Health Monitor Living: Diabetes December 22 (2024)

CONTENTS

Health Monitor Living Diabetes

THE BASICS

You can thrive despite diabetes!
Today’s medications and a few lifestyle tweaks can help you manage your blood sugar—and get the upper hand on diabetes. Work with your healthcare team to find the treatment plan that’s your perfect fit.

How medicines can help
Learn about the many different options available to treat type 2 diabetes, then work with your healthcare team to find the best treatment for you and your lifestyle.

TRUE INSPIRATION

“Yes, we have diabetes—and we’re on top of it!”
Keith, Brittany and David have all been managing the condition for years. Here, they share what’s worked for them; ask your healthcare team if their tips could work for you, too.

FEEL YOUR BEST

Become a carb-counting pro
5 simple tips for navigating food labels, portion sizes and more.

Quiz: Test your blood sugar knowledge!
Overwhelmed? Confused? Take a deep breath, then take this quiz to see how much you really know about blood sugar and keeping it stable!

Today's medications and a few lifestyle tweaks can help you manage your blood sugar—and get the upper hand on diabetes. Work with your healthcare team to find the treatment plan that’s your perfect fit.
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A closer look at diabetes
Diabetes is a metabolic disorder that disrupts your body’s ability to produce or use insulin properly, which leads to high blood sugar levels. Normally, beta cells, found in the pancreas, make insulin—the hormone that helps blood sugar enter cells to be used for energy. In type 1 diabetes, beta cells are destroyed by the immune system, so the body does not make enough insulin. In type 2 diabetes, beta cells either don’t produce enough insulin or the body’s cells do not respond correctly to insulin (this is known as insulin resistance).

When blood sugar is unable to enter the body’s cells, it builds up in the bloodstream. Over time, excess blood sugar can lead to body-wide damage, including heart and kidney disease.

How is it diagnosed?
Your healthcare provider will order a blood sample be taken after you fast—i.e., don’t eat—overnight. If the results come back between 100 to 125 mg/dL, it is considered prediabetes. If the results are 126 mg/dL or higher, it is considered diabetes. The blood test will also likely look for your A1C—that’s your average blood sugar levels over the past three months. The A1C level for someone without diabetes is below 5.7%, a level of 5.7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes.

Medicine can help
If you have type 1 diabetes, your treatment will be insulin. If you have type 2 diabetes, oral medicines, non-insulin injectables and/or insulin can help. Learn more about your options by clicking here

What you can do
Work with your diabetes care team to identify your blood sugar and A1C goals and create an action plan to achieve them. And don’t forget, lifestyle changes can also help you stay on track, achieve your goals and feel your best!

See Also

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Learn more about your medication options

DIABETES PILLS

Metformin decreases blood sugar made by the liver.

Oral semaglutide is a glucagon-like peptide (GLP-1) receptor agonist, which increases insulin secretion, slows stomach emptying time, and leads to reduced food intake and feeling full, with low risk of hypoglycemia (low blood sugar).

Sodium-glucose co-transporter 2 (SGLT2) inhibitors promote the release of excess blood sugar through urine and result in weight loss.

Dipeptidyl peptidase-4 (DPP-4) inhibitors prevent breakdown of a compound that lowers blood sugar.

Thiazolidinediones (TZDs) increase insulin sensitivity.

NON-INSULIN INJECTABLE MEDICINES

Glucagon-like peptide (GLP-1) receptor agonists increase insulin secretion, slow stomach emptying time, and lead to reduced food intake and feeling full, with low risk of hypoglycemia. An oral form is also available, with potentially fewer stomach side effects.

INSULIN INJECTIONS

Insulin helps your body take up blood sugar into cells and helps the liver to store sugar.

Basal, or long-acting, insulin is typically taken once a day and acts slowly over 24 hours.

Bolus, or rapid-acting, insulin is taken before meals to prevent blood sugar increases after eating.

