Humana project: second question!

Humana provides health insurance to nearly 1 million people with type 2 diabetes. In an effort to better understand and support these Humana members, they have partnered with Diabetes Hands Foundation and TuDiabetes to sponsor a 10-day series of discussions about “tips and tricks” for life with diabetes. Information gained through these conversations will help Humana to better serve people with type 2 diabetes, so please join the conversations, and share as much as you can!

Today is the 3rd day of the series, and today's question is:
What were the five most impactful things you learned to do to manage your diabetes after being diagnosed?
Answer question ONE
Answer question THREE
Answer question FOUR
Answer question FIVE

1. I learned to cut carbohydrates out of my diet as much as possible.
2. I learned to test regularly.
3. I learned to read my body and recognize highs and lows.
4. I learned to avoid stress as much as possible.
5. I learned to always carry a source of carbohydrate with me for emergencies.

Research! Read Dr.Bernstein. Don't believe everything "experts" tell you.

1. Learned to cut carbohydrates to lower my bsg.
2. Learned to test
3. Learned how to battle depression
4. Learned it is easier to eat the same limited range of foodstuffs (still struggling with this one).
5. Learned to keep my own counsel

1. Deciding I needed to take care of D myself, and honestly, mistrust doctors.
2. The ability to monitor BG readings and how important that is.
3. Carb counting--let's see...someone introduced me to this 10 years ago? Refer to #1--mistrust doctors.
4. Understanding how to DEAL with complications--who to trust is really important here. Again, refer to #1.
5. Research, read, research, read. Take care of me.

Being D--T1 or T2 makes no difference. It is YOUR ballgame.

1. Rest is important for good diabetes control.
2. One can eliminate carbs from your diet and still have a happy, productive life.
3. It's better to test than guess your blood glucose levels--sometimes high/low symptoms can be the same.
4. Everythng affects your diabetes.
5. The medications that help my rheumatoid arthritis are also the same drugs that contribute to my diabetes and higher blood glucose levels.

1-Ignoring it doesn't work
2-test, test, test
3-Counting carbs
4-exercise plays a major role
5-a little weight loss doesn't hurt either.

  1. Learn to count carbs. Good control begins there.
  2. Think very seriously about insulin. It's the most powerful weapon we have. Used early enough, it may allow you to get your diabetes sufficiently under control that you can eventually drop it. Instead of driving your beta cells extra hard and thereby burning them out even faster, give them a chance to rest and recuperate instead. The Joslin Diabetes Center now starts newly diagnosed Type 2 diabetics on insulin right away. Conceivably they know something.
  3. If you don't have it already, develop the habit of regular exercise. It improves carbohydrate metabolism dramatically and it's free.
  4. Learn everything you can about diabetes. No one can manage it for you; you must do it yourself. Therefore it behooves you to understand it as well as you possibly can. And never stop learning -- our knowledge of diabetes, its causes, and its control is changing almost daily.
  5. Find a doctor you can work with. If your relationship with your doctor isn't effective, do something about it. It's too important to neglect. And TEST, both with a home glucometer and by getting regular lab tests to monitor your progress; don't fly blind.

Mmmm....I think I will mostly be dittoing everyone else:

1. TestTestTest and eat to your meter.

2. Since I also have arthritis and fibromyalgia, I figured out a menu of exercise options, so I always have a way to work off some carbs---including a sitting workout.

3. I've developed a large library of lo-carb recipes that are delicious and satisfying, including adapting some old family recipes----so I never feel deprived as I sustain a lo-carb way of eating.

4. I educated family and friends about our scourge so they could be supportive---and they have been after an initial shock.

5. I kept more or less auditioning doctors until I found one that treated me as a human being capable of making informed decisions about my own health.

1. Teach yourself how to be really good at carb counting.
2. Manage your medications in such a way that you can double check to see that you have taken them, when not sure.
3. Find a way to manage your diabetes that works for you and is sustainable.
4. Test as often as needed to get information you act on.
5. Read about diabetes, ask questions. Read more. Ask questions. Read more. Before you know it, you will be answering questions!

1. Manage time -- Managing life with diabetes requires a regime.

2. Manage my expectations -- I made dramatic improvements to my A1C in the first 18 months, then life happened and my test results flattened out. "If only" are deadly words.

3. Keep some perspective -- As the saying goes, there will always be those who are better off than you and those who are worse off. All I can manage is my own situation. It's okay to be human and not infallible.

4. Develop a preference for low carb eating.

5. Tell my GP when I need more or something different from the default treatment.

Hi Lloyd! This is Meghan from Humana. Thanks so much for sharing your insights! I'm interested in learning more about how you have learned to managed your medications so that you can double check them. Could you tell me more about your system?

Hi Gary! This is Meghan from Humana! Thanks so much for sharing with us - we really appreciate your feedback! How did you learn to link your exercise with your diabetes care?

So many great suggestions! Judith, I would love to learn more about how you found exercise options that work for you - trial and error? Or did you have help? Also would love to learn more about how you educated your family and friends - this seems like a great way to create support around you! (Meghan from Humana)

Hi! This is Meghan from Humana! What carbs are easiest to keep on hand and keep well in your purse? Thanks!!

Thanks, David! Do you have any tips that helped you get comfortable with the idea of insulin? It is so true that insulin may be the best option for people but we hear frequently that people are afraid to start, or feel like shifting to insulin is a sign of failure. Thanks (Meghan from Humana)

Hahahhahaha. Sometimes it isn't the patient. Read about how I started insulin. My view is that we fear the unknown and that actually being able to hear from others who use insulin really helps.

I use a pill box, 4 compartments per day, 7 days. I have 10 prescriptions, I distribute the pills ahead of time. I use an insulin pump, I can look at the data to see if I forgot a bolus, if in question.

Oh my. Anyone who knows me will tell you that this is one of my biggest hot buttons, and one I can lecture on for hours. :-)

I'll try to be as succinct as possible. Here goes.

One of the hardest hurdles to overcome is the traditional attitude, common in health care and therefore among the public at large, that insulin is a "last resort" to be used only when the situation is desperate, or an admission of "failure", both of which are absurd when viewed objectively.

Everyone can tell you a horror story about their aunt or uncle who was put on insulin and passed away not long after. When that happens, it's nearly always because insulin was prescribed too late to make a difference, instead of early enough to actually do some good.

Think of it this way: if you had a broken leg, would you consider a cast a "last resort", and put it off as long as you possibly could? Insulin is the most powerful tool there is for controlling blood sugar. Where is the logic in eschewing it until it's too late to matter?

There's another factor at work, and it too stems from an erroneous belief commonly held by doctors. Often a doctor will hesitate to prescribe insulin because of the belief that patients are afraid of injections. While it is certainly true that some people are needle phobic, that turns out to be much less of a factor than doctors think it is.

A while back I saw the results of a study that surveyed both doctors and their patients. About two-thirds of the doctors said they refrained from prescribing insulin because their patients were afraid of injections. But only about one-third of the patients themselves expressed the same reservation! Which means that thousands (possibly millions) of people are being needlessly denied the therapy that could make a life-changing difference and result in a dramatically different outcome.

I'll just end this by saying that I wish I had asked for insulin a decade earlier than I did; I would almost certainly have many more working beta cells today than I actually do.

So the bottom line, as it so often is, is the need for a change in attitudes; a paradigm shift, if you like. The only solution I know of is education. And that has to begin within the health care professions themselves because it is from them that the media and the public take their lead.

Well said. Me too, after stalling 5 months after it was suggested, and showing little improvement, I asked for insulin. I had mediocre glucose management for 12 years on oral medications.

-Lloyd