If you've been diagnosed with diabetes or prediabetes, you'll have to make some changes to your lifestyle. These changes may seem challenging, however, with help from your physician and other health care providers, these changes can become a permanent part of your every day life.
Certified diabetes educators can help you make lifestyle changes, create a diabetes care plan and provide education on blood sugar levels, medication/insulin and possible health complications.
Listen as Laurie Sandberg, RN, explains what you need to know about living healthy even with diabetes.
Selected Podcast
Living With and Managing Diabetes
Featured Speaker:
Laurie Sandberg, BSN, RN
Laurie S. Sandberg, BSN, RN, CDE, graduated from the University of Maryland School of Nursing with a Bachelor’s of Science degree in nursing. She has over 35 years of nursing experience in a variety of areas including medical/surgical, long term care, intensive care, case management and nursing education. She has provided both inpatient and outpatient diabetes education since 2000. She is a certified diabetes educator and a member of the American Association of Diabetes Educators and the American Diabetes Association. Transcription:
Living With and Managing Diabetes
Melanie Cole (Host): If you’ve been diagnosed with diabetes or prediabetes, you'll have to make some changes to your lifestyle. These changes may seem challenging; however, with help from your physician and other healthcare providers, these changes can become a permanent part of your everyday life. My guest today is Laurie Sandberg. She’s a registered nurse and a certified diabetes educator with Meritus Health. Welcome to the show. What is diabetes? Explain the different types for us.
Laurie Sandberg, BSN, RN, CDE (Guest): Diabetes basically is a problem with the hormone called insulin. Insulin is a hormone that helps our body use our food for energy and store our food for later use. In the absence of insulin, we can't survive. Our energy source is sugar – we call it glucose in the medical community – and that sugar comes from food that we eat and also from the liver. We need glucose, but we can't use our glucose if we have a problem with our insulin. Type 1 diabetes really is a small segment of a diabetes population – about 5-10% of the people with diabetes have type 1. It is an autoimmune disease and the body attacks the insulin making cells and the body is unable to make insulin. The only treatment is really to replace that hormone. Type 2 diabetes is more when we think about diabetes – 90-95% of the people who have diabetes have type 2. There is a hereditary component to that, there are risk factors for diabetes and obviously the more risk factors you have, the higher your risk of developing diabetes is going to be.
Melanie: Explain a little bit about some of those risk factors. Who would be most at risk for type 2 diabetes?
Laurie: There is quite a list of risk factors, some of which we have no control over. Our family history – if you have family with diabetes, you're at a higher risk. It’s that hereditary factor – we really can't change that. Your race – blacks, Hispanics, American Indian, Asian American – they have a higher risk for diabetes. Your age – the older you get. Whether you had, as a woman gestational diabetes, or a baby weighing more than nine pounds. We really can't change those things. Some things that we can change is increased weight – a higher weight increases our risk - having high blood pressure or abnormal cholesterol levels – specifically a low good cholesterol, which is called HDL - and sometimes weight will affect both high blood pressure and cholesterol, and also inactivity gives us a higher risk. Of that list, the only ones we truly have control of as human beings – what can I do now – is how much we weigh and how active are we. Those are usually the things that we would concentrate on to prevent or delay the onset of diabetes.
Melanie: What do you tell people that may have some comorbidities besides just diabetes – maybe they have high blood pressure, maybe their diabetes and high blood pressure puts them at risk now for heart disease? What do you tell them about managing these symptoms altogether? It can be very confusing.
Laurie: They are symptoms or problems that tend to travel together. People who have diabetes tend to have high blood pressure and high cholesterol, which in it of itself leads to that heart disease problem, but the good news is the reduction in weight and the increase in activity will actually improve all of it. What I typically tell people is if you start losing weight and if you become more active, often your need for medication for blood pressure decreases, your need for medications for diabetes decreases, your need for medication sometimes for your cholesterol and heart disease will decrease because weight and activity connect to all of those.
