Type 2 Diabetes For Dummies,

Chapter 1

Dealing with Type 2 Diabetes

In This Chapter

Developing techniques to live with diabetes

Getting used to the idea of having diabetes

Looking at why your mental health is important

Maintaining a high quality of life after diagnosis

If you’ve picked up this book, chances are you or someone you know has been diagnosed with type 2 diabetes. A diagnosis of any medical condition is simply a way of understanding that condition by putting it in a category that helps to predict what’s likely to happen to you. A diagnosis also allows doctors and health care professionals to make assumptions about your treatment and prognosis. A diagnosis is, where possible, based on evidence.

However, if you have diabetes, you’re more than a diagnosis or a measurement of abnormal blood glucose levels. You have feelings and a history. The way that you respond to the challenges of diabetes helps to determine whether the disease is a moderate annoyance or a source of major sickness.

You’re not alone. Type 2 diabetes is a common disease, and getting more common. Diabetes shouldn’t stop you from doing what you want to do with your life. We encourage you to follow the guidelines of good diabetes care, which we describe in Part III. If you follow the guidelines, you can often be just as healthy as the person without diabetes.

Also, your diabetes doesn’t affect just one person. Your family, friends and colleagues are affected by how you deal with your diabetes and by their desire to help you. In this chapter, we introduce you to what it means to be diagnosed with type 2 diabetes, the kinds of feelings you may struggle with after diagnosis and how you can move forward and learn to live with diabetes.

Living with Type 2 Diabetes

Diabetes is a chronic disease that can create short- and long-term complications (see Chapters 4 and 5 for more). Here are some tips for living with type 2 diabetes:

Get to know the doctors, nurses and other health professionals involved in your care. Identify people you feel comfortable with and agree with on what works for you. You want to share a common vision and treatment plan with your doctor and treating team. Ensure you have a general practitioner you can relate to and stick with one rather than choosing to just turn up at a medical centre.

Keep a list of questions. Have a list of questions for your doctor or diabetes care team. Write these down when you think of them and take them with you on your next visit.

Find out if you can talk to people who have managed their diabetes well. Most people know someone with diabetes, but that doesn’t mean they know what’s best for you to do, or anything about your diabetes. Your diabetes care team, the Australian Diabetes Council (in NSW) or Diabetes Australia (in other states and territories) can help you get in touch with people whose circumstances are (or were) similar to yours. You may also know someone within your circle of family, friends or colleagues.

Surround yourself with loving positive support. With luck, you not only accept the diabetes diagnosis yourself, but you also share the news with your family, friends and people close to you. Having diabetes isn’t something to be ashamed of and isn’t something that you should hide from anyone. Identify who’s ‘there for you’ and let those people know you appreciate it. If possible, give them things they can do — people do better when they have a tangible way of supporting you.

Understand how you cope with stressful situations and change, and build healthy coping skills. Diabetes often starts at times of stress — just when you don’t need another thing to be happening. Being diagnosed with the condition presents you with an opportunity to reflect on how you deal with stress and what kind of coping skills you have developed. When it comes to your long-term health — both physical and mental — adopting coping skills that are healthy and help you build and maintain your motivation for making lifestyle changes pays off.

Make sure you have good information. Reading this book is a great start! Your next step is to find out about other reliable sources of information and support. Excellent resources are available and your diabetes care team is available to assist. Throughout the book, we provide details of useful websites for further information about diabetes. Here are some to get you started:

• Australian Diabetes Council: Previously known as Diabetes Australia NSW. Provides information about all aspects of diabetes. www.australiandiabetescouncil.com.au

• Australian Diabetes Educators Association: This is the official website of the organisation representing diabetes educators in Australia. www.adea.com.au

• Baker IDI Heart and Diabetes Institute: This Victorian-based institute is the largest diabetes clinic in Australia. www.bakeridi.edu.au

• Diabetes Australia: Diabetes Australia has branches in all states and territories except NSW. They represent people with diabetes, research organisations, doctors and other health professionals involved with diabetes. www.diabetesaustralia.com.au

Adjusting to the Diagnosis

Getting used to a diagnosis of diabetes can take some adjustment. You may also feel an unjust stigma is attached to type 2 diabetes. You may feel that some people think it’s your fault that you developed diabetes — that it was caused simply by eating too much and not exercising enough.

As well as having to deal with the stigma attached to having type 2 diabetes, you may also have to deal with guilt. Type 2 diabetes may occur, for some, after they feel they have neglected their health. In this case, some people ‘beat themselves up’ after being diagnosed. While this is understandable, like anger, it’s unnecessary and destructive. Think about what you can learn from your diagnosis and what steps you can take to improve your health. See Chapters 8 and 9 for more on improving your health through making changes to your diet and exercise.

A diagnosis of type 2 diabetes may also occur in people who take certain medications (such as prednisone or olanzapine) long term. Again, developing diabetes in this case isn’t your fault and the medications may be something you need to continue. Talk to your doctor and diabetes care team about what medications you should be taking (and should continue to take) to ensure full physical health. See Chapter 7 for more on medications.

Having type 2 diabetes can also affect, or be affected by, other aspects of your life. If you are overweight or unfit, talk to your GP or specialist diabetes dietitian about developing an eating and exercise plan to improve your overall health. Some people can improve the control of their type 2 diabetes by improving their general fitness, while some can’t. Even if you still require medication to manage your diabetes, it’s still worth incorporating more exercise into your daily routine, because improving fitness helps improve your general physical and mental health.

If you have previous mental health problems, talk them over with your GP, psychologist or counsellor. If you’ve had episodes of depression, anxiety, eating disorders, substance abuse (alcohol, sedatives and street drugs), these can recur when you are stressed and affect your diabetes.

Working On Your Mental Health

Mental health is now recognised as a key issue in the management of diabetes. People with diagnosed diabetes are twice as likely to experience depression or anxiety compared with people without diabetes. People newly diagnosed often also have to move through feelings of anger. The following sections look at these common and understandable reactions, as well as offering information on where to go for more help if your feelings of anger and depression become more long lasting.

Dealing with depression

Experts now recognise a two-way relationship exists between diabetes, stress and depression. Stress can precipitate the onset of diabetes, and ongoing diabetes-related distress has a direct effect on blood sugar levels. In turn, the pressure of living with a chronic disease can affect your mental health and capacity to cope with daily life.

Depression can make it more difficult for you to self-manage your diabetes. Depression can decrease concentration and motivation, and affect lifestyle and exercise habits, as well as pain tolerance and overall mood — which in turn affects your diabetes. If depression isn’t treated in people with diabetes, it can affect blood sugar levels and contribute to more diabetes-related complications.

The good news is that this cycle can be reversed. By taking steps to use more helpful ways of coping with diabetes and by treating mental illness, you can improve your mental health, increase your confidence in managing your diabetes and increase your motivation for self-care and making required lifestyle changes, such as adopting healthy eating patterns (see Chapter 8) and increasing physical activity (see Chapter 9). These changes, in turn, can improve your physical health.

Getting through your anger

Anger often keeps you from successfully managing your diabetes — as long...