COMBINATION INJECTABLE MEDICINES

Insulin and GLP-1 agonist medicines can be combined. The insulin helps keep blood sugar levels in target range while fasting and overnight, while the GLP-1 agonist medicine helps the pancreas release insulin after eating, often increasing the feeling of fullness, and is helpful for weight loss. It comes in a fixed dose pen, which allows for ease of use.

When it comes to dealing with diabetes, there are plenty of different strategies you can try, from making healthy food swaps to connecting with a community for support. Here, Keith, Brittany and David share what’s worked for them. Ask your doctor if their tips make sense for you, too! —by Joana Mangune and Kathleen Engel

Keith, before losing 150 lbs.

“Diabetes can’t slow me down!”
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B. KEITH CREAR
HOUSTON, TX

As a sports photographer, Houston-based B. Keith Crear loves being out on the sidelines capturing highlights during Houston Texans football games and Houston Dynamo soccer matches. “It’s definitely a fun work environment,” Keith says. And an active one, too, requiring him to bounce around the field in search of the perfect shots throughout each game.

But there was a time just a few years prior, when running around after athletes would have been impossible. “I was overweight and I wasn’t taking my health seriously. I needed a change.”

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“I THOUGHT I ONLY HAD PREDIABETES”
That change began one sweltering Houston summer day in 2017, when Keith—who, at the time, was employed as an automotive photographer—was taking photos at a dealership when he suddenly felt dizzy.

“I sat down and leaned up against a tree, thinking I just needed a breather,” Keith recalls. “Next thing I knew, I was waking up in the ER.” Keith had passed out, prompting a coworker to call 9-1-1. “I thought it was just heat exhaustion, but when the attending nurse came back, she asked me, ‘How long have you had diabetes?’ I was shocked. I’d been told I had prediabetes by my PCP, but I didn’t think it had progressed.”

Keith’s fasting blood sugar reading was 295 mg/dL (a fasting level between 70 and 99 mg/dL is considered normal; 100-125 mg/dL indicates pre-diabetes, and 126 mg/dL and above indicates diabetes), and his A1C (the measure of average blood sugar levels from the past three months) was 8.9% (a normal A1C level is below 5.7%, a level of 5.7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes). He was told if he didn’t take control of his numbers, he’d wind up right back in the ER. Keith knew at that point he couldn’t keep ignoring his health.

“I made an appointment with my PCP immediately after being discharged. He put me on a non-insulin medication to help control my blood sugar numbers, and I promised him I was going to work hard on adjusting my eating and activity routines this time.”

“CHANGE IS HARD—BUT SO WORTH IT!”
Knowing he needed help, Keith consulted a diabetes education and care specialist. “The specialist really got me and understood where I’m coming from,” Kevin recalls. “She broke down everything for me and explained how eating and activity affect my blood sugar so I could really understand how what I ate and what I did affected my body.”

From there, Keith and his specialist created a eating plan and activity regimen that focused on “sustainability”—changes that Keith knew he could stick with.

“I am an ‘out of sight, out of mind’ type of person, so one of the first things I did was go home and clean out the kitchen cabinets. I got rid of all the sugary snacks, chips and pancake mix,” he says. Keith found healthy alternatives to his favorite carb-heavy meals, like zucchini noodles instead of pasta and mashed cauliflower instead of mashed potatoes. “I realized there’s so many healthy foods out there to try! Instead of feeling limited, it actually opened my palate a lot more,” Keith says.

On top of revamping his eating plan, Keith also started to work out at the gym and made a promise to himself to walk every day. “Not even the hot Houston sun can stop me! I know that if I keep going, then it stays a habit. So I plan the gym for bad weather days and I keep showing up to my daily walks. It makes a big difference,” he says.

“I’M A BETTER VERSION OF MYSELF”
Keith’s work paid off. Between his medication and the lifestyle changes, his A1C went down to 7.6 and his post-meal blood sugar readings average less than 140 mg/dL. And best of all? He lost a total of 150 lbs, going from a high of 425 down to 275 lbs.

