (less than 120/80 mm hg)
  • Body weight (BMI less than 25.0)

Why metabolic health is important?

Your metabolic health is simply looking at these five measurements and comparing it to the normal range. It is letting us know your current health status as it relates to these five categories.

Why are these five measurements important? These measurements happen to be the same measurements used to determine your risk for a cluster of abnormalities called the metabolic syndrome.

If any 3 out of the 5 measurements above are abnormal, then this is called metabolic syndrome. Metabolic syndrome there is a higher risk for cardiometabolic disease is higher. To learn more about metabolic syndrome click here.

How to measure your metabolic health

Step 1 -check your weight and take your height.

I usually recommend checking your weight first thing in the morning, after you have used the bathroom and preferably with no clothes on. This gives a more accurate measure of your fasting body weight with no fluid fluctuations that could occur during the day.

Again I prefer this measurement first thing in the morning after a stretch. Stand against a door post and have a friend or family member mark the top most part of your head with a marker.

Next, plug these two numbers into a BMI  calculator.

To calculate your body mass index click here

Step 2-measure your waist circumference

Your waist is the mid-point between the tip of your hip bones and your lower midcage. If you bend to the side the crease you see is your natural waist line. Measure your waist circumference with a measuring tape at this point standing up tall and after you have completely exhaled. In women the waist circumference should be less than 35 inches and in men less than 40 inches.

Step 3 -check your blood pressure

Blood pressure can be measured with a machine called a sphygmomanometer. Most local pharmacies and even department stores have digital blood pressure machines. You can also schedule a nurse visit at your healthcare provider’s office and have your blood pressure checked there. It’s important to take a few deep breaths, sit up straight with your two feet on the ground and using the left arm. It’s a good idea to take three readings at least five minutes apart and then take use the best of the three readings.

Step 4 – have your fasting blood sugar and your fasting lipid panel checked.

You may need to schedule an appointment with your healthcare provider to have this done.

Once you have all the measurements, you’ll be better able to know your metabolic health.

Remember that knowledge is the first step to personal empowerment. Perhaps your metabolic health is not at par. That’s not really where I want to focus on right now. We already know that only 12% of Americans meet the criteria for being metabolically healthy. So, let’s not focus on the doom and gloom.

What I find reassuring when I look at this information, is that these measurements can be modified. They are called modifiable risk factors.

Modifiable means that you can do something about them.

As I point out in my award-winning book, “Dr. Eno’s A-to-Z Guide to Thriving with Type 2 Diabetes” the first three steps to dealing with any challenge are critical mindset strategies- acceptance, belief, and commitment to change.

Instinctively we know what we need to do, eat ‘healthier’ and exercise more. But if it were as simple as that why do we have an obesity epidemic?

My mission is to provide you with tools which will allow you to create a permanent shift in your way of being so that you can become more empowered in the choices you make when it comes to your overall wellbeing.

In my next article I’ll be reviewing how fasting can help improve your metabolic health.

Until next time,

To your health and wellbeing,

To download a free copy of the first three chapters of my book click here

How This Simple Strategy is Helping Me Tiptoe Past Overwhelm

personal developmentRecently I’ve had a lot on my plate. Between going to several work locations as a travel physician, building my online wellness platform; working on marketing and publicity; preparing for the release of my upcoming book, plus training for a fall marathon, it’s little wonder I’m beginning to experience some overwhelm.

In an earlier article I wrote about a strategy to get past overwhelm and get back into action.

But when we try to get back into action, we tend to set big goals and we get overwhelmed again.

Let’s say your goal at the beginning of  the year was to be a svelte size 6 by the start of the summer season. But somewhere around February, you stopped exercising, stopped watching your diet. Now you are 10 lbs heavier than you were at the beginning of the year!

You’re wondering if it’s worth even trying to lose all that weight. Perhaps you’re feeling so defeated that you’ve decided you’ll wait until 2018 to set another new year resolution.

In my upcoming book, I write about ‘the stages of change’. Too often we go straight into action without too much preparation. And when we do get into action we tend to go all out. You know the slogan ‘Go BIG or go home!’  Then we find we’re having a hard time keeping up the momentum. Next we become overwhelmed!

What if there was a way to tiptoe past overwhelm so that we stay in action and on the road to producing the results we desire?

Well, there is a way, I’ve learned about. It is called the Kaizen method. It teaches how to take simple small steps. When starting out with the kaizen method, the steps are so ridiculously small, that it may seem impossible they could create longlasting change. That’s the beauty of the kaizen method. The steps seem so small initially that we may not even feel we are making any change. The key is to success in the kaizen method is to consistently build on these small steps.

You see when we set BIG goals, we trigger an alarm in an area of our brain called the amygdala.
The amygdala is part of our primitive brain and was developed in pre-historic times to protect us from harm. So if the primitive man ventured into unfamiliar surroundings, it was the amygdala that fired off alarm signals warning him to retreat back to familiar surroundings.

The amygdala fires off the same way when we venture into the unfamiliar territory of making changes. Even when we know those changes could make us healthier and happier.

No wonder we never quite seem able to sustain a weight loss goal, exercise regimen, better diabetes numbers etc. because to our brains these all represent change. And our amygdala thinks change could be bad.

By learning to take simple small steps, consistently, we can make the needed change and not alarm our amygdala!

So what could this look like?

Let’s go back to the weight loss goal example and see how we can apply the kaizen method.

Rather than focus on the short-term goal of weight loss, focus on the long-term benefits losing weight will give you.

If you are living with type 2 diabetes or borderline diabetes, perhaps you may focus on the fact that in the long-term, losing weight has been proven to help with better blood sugar control and in the case of borderline diabetes can possibly reverse it.

Think of something really small that you can start with. This is the time to get really creative. Then commit to taking a simple small step.