Melanie: If people have been identified as being at risk, and maybe they’ve even been told that they have now prediabetes, what do you tell them is the first thing that they should be doing to get that lifestyle management under control so that maybe it doesn’t become full blown diabetes? What do you tell them about exercise and include about food? That’s such a major factor in diabetes and they heard the word ‘carbohydrate’ and go running the other way, but fruits and vegetables are carbohydrates, so people get confused about what they're supposed to do. What's the first thing you tell someone who’s just been told that they have prediabetes?
Laurie: Usually I tell them to relax. It’s not as difficult as you may have worked it up in your mind to be. There are several suggestions we can make. We typically tell you about several, and we say institutes, one at a time. It is hard to change. Work towards whichever one of these things that you can work toward first. Physical activity is huge. Physical activity is better than any medication that people can give to you for anything. Physical activity makes insulin work better, lowers your blood pressure, increases your feelings of well beings, so it helps with depression. Just moving more is #1. There are three common factors with type 2 diabetes. One of the problems is insulin resistance. Insulin resistance is a big problem with diabetes and the way to combine insulin resistance is twofold – move more and lose weight. That typically is what starts prediabetes and diabetes. While we’re at it, we may as well just define prediabetes.
Prediabetes is when your blood sugars are higher than normal, but they are not high enough yet to be called diabetes. Many people are saying ‘we just caught your diabetes early,’ so the treatment is the same whether you're just diagnosed with prediabetes or with diabetes. We’re going to say ‘try to move more.’ We will say ‘watch carbohydrates,’ and you're right. Everything you like to eat is carbohydrates, but knowing where your carbohydrate is coming from, looking at how many carbohydrates are you eating and sometimes we eat them mindlessly. We don’t realize the amount, and so just being conscious of how much are you eating and what's the size of your portions. There are obviously registered dieticians that can help you identify what carbohydrates are. We have the diabetes center here that we can go over that in more detail. There are programs like the Diabetes Prevention Program that are offered in our area and in many areas that can also help you with that. Basically everything is a carbohydrate, except for meat and fat.
We all know about the big ticket items – cakes, cookies, sodas – but also things like rice, pasta potatoes, the starch portion of your meal. We really typically say try to keep it to about fist size when you're eating. Physical activity is very important wherever you can add it into a day. They do say try to work up to 150 minutes a week, which is about 30 minutes a day. The exercise you would want to work up to would be an exercise that makes you a little short of breath, not panting. Start slow, 10 minutes for a week, maybe add another 10 minutes, maybe 10 minutes in the morning and 10 minutes in the evening, but the goal in several months is to be trying to move 150 minutes a week. Physical activity is important, looking at what carbs are you eating and with that comes weight loss.
Melanie: Tell us about the diabetes center at Meritus Health.
Laurie: We are an American Diabetes Association recognized program. We deal with any sort of diabetes – type 1 diabetes, type 2 diabetes, gestational diabetes, insulin pumps – we deal with anything having to do with education for diabetes. I am a nurse, an RN, a certified diabetes educator, and Tim Higgins is an RD, he’s also a certified diabetes educator. We typically will meet with someone either one-on-one or we do have an orientation class, and we just get to know you, where are you starting from, what are you interested in learning and we help you just pick out some goals to work on to help get you on a better track. I have had people who have been on insulin and oral medications to control their diabetes, and now are on no medicine to control their diabetes just through watching what they eat, moving more and weight loss. I've also seen people just at the brink of diabetes how have gotten their A1C back into the normal range just by learning a few things about food and exercise. Often people say to me ‘these aren’t that hard to do, I wish I had come sooner.’ We do require a referral for your physician, we do work with your physician and we will send the patient’s plan – like ‘we met with this person and here's what they're plan is’ – and we will follow up with them as long as they need followed to help them stay on track.
Melanie: To wrap up, what's your best advice about preventing diabetes in the first place and living with and managing if you have been told that you have diabetes?
