"Self-management" isn't a term doctors use much when they talk to patients about illnesses such as cancer or pneumonia. But when it comes to diabetes, self-management, with guidance from a medical professional, is key.
Diabetes is a chronic condition involving blood sugar that affects more than one in 10 US adults. To stay healthy, most diabetics need to make lots of changes in their everyday life. These changes usually include modifying the foods they eat, getting more physical activity and checking blood sugar levels frequently.
These changes sound daunting, but many diabetics have been able to incorporate them into their daily lives -- without giving up their favorite foods or changing jobs. Al Whitaker, a 54-year-old associate church pastor in Boston, was diagnosed with diabetes nine years ago, after he found himself too thin to fit into a suit he had purchased 5 days earlier. He had lost 30 pounds in eight months, but had avoided getting a check-up because he was afraid he might have cancer, and felt unprepared to cope. Instead, his doctor told him that his sugar was 4 times normal, and that he had type 2 diabetes, the most common type.
"I had never thought about diabetes," he said recently. "And lo and behold, my sugar was 450."
The diagnosis was unsettling, and initially wasn't easy to manage. Al knew of a diabetic cousin who had had a toe amputated, and he experienced several episodes of low blood sugar after beginning medication. But he found comfort as he read about diabetes on the internet and in brochures he found at his pharmacy.
"The fear I had subsided once I realized that if I changed my diet I could manage" diabetes, he said. "There's such a wealth of knowledge out there."
Two years ago, Al took a job with the American Diabetes Association, organizing community programs to educate the public about diabetes. Below is some of his advice, as well as tips from other diabetics and from Kellie Rodriguez, a veteran nurse educator at the Diabetes Research Institute at the University of Miami Miller School of Medicine (full disclosure: I work for the same school, in a different department). This is not a comprehensive list, and you should discuss your individual circumstances with your doctor.
If you lack insurance and need a place to go for primary care, the Needy Meds website lists clinics that are free or charge fees based on a sliding scale.