For instance if you want to start a walking program, don’t rush to the fitness store and spend hundreds of dollars getting geared up in the ‘latest and the greatest gadgetry’. Rather, start with something as small as walking in place at home or at work for 1 minute a day. Or maybe you want to cut down on your food intake. Rather than look for ways to immediately cut out 500 calories per day, as most nutritionists may recommend, start with simply leaving a spoonful of food on your plate.

As these simple actions become easy, add on to with more small steps. For instance walk in place for 2 minutes a day. Leave two spoonfuls on your plate.

Be consistent. Make it a habit. Celebrate your wins.

Using the kaizen method can create a snowball effect. You will notice yourself wanting to take on more as your newfound habit becomes fun.

Can you think of other aspects of your life that could benefit from using the kaizen method?

Too often we tend to focus on what needs to be fixed. This is a very narrow way of looking at our lives. Every aspect of our lives are interconnected. You spiritual health affects your emotional health as well as your physical health. How you eat, sense and feel, relate to others as well as your perception of the world affects your whole person, and ultimately your health.

Whether you are living with a chronic illness or just looking to be healthier, it is always best to take a whole person approach to wellness.  The kaizen method is just one way that allows us to focus on the small things that ultimately affect the whole.

In my upcoming coaching programs, I’ll be sharing several strategies that help to focus on the whole person when it comes to improving our overall health and wellbeing.

I’m also excited that the second edition of my book “Dr. Eno’s Guide to Living Powerfully with Type 2 Diabetes’ will soon be released.  If you would like to download a free copy of the ebook that highlights the first three chapters of my upcoming book, click here.

To your health and wellbeing,

May 2017 Awareness Topic: The Difference Between Overweight and Obesity

In the May 2017 Health Awareness Topic, I’ll discuss the difference between what it is to be obese and how this differs from being overweight. In my years of clinical practice, I have found that people do not like to describe themselves as obese. Somehow the word obese has become ‘politically incorrect’ and offensive. So people, even healthcare professionals, choose to use the word ‘overweight’ even when they really mean that a person is obese.

I recall once when I was educating a patient about the fact that her CT scan showed that she had fat in her liver and this put her at a higher risk of diabetes. She later reported me that I said she was fat!

My assertion is that if we continue to tiptoe around this issue and not address obesity for what it is we will never be able to take control of the rising obesity or type 2 diabetes and borderline diabetes epidemic. Our patients look to us to tell them the truth. Being told the truth does not have to be offensive, but it may require an uncomfortable conversation that more healthcare professionals need to get comfortable having.

The similar statistics between obesity and type 2 diabetes

If you look closely at the statistics that I started this article with you will notice that they are similar over 100 million of adult Americans are either obese or overweight. Over 100 million adult Americans have either type 2 or borderline diabetes

Body Mass Index- BMI

The body mass index (BMI) is used to define normal weight, underweight, overweight and obese conditions. For the most part, BMI correlates with the amount of fat a person has. So a higher BMI correlates with a higher risk for obesity. There are some exceptions to using the BMI exclusively. For instance a person who is muscular may have a high BMI but they are not obese.

The BMI is calculated by dividing the weight in kilograms by the height. There are many BMI calculators online. All you need to know is your height and your weight (in kilograms) and then you can plug those numbers in. For an example of a BMI calculator, click here.

Categories of BMI:

Underweight -BMI less than 18.5

Normal weight- BMI 18.5- 24.9

Overweight- BMI 25-29.9

Obesity class I 30-34.9

Obesity class II 35- 39.9

Obesity class III greater than 40

Over two-thirds of the adult population in America is either overweight or obese. Currently there are over 29 million Americans living with type 2 diabetes. There are an additional 86 million are living with borderline diabetes. The common denominator for both of these conditions is the rising obesity epidemic.

Consider this, if you have been diagnosed with borderline diabetes and commit to losing just 10% of your body weight, you can reduce your chance of developing type 2 diabetes.

The goal is to maintain a healthy and normal BMI of between 18.5 and 24.9

For people who are overweight or obese I usually get a lot of rebuttal telling me they have not had BMI in that range since they were in high school or middle school.

That’s OK. Just as it took some time to gain weight, it will also take some time to lose weight. So let’s start with that statement. You are OK.  Accept that you are overweight or obese. This statement should not be seen as  someone making a derogatory statement about you. It simply means that if you want to live a long and healthy life there is work to do. You are not alone in this obesity epidemic.  There are close to 200 million people in the United States alone. Start by developing a support system. Work closely with your healthcare professional.

Changing old habits is never easy. There are several stages to change. One thing you can start today is to start taking simple small steps every day. Taking simple small steps helps to reduce the sense of overwhelm that making big changes can cause. And because the changes seem so small in the beginning you are more likely to stick with them.

Here’s an example of a simple small step you can take on. Purchase a fitness tracker. What is the common step goal everyone says when you start counting steps? 10,000 steps! Look at that number, doesn’t ten thousand sound like a whole lot to start with? Consider this. Set a goal to walk 1000 steps on your first day. And then when you reach that goal (or exceed it) slowly increase your daily goal. Eventually you’ll reach your goal without feeling overwhelmed and along the way you’ll discover ways to increase the amount of steps you take every day.

It all starts with what I call the ABCs – Acceptance, Belief and Commitment.

For more information about the ABCs and how you can use these to start making changes in your life, you can download a free copy of the first three chapters of my upcoming book, ‘Dr Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes’ by clicking here.

To your health and wellbeing,

 

Today’s Health Awareness Topic – Women and Heart Disease

 

heart healthFebruary is heart health month. I am committed to helping women, especially women living with chronic illnesses such as diabetes, learn all they can to enhance their health and wellbeing.

But I have found that a lot of women do not know the facts when it comes to heart disease. Only 54% of women know that heart disease kills more women than breast or lung cancer.
According to the most recent statistics by the Centers for Disease Control, heart disease is the leading cause of death in the United States in women over the age of 35 years.