Laurie: My advice would be don’t be afraid. Do not stick your ground in the sand – it is not as difficult as you might think. We need to try to move more, watch our intake of food, talk to your physician, ask to be referred either to the diabetes center if you have diabetes or to a local community program about prediabetes, but prevention starts with the little changes that we make on a daily basis in our food choices and whether or not we take that walk after our meal.
Melanie: Thank you so much for being with us today. It’s great information. This is Your Health Matters with Meritus Health. For more information, you can go to meritushealth.com. That’s meritushealth.com. This is Melanie Cole. Thanks so much for listening.
Living With and Managing Diabetes
Melanie Cole (Host): If you’ve been diagnosed with diabetes or prediabetes, you'll have to make some changes to your lifestyle. These changes may seem challenging; however, with help from your physician and other healthcare providers, these changes can become a permanent part of your everyday life. My guest today is Laurie Sandberg. She’s a registered nurse and a certified diabetes educator with Meritus Health. Welcome to the show. What is diabetes? Explain the different types for us.
Laurie Sandberg, BSN, RN, CDE (Guest): Diabetes basically is a problem with the hormone called insulin. Insulin is a hormone that helps our body use our food for energy and store our food for later use. In the absence of insulin, we can't survive. Our energy source is sugar – we call it glucose in the medical community – and that sugar comes from food that we eat and also from the liver. We need glucose, but we can't use our glucose if we have a problem with our insulin. Type 1 diabetes really is a small segment of a diabetes population – about 5-10% of the people with diabetes have type 1. It is an autoimmune disease and the body attacks the insulin making cells and the body is unable to make insulin. The only treatment is really to replace that hormone. Type 2 diabetes is more when we think about diabetes – 90-95% of the people who have diabetes have type 2. There is a hereditary component to that, there are risk factors for diabetes and obviously the more risk factors you have, the higher your risk of developing diabetes is going to be.
Melanie: Explain a little bit about some of those risk factors. Who would be most at risk for type 2 diabetes?
Laurie: There is quite a list of risk factors, some of which we have no control over. Our family history – if you have family with diabetes, you're at a higher risk. It’s that hereditary factor – we really can't change that. Your race – blacks, Hispanics, American Indian, Asian American – they have a higher risk for diabetes. Your age – the older you get. Whether you had, as a woman gestational diabetes, or a baby weighing more than nine pounds. We really can't change those things. Some things that we can change is increased weight – a higher weight increases our risk - having high blood pressure or abnormal cholesterol levels – specifically a low good cholesterol, which is called HDL - and sometimes weight will affect both high blood pressure and cholesterol, and also inactivity gives us a higher risk. Of that list, the only ones we truly have control of as human beings – what can I do now – is how much we weigh and how active are we. Those are usually the things that we would concentrate on to prevent or delay the onset of diabetes.
Melanie: What do you tell people that may have some comorbidities besides just diabetes – maybe they have high blood pressure, maybe their diabetes and high blood pressure puts them at risk now for heart disease? What do you tell them about managing these symptoms altogether? It can be very confusing.
Laurie: They are symptoms or problems that tend to travel together. People who have diabetes tend to have high blood pressure and high cholesterol, which in it of itself leads to that heart disease problem, but the good news is the reduction in weight and the increase in activity will actually improve all of it. What I typically tell people is if you start losing weight and if you become more active, often your need for medication for blood pressure decreases, your need for medications for diabetes decreases, your need for medication sometimes for your cholesterol and heart disease will decrease because weight and activity connect to all of those.
Melanie: If people have been identified as being at risk, and maybe they’ve even been told that they have now prediabetes, what do you tell them is the first thing that they should be doing to get that lifestyle management under control so that maybe it doesn’t become full blown diabetes? What do you tell them about exercise and include about food? That’s such a major factor in diabetes and they heard the word ‘carbohydrate’ and go running the other way, but fruits and vegetables are carbohydrates, so people get confused about what they're supposed to do. What's the first thing you tell someone who’s just been told that they have prediabetes?