Although the rate of death from heart disease for men has dropped in the last thirty years, they have not done so for women. In 2013, heart disease was responsible for killing close to 290,000 women. This translates to 1 in every 4 women dying due to heart disease.

There used to be a time when there was a general belief in the medical community that women under the age of 50 could not suffer a heart attack. So you can imagine what happened if you were a woman and you went to see your doctor with a complaint of chest pain. Your doctor would usually reassure you that it was not your heart and perhaps you had indigestion or were under a lot of stress and prescribe something for that.

As a woman it is extremely important to arm yourself with facts about your heart health.

Some other heart health facts that you need to be aware of:

  • Heart disease will kill six times more women this year than breast cancer.
  • 71% of women do not experience the early signs of a heart attack as chest pain as do men. They may experience a sudden onset of weakness. Almost 2/3rds of women who die suddenly of heart disease did not have any symptoms.
  • Women who smoke are twice as likely to have a heart attack as men who smoke. The risk of a heart attack is 19 years earlier than women who do not smoke. So think about it, if you are a woman and you have been smoking since you were in your teens (which by my experience is the time that most people start a bad habit like smoking ☺), then your risk of having a heart attack begins to rise toward your forties.
  • Type 2 Diabetes increases a woman’s risk of developing heart disease. Women living with diabetes who have had a heart attack have double the risk of having a repeat heart attack in their lifetime or developing heart failure.
  • Women with metabolic syndrome have an increased risk of developing heart disease, especially at a younger age.
  • Women under the age of 50 have twice the risk of dying from a heart attack as men in the same age range. This is all the more reason to be persistent when something does not seem right. I have often shared that as women we have an inner knowingness about ourselves and/or situations. This is called intuition and you can learn to use it to guide you in all aspects of your life.
  • Marital stress worsens the outcome of a heart attack.

What happens to you when you have a heart attack?

When you develop a heart attack, the blood supply to an area of the heart muscle gets blocked off. Sometimes the blockage may not be a complete blockage and blood can still get by to the heart muscle. This is called ischemia or angina. The classic symptoms of angina are chest pain, chest discomfort, and chest heaviness. Sometimes the pain or discomfort may go down the left arm or into the jaw.

As women we may have what is called ‘atypical symptoms’ like unusual weakness, heartburn, dizziness, etc.

But remember just as I pointed out, some women may not have the classic presentation of a heart attack or angina.

The good news is that if the blood supply is restored at this point, then no permanent damage occurs to the heart muscle.

When the blood vessel to a particular are of the heart remains blocked for a period of time, eventually the heart muscle begins to die off. Sometimes the damage cannot be reversed and the heart muscle dies and it is replaced by scar tissue. Scar tissue reduces the functioning of the heart and eventually causes heart failure and death.

It is important to get to an emergency room as soon as possible if you develop any symptoms suspicious for a heart attack. This is because the sooner you get intervention by a heart specialist to open up the blocked vessels the less the risk of permanent damage to your heart.

What you can start doing today:

  • Become knowledgeable about your risk for heart disease. Even if you do not have a family history of heart disease you can still be at risk!
  • If you smoke then quit. No more excuses! It’s still early in the year and you know you can do it.
    If you are obese or even over 10% of your ideal body weight, then commit to losing weight.
  • Schedule your annual physical and know your numbers! These numbers include- your blood pressure, fasting lipid profile (cholesterol), and blood sugar. If any of these numbers are outside of normal range then take action and work on getting them back to normal.
  • If you have high blood pressure or borderline diabetes or type 2 diabetes, then make sure that you are being treated by the appropriate healthcare professional. Do not ignore this part of your care. Denial only worsens things in the long run.
  • Find ways to cope with stress in your life. Stress is so prevalent that we as humans do not believe they can live a stress free life. It is our perception of stress that matters and what we do to modulate its effects.

Now more than ever we as women need to become more pro-active in our overall health and wellbeing. We need to stop making excuses for poor lifestyle choices. More importantly we need to accept that these lifestyle choices not only shorten our lives, but also the quality of the life that we have left. I’m not sure about you but I want to be health and vibrant into my 90s and beyond!

My mission in creating this blog is to provide a whole person approach to living with type 2 diabetes and other chronic illnesses.

Along those lines, over the next few months, in addition to the release of my updated book, Dr. Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes’, I will  be rolling out several programs. I look forward to working closely with those who are willing to invest the time and effort to enhance their health and wellbeing.

 

 

Today’s Health Awareness Topic: The relationship between your emotions and diabetes symptoms

 

 

 

 

People living with diabetes  may experience a wide range of emotions on a day-to-day basis. These emotions may range from initial anger, resentment, disbelief, and even denial. At times these emotions can be very intense. Sometimes these negative emotions are inappropriately directed at the healthcare provider who gave the bad news of the diagnosis.

Being diagnosed and living with type 2 diabetes does not have to be a stressful experience. Consider that contrary to popular opinion, being ‘stressed out’ does not have to be part of living with any chronic illness including type 2 diabetes.

It is predictable that over time, your emotions will wax and wane. Some days you may feel more upbeat than other days. Rest assured that you are OK. One of the first things that I do with my patients and clients is to work on getting those emotions out in the open so that we can deal with them at the outset.

You have the power to choose how your emotions impact your overall health and well being.

This is especially important if these emotions are not empowering. We all have the power to choose how our emotions impact us. I know this may sound so cliché. But really and truly this is one of the times that you get to choose and that choice directly impacts your blood sugar control. Living with diabetes is a prime example where having the power of choice impacts your overall health and blood sugar levels.

If you are constantly stressed out and angry then it’s predictable that it may be more challenging to get your blood sugars within normal range.

Stress causes the release of hormones in the body. The stress hormones are called adrenaline, noradrenaline and cortisol. These hormones help to prepare the body for ‘fight or flight’. One way that they prepare us for ‘fight or flight’ is by increasing the production of glucose from the liver stores. This is a normal stress response.

However, when you have diabetes, the last thing that you need is more sugar in your blood stream. Your body is already not able to handle the glucose that it has already!

Research has been performed on the effects of a positive mood on our overall health and well-being. On a chemical level, being happy helps to reduce stress hormones. It enhances the release of endorphins and natural serotonin both of which enhances our emotional state and enhances our well-being. If you have a positive and optimistic mindset, then you will feel more empowered in finding ways to better control your blood sugars.

The first step to living an empowered life with diabetes is to get those emotions out in the open. The next step is to deal with these emotions.

It can be challenging for healthcare providers to be able to address all the emotional concerns of our patients  living with a chronic illness. There is no  doubt the 15-minute ‘double-booked’ appointment slot may not help us to connect with our patients and understand how they are actually experiencing their disease but this discussion is important. Be certain to speak to your healthcare provider if you are feeling stressed out or overwhelmed.

Over time some people living with diabetes may begin to experience what is known as diabetes distress.  Diabetes distress is not true depression. Some patients may need the support of talk therapy. It may be helpful to work with a health coach or a psychologist.

As a professional life coach and a physician my stand is for patients and clients living with type 2 diabetes or any chronic illness to experience a vibrant wholesome life.

It is what motivated me create this platform as a way to empower women living with diabetes.

By empowering women, we empower our communities and eventually the planet.

One of the most important things to do is to deal with your mindset and your perception of living with diabetes.

In the first three chapters of the soon to be released updated version of my  book, ‘Dr. Eno’s A-Z  Guide to Living Powerfully with Diabetes’ I write about what I can best describe as the ‘ABCs of a positive mindset’.

They are:

  • A-Acceptance
  • B-Belief
  • C- Commitment to change

Yes you have the power to choose whichever way it goes. Remain committed to how your health and well-being even on days that you may not feel your best.

To take a FREE peek of the first three chapters my upcoming book, click here.

To your Health & Well-being,

How fiber can help reach healthy blood sugar levels in type 2 diabetes

type 2 diabetesA friend of mine was recently sharing me how frustrated her husband was with his blood sugar levels. They seemed to fluctuate widely from high blood sugar levels to low blood sugar levels. He did not know how to react to this and had decided that he was not going to take his medications any longer. Naturally she was at her wits end when she reached out to me. How could she convince her husband that stopping his medications was not the way to deal with fluctuating blood sugars?

Fluctuating blood sugars are not unusual in type 2 diabetes. Whether you are a woman living with diabetes or you know someone living with diabetes, this can be very frustrating .

Let me start by normalizing this for you. You are not alone. There are many reasons why the blood sugars fluctuate. I will cover this topic in more detail in an upcoming article.  In addition to scheduling an appointment to see your healthcare provider, you may also need to make sensible lifestyle changes- to your diet and exercise regimen.

One of the ways things to tweak in diet to increase the amount of fiber. Fiber is a form of carbohydrate. Contrary to popular belief, not all carbohydrates are bad for you!

There are two kinds of fiber-soluble fiber and insoluble fiber. Insoluble fiber does not get absorbed from the intestinal tract. This kind of fiber helps to reduce constipation. Soluble fiber has many proven benefits. Soluble fiber gets absorbed into the bloodstream and so can help regulate blood sugars. It also helps to control cholesterol levels.

Soluble fiber can help to reduce the risk of stroke and heart disease by up to 50%. This is especially important for someone living with type 2 diabetes, where the risk of stroke and heart attacks is increased.

Another benefit of soluble fiber is that it help reduce hunger by maintaining a sense of fullness. This can be useful in weight management. When you feel full you tend to eat less. 

Research has proven that simply losing 10% of your body weight helps to prevent borderline diabetes from becoming full blown type 2 diabetes. Some examples of soluble fiber include psyllium, pectin and wheat dextrin and oat products.

So exactly how much fiber is enough?

 Women should eat about 25 g of fiber and men up to 38 g of fiber a day. With the ‘standard American diet’ we consume an average of 17 g fiber per day.   A study in the New England Journal of Medicine found that by increasing daily fiber up to 50 g, a person living with diabetes was able to achieve healthier blood sugar and cholesterol control.

Some ways that you can start to increase your fiber intake? 

 I usually recommend gradually increasing fiber in your diet. Remember this is a long-term change you are making to your lifestyle.  If you rapidly increase fiber, it may cause gas and abdominal bloating. Too much fiber could also cause constipation if you do not drink enough water.

 So here are some suggestions on ways to increase your fiber intake: 

  1. Create a list of fiber rich foods.  You can do research this online. Click on this link to research a variety of food sources that have high fiber content.
  2. Try experimenting with some new sources of fiber every day.
  3. Gradually increase your fiber intake by 5 g per day until you reach the goal.
  4. As you increase fiber intake also make sure to increase your water intake to reduce bloating and constipation.

Remember to be kind and patient with yourself. There is no quick fix to diabetes. Your goal is to achieve healthy blood sugars so that you reduce the complications associated with diabetes. Increasing the amount of fiber in your diet can be one of your most powerful tools in achieving healthy blood sugars. So start today to take simple small steps each and every day and don’t give up.

To your health and wellbeing,

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Seven Tips On How to Maintain Healthy Blood Sugars During The Holiday Season

holiday-feast

I recall a number of years ago, when a patient left my office based practice and sent me a very nasty note three months later. She expressed how disappointed she was that I was not a person of my word. I had assured her that due to the fact that her blood sugars were well controlled and her A1C was less than 7% that I would attempt to wean her off some, if not all her medications.

The catch was that at the time that this discussion was going on, the holiday season was also upon us. I had made a mental note to address this in the New Year, as I hate to see anyone fail due to no fault of his or her own.
I should have educated my patient on what it was that I intended to accomplish and my reasoning.