Laurie: Usually I tell them to relax. It’s not as difficult as you may have worked it up in your mind to be. There are several suggestions we can make. We typically tell you about several, and we say institutes, one at a time. It is hard to change. Work towards whichever one of these things that you can work toward first. Physical activity is huge. Physical activity is better than any medication that people can give to you for anything. Physical activity makes insulin work better, lowers your blood pressure, increases your feelings of well beings, so it helps with depression. Just moving more is #1. There are three common factors with type 2 diabetes. One of the problems is insulin resistance. Insulin resistance is a big problem with diabetes and the way to combine insulin resistance is twofold – move more and lose weight. That typically is what starts prediabetes and diabetes. While we’re at it, we may as well just define prediabetes.
Prediabetes is when your blood sugars are higher than normal, but they are not high enough yet to be called diabetes. Many people are saying ‘we just caught your diabetes early,’ so the treatment is the same whether you're just diagnosed with prediabetes or with diabetes. We’re going to say ‘try to move more.’ We will say ‘watch carbohydrates,’ and you're right. Everything you like to eat is carbohydrates, but knowing where your carbohydrate is coming from, looking at how many carbohydrates are you eating and sometimes we eat them mindlessly. We don’t realize the amount, and so just being conscious of how much are you eating and what's the size of your portions. There are obviously registered dieticians that can help you identify what carbohydrates are. We have the diabetes center here that we can go over that in more detail. There are programs like the Diabetes Prevention Program that are offered in our area and in many areas that can also help you with that. Basically everything is a carbohydrate, except for meat and fat.
We all know about the big ticket items – cakes, cookies, sodas – but also things like rice, pasta potatoes, the starch portion of your meal. We really typically say try to keep it to about fist size when you're eating. Physical activity is very important wherever you can add it into a day. They do say try to work up to 150 minutes a week, which is about 30 minutes a day. The exercise you would want to work up to would be an exercise that makes you a little short of breath, not panting. Start slow, 10 minutes for a week, maybe add another 10 minutes, maybe 10 minutes in the morning and 10 minutes in the evening, but the goal in several months is to be trying to move 150 minutes a week. Physical activity is important, looking at what carbs are you eating and with that comes weight loss.
Melanie: Tell us about the diabetes center at Meritus Health.
Laurie: We are an American Diabetes Association recognized program. We deal with any sort of diabetes – type 1 diabetes, type 2 diabetes, gestational diabetes, insulin pumps – we deal with anything having to do with education for diabetes. I am a nurse, an RN, a certified diabetes educator, and Tim Higgins is an RD, he’s also a certified diabetes educator. We typically will meet with someone either one-on-one or we do have an orientation class, and we just get to know you, where are you starting from, what are you interested in learning and we help you just pick out some goals to work on to help get you on a better track. I have had people who have been on insulin and oral medications to control their diabetes, and now are on no medicine to control their diabetes just through watching what they eat, moving more and weight loss. I've also seen people just at the brink of diabetes how have gotten their A1C back into the normal range just by learning a few things about food and exercise. Often people say to me ‘these aren’t that hard to do, I wish I had come sooner.’ We do require a referral for your physician, we do work with your physician and we will send the patient’s plan – like ‘we met with this person and here's what they're plan is’ – and we will follow up with them as long as they need followed to help them stay on track.
Melanie: To wrap up, what's your best advice about preventing diabetes in the first place and living with and managing if you have been told that you have diabetes?
Laurie: My advice would be don’t be afraid. Do not stick your ground in the sand – it is not as difficult as you might think. We need to try to move more, watch our intake of food, talk to your physician, ask to be referred either to the diabetes center if you have diabetes or to a local community program about prediabetes, but prevention starts with the little changes that we make on a daily basis in our food choices and whether or not we take that walk after our meal.
Melanie: Thank you so much for being with us today. It’s great information. This is Your Health Matters with Meritus Health. For more information, you can go to meritushealth.com. That’s meritushealth.com. This is Melanie Cole. Thanks so much for listening.