For people living with type 2 diabetes, this is one of the more challenging times of the year. Blood sugar levels may gradually begin to rise with each holiday party. And with that, the A1C rises.

By following these seven simple steps, you can survive the holiday season and come out a winner ready to embrace 2017 as you live powerfully!

Tip number 1- Plan your meals

In order to keep blood sugars within a normal range, planning your meals is very important at this time of the year.

Here’s a simple tip-If you know that you are going to be out at a holiday party later on in the day, consider having a light snack just before leaving home. That way you are less hungry and less likely to go for the sweets that will cause your sugars to rise.

Also consider cutting down on the portion sizes of your earlier meals. Be careful if you are on insulin or an oral hypoglycemic agent not to cut down too low so that you do not experience hypoglycemia.

Tip number 2- Increase your amount of fiber intake

Fiber is a complex carbohydrate. The average American diet contains a low level of fiber. Most nutritionists recommend a daily fiber intake of up to 35G.

Studies have shown that by increasing the amount of fiber in the diet can help control blood glucose levels. This is especially if it is soluble fiber. An example of soluble fiber is oatmeal.

Fruits and vegetables are all good sources of fiber. By making a conscious choice to increase the amount of fiber rich foods in your diet will get you to your goal of maintaining a normal blood sugar range throughout the holiday season and beyond.

Tip number three- Plan to incorporate physical activity

The Winter & Holiday season is traditionally the time when the average American gains between 7-10 lbs. Studies have shown that people living with type 2 diabetes can achieve normal blood sugar range by increasing physical activity. During the winter months make an effort to maintain some form of physical activity. Choose an exercise regimen that is easy to follow.  As always be sure to see your physician before starting out on an exercise program. So if you have not already scheduled your annual physical, now is a great time to go ahead and do so.

Tip number four- Drink enough water

There are a myriad of benefits to drinking water. The important thing in a type 2 diabetic is to maintain good kidney function. Drinking water may also keeps you feeling full and so help with weight loss. The traditional recommendation has always been 8 glasses of water a day. However something else to consider is drinking half of your body weight in ounces. So if you weigh 170 lbs. that equals 85 ounces of water a day.

Tip number five- be consistent with monitoring your blood sugars

This is not the time of the year to slack off testing your blood sugar levels.  It is not the time to stick your head in the sand and rationalize that your blood sugar levels are going to be high and there’s nothing you can  do about it anyway. Your mindset is very important. If you have not been checking your blood sugar levels regularly, this is the time to start. By regularly checking your blood sugar levels,  you get instant feedback. Living powerfully with diabetes, requires that you have an awareness attached to action. High blood sugar levels just do not happen to you. You can make the necessary adjustments in your lifestyle in order to control your blood sugars.

Tip number six- Keep all scheduled appointments with your healthcare providers

This is the time to make your healthcare provider aware of any challenges that you may be encountering during the holiday season. That way you both can explore ways to better control your blood sugar levels.

Depending on your A1C, your healthcare provider may decide to adjust your medications. This is a much better option than starting out the New Year with high A1c levels and blood sugar levels out of control. Sometimes it can take more than 6 months to normalize the blood sugars.

Tip number seven- Enlist the support of family and friends

I have written in a previous article about the importance of a support network. Now more than ever is the time of the year to enlist the support of family and friends. Want to get started in an exercise program? Call up a workout buddy. Not sure how to handle ‘Aunt Martha’s’ three layer chocolate cake? Have a family member share a portion with you. It takes teamwork to make the dream work. Do not be afraid to ask for support. Sometimes just knowing there is someone else looking out for you is what makes the world of difference.

I’d love to read your comments and any other strategies that you may have in place to ensure that you keep your diabetes type 2 sugar levels normal this holiday season and beyond.

Until next week,

Here’s to your Health & Wellbeing,

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Blood Glucose Monitoring-Some Strategies to Check Blood Sugar Levels Once a Day

blood glucose monitoringWelcome back! Over the last few weeks I shared some of the lows and highs of living with type 2 diabetes. Namely hypoglycemia and hyperglycemia.

According to American Diabetes Association guidelines, normal fasting blood sugar levels range between 80-130 mg/dL. Blood sugars should also be checked after eating. This is called postprandial blood sugars. The best time to check postprandial blood sugars is  two hours after a meal. Normal postprandial blood sugar levels should be below 180 mg/dL. In order to reduce diabetes complications, it is important to try and keep blood sugars within this range.

Sometimes it may be necessary to check blood sugars several times a day in order to make the necessary adjustments to get blood sugars in the healthy range. This is usually where I would encounter a lot of resistance from my patients. They complain that testing their blood sugars several times a day is painful. Test strips cost a lot of money. Or it may be that because of their work schedule they just don’t have the time.

I found that the more I argued with my patients about monitoring their blood sugars more than once a day, the more resistant some patients became. In fact some even stopped coming in as scheduled. They would stretch out their appointments. For instance, instead of coming in every three months, they made it twice a year.

Now that can be harmful as it is a surefire way to develop complications related to diabetes!

So I had to get creative with that segment of my patients that just were not going to check their blood sugars consistently.

Well here are some strategies that I came up with. For the most part they ended up being about compromise, which I think is something that is very important if you are committed to living powerfully.

Strategy number 1-alternate checking fasting blood sugar levels with post prandial blood sugar levels

This is by far my favorite strategy. This is how it works:

On a calendar, divide the month into odd numbered and even numbered days.

On odd numbered days of the month, check your fasting blood sugar levels.

On even numbered days, check your postprandial sugar levels.  Try to vary the times that you check your postprandial levels. For instance on one day check the levels after breakfast, the next time after lunch. At another time after dinner.

This is a great way to get a general view of how your sugars run during different times of the day and not test more than once a day.

Remember to make a note of the times that you check your sugars so that your doctor can understand the trend. Some blood glucose monitors allow labeling the blood sugars also. Check your glucose monitor to see whether you can do this.

Strategy number 2- check postprandial sugars over the weekend

Here is when I would recommend this strategy:

If a patient cannot check their postprandial levels during the week due to their work schedule, then I encourage them to check the fasting levels during the week and then over the weekend, just to focus on checking their postprandial levels.

They can do this by alternating postprandial levels between breakfast, lunch and dinner over the weekend

Strategy number 3- check your blood sugars for two weeks before you see your healthcare provider

I only bring out this strategy when I am pushed to the wall. Literally I am begging a patient to work with me so that I can help them reach their blood sugar goals.

There is nothing more frustrating than not having an idea about how the blood sugars of a patient are running in between scheduled office visits. It is like shooting in the dark. You get a blood test result that is high, but you have no idea how to go about correcting it.

As I tell my type 2 diabetes patients, on average they get to see their healthcare provider between three to four times per year for routine diabetes care. What happens the remaining 361 days is left in their hands.

With blood sugars taken consistently for even two weeks before an office visit, when combined with the hemoglobin A1C most times it is much easier to spot the problem.

Why is it important to check both the fasting and postprandial blood sugar levels?

In an earlier article I shared some important numbers that a person living with diabetes needs to know. One of those numbers is the A1C also known as the glycosylated hemoglobin. The target range for the A1c is less than 6.5- 7%.  In order to achieve that goal, the fasting blood sugars are within the target range of 70-130 mg/dL. The postprandial levels also have to be consistently less than 140 mg/dL two hours after a meal.

If your A1C is high, then by keeping a log of the blood sugars, you will be able to pinpoint the problem.

For instance if the fasting blood sugar levels are within normal range, but the post prandial levels are high, then perhaps you need to adjust portion sizes.

If the fasting levels are running high, it may be that the evening medications need to be adjusted or that a late night snack needs to be cut out. Sometimes this may even mean that the nighttime medications may need to be cut down. But your physician needs to see your glucose log so that they can target the problem and create a customized plan for you.

Start today to check your blood sugars

Perhaps you are a newly diagnosed diabetic or even if you have had diabetes for some time but just never thought it important to check your blood sugars. Let’s start out fresh.

Review the instructions of your glucometer. If you do not understand how to use it then check to see whether your local pharmacist can help you. If not call your doctor’s office and schedule a visit with the nurse. Most times they can help you. Most times the machines work the same way. A few have extra ‘bells and whistles’ attached to them.

Just as I share in my upcoming book, “Dr Eno’s A-Z Guide to Living Powerfully with Type 2 diabetes”,  two of the hallmarks of living a powerful life with diabetes is being committed and persistent. If you do that you will go a long way to living free of diabetes complications.

I welcome your comments or questions so please leave them here. I’d also love to hear some of the issues that you have as a type 2 diabetic. Come over to my Facebook page and share some of your thoughts with me. It just may be a topic for an upcoming article.

Until next week Here’s to your Health and Wellbeing,

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The Importance of Your Oral Health – Type 2 Diabetes Can Hurt the Teeth and Gums

canstockphoto33393786It is important for people living with type 2 diabetes to pay attention to all aspects of their health and wellbeing. Your oral health is a very important aspect of your overall health and wellbeing.

Recent studies have shown an increased risk between poor oral health and heart disease.

The risk for heart disease increases even more when you have 2 diabetes and poor oral health.

This is because diabetes already puts you at twice the risk of heart disease than the general population. So when you add poor oral health to the mix you could more than double your risk.

The mouth contains thousands of different bacteria, fungi and viruses. Normally with proper oral hygiene and well functioning salivary glands, these do not cause any problems.

However when the mouth becomes unhealthy then a number of dental problems can set in.

The most common teeth and gum problems associated with type 2 diabetes are:

  • Tooth decay
  • gum disease
  • altered taste
  • fungal infections commonly oral thrush
  • dry mouth
  • infections

Poorly controlled Diabetes can lead to tooth decay and gum disease

When blood sugars are high, this is called hyperglycemia. Hyperglycemia can cause bacteria and fungi to thrive in the saliva. This leads to the development of plaque.

Plaque is a hard material that builds up in the mouth. It attaches to the surface and in between the teeth. It can also collect beneath the gum line. When this happens, the gums become inflamed. This is called periodontal disease.

High blood sugars can put you at a higher risk for periodontal disease. Eventually, the gum disease becomes so bad that they lose their teeth.

Here are some signs of periodontal disease. If you have any of these signs then see a dentist as soon as possible

  • gums that bleed easily
  • red swollen and painful gums
  • bad breath
  • bad taste
  • pus in between teeth or when the gums are pressed
  • gums that have been pulled away from the teeth

Diabetes can also fungal infections

Oral thrush is a fungal infection that can occur in people with diabetes type 2.

There are several reasons why you can get fungal infections in the mouth:

  • Wearing dentures
  • Cigarette smoking
  • Hyperglycemia
  • Antibiotics
  • Dry mouth

How to reduce dental problems

  • Brush your teeth twice a day with a soft toothbrush. You can also use a electric toothbrush.
  • Floss between your teeth at least once a day
  • Change your toothbrush at least every 3 months
  • Use an antimicrobial mouthwash
  • Use a toohpaste that contains floride
  • Watch for any signs of dental problems and inform your dentist
  • Quit smoking
  • Drink water regularly to keep the mouth moist

See your dentist regularly

  • Schedule an appointment twice a year to see your dentist.
  • If you have any sores or pain in your mouth be sure to let your dentist know.
  • Let your dentist know if your blood sugars are high.
  • Inform your dentist if there is any change in your medical history.
  • Do not take any oral medications that could lower your blood sugar before seeing the dentist.
  • If you are going to have dental work done and you are taking a blood thinner, be sure to let your dentist know this. The dentist may want to get a medical clearance from your primary healthcare provider if planning a dental procedure such as a root canal or deep scaling to remove plaque.

Take the time to make sure that you pay attention to health of your mouth.  That way you will not go through the pain from lost teeth.

Let’s face it dental care to replace lost teeth can be very costly. So why not invest in prevention rather than a cure?

I’d love to read your comments. Do you have any questions or suggestions for an upcoming article? Then let’s chat on my facebook page so that I can meet you.

Here’s to your health and wellbeing,

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Healthy Tip:

If you have a cold or cough, be sure to change your toothbrush. That way you will not reinfect yourself.

Also be sure to increase your intake of Vitamin C this winter season, it will help accelerate healing from colds and flu like symptoms.

The relationship between obesity and increase in type 2 diabetes in teens

Type 2 DiabetesThe number of teenagers being diagnosed with type 2 diabetes is rising.  About 3,700 teens are diagnosed with type 2 diabetes every year. There was a time when only older people got type 2 diabetes. This used to be called ‘maturity onset diabetes’.

However, with changes in our lifestyle, including the rising obesity epidemic, type 2 diabetes is now being diagnosed at much younger ages.

Here are some of the reasons for the increase in type 2 diabetes in our teenage children

  • Decreased levels of physical activity
    Let’s face it, unless a teenager is actively involved in sports, they are less likely to be physically active. These days teenagers live in a more technology-oriented world, social media, video games etc. that tends to lead to a more sedentary lifestyle. Teens should be encouraged to increase physical activity into their lives.
  • Increased access to fast foods
    With the fast paced lives that we live in the 21st century it is not unusual for a teenager to eat more fast foods. Fast foods are not very nutritious and so could contribute to increase body weight.
  • Distorted body image
    Some ethnicities, such as African Americans, Native Americans and Latinos may buy into the thought that ‘thick is it’, or that they are just a little ‘overweight’. This distortion of self-image contributes to a rise in obesity and also an increase in type 2 diabetes.
  • Genetic Tendencies
    If the parents of a teenager are obese, the chance of their children being obese is high. Obesity is related to behavior patterns. If both parents are obese, then the chances of an obese child are 66%. The risk is 50% if one parent is obese.
  • Lack of nutrition awareness
    A lot of people do not know a lot about what makes a healthy plate. We need to become more aware of the choices we make when it comes to what we eat.
  • Lack of recreational space and food islands in inner cities
    The lack of easy access to supermarkets that stock fresh produce in inner cities is an ongoing problem. This needs to be addressed by our policy makers if we are truly serious about making a dent in diseases caused by lifestyle choices such as type 2 diabetes. In addition, there is also shortage of adequate recreational space in inner city neighborhoods. This combined with the fear of violence associated with the inner city are also factors that contribute to the rise in obesity.

Here are some simple small steps that we can take to reduce teenage diabetes

  • Become a more active as a family and a community
    GET MOVING and encourage your teen to get moving also! There is no short cut to increasing the level of daily physical activity. Keep it simple. Get a fitness tracker such as a fitbit® for family members. Form a team. Have each family member make it a goal to increase the number of steps they walk to 10,000 steps every day. Use social media such as twitter or Facebook to gain support from friends. More importantly make it FUN! Set up healthy competition with siblings. Even involve the dog ☺.
  • Pay attention to nutrition labels
    Thanks to recent revisions by the US Dept. of Agriculture, food labels are becoming a lot easier to decipher. Make it a habit to read food labels and learn about the ingredients in your food. I use a rule of thumb that is pretty straightforward- if the label reads like something from my medical school biochemistry class then perhaps it’s not as healthy as it looks. ☺
  • Create a culture of wellness
    As women, we have traditionally been the custodians of the health of our households. I believe that knowledge is the first step to personal empowerment. By becoming empowered, we can make decisions that will impact not only our personal health, but also that of our families. We need to get the right information. Information that is easy to understand. Without access to the right kind of information, people cannot make good lifestyle choices. That is the mission of this website, to provide information in an easy to understand format so that we can all collectively get into action to stave off this epidemic of diabetes and obesity.

We need to arm ourselves with this knowledge so that we can transmit this information in the healthy lifestyle choices that we make for our children.

We need to rid ourselves of the belief that just because we may have a family history of obesity, diabetes or some other chronic illness, that this is the norm and to be expected and we cannot do anything about it for our children or ourselves.

Collectively as women, mothers, aunts and matriarchs- we need to take personal responsibility for creating a culture of wellness in our families, communities and the world at large.

The time to act is NOW!

To your Health and Wellbeing,

511952242dd5056a22054e09-2

Is There a Link Between Type 2 Diabetes and Hypertension?

Type 2 DiabetesSo you are living with type 2 diabetes. You are doing everything your healthcare provider has recommended. You are maintaining a healthy lifestyle with diet and exercise. You are checking your blood sugars and they are within target range. Your A1C is less than 7%.

You are scheduled to see your healthcare provider for your routine visit. You’re feeling good.

“Everything looks good, it’s just that your blood pressure has been rising over the last few months”, you’re healthcare provider reports, “We are going to have to start you on blood pressure medications”

You’re bewildered. How can this be? Everything seemed to be going well. How come you’ve just been diagnosed with hypertension?

Is there a link between Type 2 Diabetes and hypertension?

YES there is a link and it is called metabolic syndrome.

Metabolic syndrome is a group of characteristics. It is not a medical illness per se. These characteristics put you at an increased risk for developing certain diseases.

These diseases include diabetes type 2, hypertension and heart disease. Metabolic syndrome is also called syndrome X and also insulin resistance syndrome.

Most clinical experts define metabolic syndrome as having three or more of any of the following:

  • If your waist measurement is more than 35 inches in women and 40 inches in men.
  • A fasting blood sugar level more than 100-125 mg/dl
  • High blood pressure of more than 130/85 mm hg. Or if you have already been diagnosed with hypertension (high blood pressure).
  • High triglyceride level of more than 150 mg/dl
  • A low HDL level of less than 40 mg/dl.

How common is metabolic syndrome?

More than 2/3rd of the adult American population is either overweight or obese.  The number of people with metabolic syndrome has risen just as the obesity epidemic in this country. Currently that rate is at 34% of the adult population.

The following factors put you at risk for developing metabolic syndrome:

  • Being overweight. In other words a BMI of more than 25. Click here for the BMI calculator
  • Smoking
  • Eating a diet that is high in carbohydrates
  • Smoking
  • Lack of exercise
  • Menopause
  • Family history of diabetes or metabolic syndrome.
  • Increasing age.

What health risks are associated with metabolic syndrome

  • People with metabolic syndrome are more likely to develop diabetes type 2
  • They are also at risk for developing heart disease.

How is metabolic syndrome diagnosed?

Schedule an annual physical exam with your healthcare provider. Check your weight and calculate your BMI using the BMI calculator.

Remember to get your waist measurement taken.

Have your healthcare provider do blood tests to check your fasting lipid profile and blood sugar.

For more information about knowing your numbers click here

It is always a good idea to schedule an appointment for your annual physical first thing in the morning. That way, you can go in fasting- without having eaten anything.

Please do not to take your medications if you do not eat. This will reduce your risk for hypoglycemia. 

How to treat Metabolic Syndrome:

The primary goal is weight loss. Become more physically active and eat a healthy diet.

This will help to reduce your cholesterol and also keep your blood sugars in target range.

If you smoke, make a commitment to quit smoking.

High blood pressure is when your blood pressure is more than 140/90 mmhg. It is diagnosed after your healthcare provider has obtained more than 3 readings of an elevated blood pressure.

When diet and exercise fail to bring the blood pressure down to normal range, then your healthcare provider may decide to start you on medications.

The common link between high blood pressure and diabetes is metabolic syndrome. It is because of this link that a lot of people with diabetes type 2 may end up being diagnosed with high blood pressure.

The goal is to control or reduce your risk for metabolic syndrome. That way you reduce your risk of complications of diabetes.

As always, I welcome your comments, feedback and any suggestions you have for upcoming topics.

To your health and wellbeing,

511952242dd5056a22054e09-2

Why Women living with type 2 diabetes need to build a support system?

Type 2 diabetes

If you are a woman living with type 2 diabetes or caring for someone living with diabetes, you may notice that this can be a very stressful experience. Your life as you knew it seemed to change the instant you were diagnosed. And just like any other chronic illness, there is a lot to be learned.

It may seem that there is no clear place to turn for help on learning about how to live with a chronic illness. Your healthcare providers may have very little time in their double-booked schedules to provide additional information on how to live with diabetes. Diabetes education classes are are a great resource to  have a structured curriculum. So these classes may or may not cover your own unique concerns. And then of course the Internet is filled with information overload!

Building a support network is an indispensable tool

If you are living with diabetes or any other chronic illness, do not try going it alone. As women we usually try to put on a brave face and try to do it alone. We may feel afraid to ask for support, because we have a mindset that tells us we don’t want to be a bother to anybody.

We are so used to being caregivers, that may of us have forgotten how to receive care from others. 

However, a surefire way to end up stressed out and depressed is to stay with this mindset.

Living with a chronic illness can be stressful. This is why it is important to build a network of people who are there to support you.

There are many ways to build a good support network. The bottom line is you want like-minded people whose sole purpose is to support you, energize you and to raise your spirits up. Period.

The types of support

There are several types of supporters to consider. Try not to lean on just one person for support. Just like different voices in a choir, there may be many types of support that you need. Also depending on the season in your life, the types of support will also change.

Combined they should contribute a high sense of value to your life as a person living with diabetes. If you have people who are attempting to do any other than supporting you such as – convince you that you do not need to be on medication, or that your healthcare provider does not know what they are doing, or recommending some ‘off the cuff’ regimen that they saw on a late night TV infomercial- they are not the kinds of people that you need in your support network.

Below is a list of some of the types of supporters that I recommend that you have:

Emotional supporters- I call these your ‘personal cheerleading squad’. Granted they may not have the faintest idea of what your target blood sugars need to be, but one thing they are good at doing is seeing the glass half full, not half empty. And so emotional supporters are the people that you call on when you are not feeling very optimistic. When you’re doing your best to get your blood sugars under control and it just does not seem to be working well this week.

Your emotional supporters have a great sense of humor and so they help to brighten up your mood. You may even have your emotional supporters willing to go with you on visits to your healthcare providers.

Spiritual Supporters- No matter your religious inclination (or lack thereof), we all have an inkling that that there is much bigger picture than our mere individual existence. And we do not always have the answers why things happen the way they do. Your spiritual supporters are the people who keep you in tune with that bigger picture. Spiritual supporters come in different forms. Spiritual supporters may include your clergy, to a favorite spiritual verse, a special spiritual text or even a spiritual mentor.

Social supporters- this is your social support network. They could be an online social support network of other people living with type 2 diabetes.  Or live groups that meet online or offline. Either way, social support networks are a great resource which could help it’s members navigate online as well as offline resources, host meetings or online chats on different topics, be a source of referrals etc. When social support networks are well run, members not only support each other, but they also learn from one another.

Healthcare support

Finally, there is the kind support that you can get from your healthcare provider. Usually this may be healthcare based information designed to highlight different aspects of living with diabetes.  This kind of support may take the form of exit questions that your healthcare provider’s assistant may ask you at the end of an office visit, or a nurse calling you in between visits. Or even lifestyle coaching! When used well healthcare support provides you with a roadmap that helps you to keep your target goals in full view. By keeping your target goals in view, you are well on your way to living powerfully with diabetes.

To your Health and Wellbeing,

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What do you think? Are you getting enough support right now in living with diabetes? Have you been diagnosed with borderline diabetes but don’t have enough information?  Do you think online support works?