“I’ve always been a big guy and seeing a smaller and healthier version of myself felt amazing. Also, I was told I couldn’t have kids because of my weight, and losing the extra pounds did seem to make the difference,” he says. On January 8, 2020, Keith and his wife Latoya welcomed their son, Braxton. “He’s our blessing.”

Today, Keith works with an endocrinologist, continues to manage his diabetes through medication, healthy diet and consistent workouts, and keeps in touch with his diabetes specialist. “I just sent her pictures of my 44^th birthday with me and my son. I like to show her my progress and told her, ‘Look! I’m wearing a 2x size shirt now,’ ” he shares. “Once I made up my mind to change and live a healthier lifestyle, I became committed to it and never looked back. My grandparents really struggled with diabetes and high blood pressure, and when it was my turn to manage my diabetes, I decided to write a different story for myself!”

Keith’s tips for creating a healthier lifestyle

Ask your healthcare provider if these tips could work for you, too!

Find a care team you click with. For Keith, it was important to create a team that was supportive. “I needed people who will listen to me and understand my concerns. I’m lucky to have an amazing diabetes care team. They are willing to listen to me when I come in and vent and really take the time to explain their answers to my questions.”

Write your stress down. “When I was first diagnosed, I started journaling to relieve my stress and keep track of my habits. Then I started blogging about sports and I just wanted to do more of it. That’s when my partner and I founded our sports site, sportsfusionlive.com, and then we started covering the local Houston sports teams!”

Have a sense of humor. “Diabetes is a serious condition, but I like to cope with it by joking. One time, when I was at a family BBQ, I was struggling trying not to overindulge in the ‘good stuff’ so I took a picture of a wedge of romaine lettuce on the grill and I posted it on my Instagram (@56grizzlymedia). I captioned it with, This is all I can eat. And everyone thought it was so funny! I got so many comments and someone from the organization BeyondType2 reached out to me and asked me if I would be interested in becoming an advocate and speaking on their panel!”

Enlist your friends and family. “My business partner knows about my condition. I told him, ‘If you see me on the sidelines sweating and shaking, you know that means I might be having a blood sugar low and need glucose tablets to correct it.’ He keeps plenty of those tablets, as well as water, a meter and test strips in his bag—same as mine!”

“It’s all about trial and error!”
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BRITTANY SMITH
SCOTTSDALE, AZ

When Brittany Smith started feeling fatigued with extreme thirst and having to wake up at least five time a night to go to the bathroom, she knew something was off. “I had been experiencing symptoms, but had no idea what they were related to. My mom thought it was possibly a urinary tract infection (UTI),” she says. But a trip to her doctor’s office back in 2006 revealed something different: diabetes. “I was one of the lucky ones because I did not have to go to the emergency room. I was treated as an outpatient over the weekend until I could see my endocrinologist the following Tuesday.” Today, Brittany’s A1C has gone down from 8% to 6.6%. Here’s how she got her numbers there.

Brittany’s blood sugar management strategies

Live in the present. “I cope with challenges by taking them one day, one moment at a time. I also remind myself that I have to expect the unexpected when living withdiabetes.I do my best to keep a positive attitude and focus on how I can change or make things better next time. I don't dwell on what could have been.”

Opt for all-natural sugars. “I prefer raisins to snack on, because there are no other added ingredients. Plus, they come in little boxes that are easy to carry with me regularly.”

Find an exercise you enjoy! “For me, running affects me very differently than cycling. With running, my blood sugar tends to trend slowly upward and will come down usually 30 minutes after my run, so I have to be careful not to take fast-acting insulin when I see it going up and let the exercise naturally bring it back down post-workout. With cycling, it depends how far I ride. When it’s a long ride, I always like to start with a higher blood sugar because I know for a fact that it will come down fast. Sometimes I have to shut off my insulin pump completely and make sure I pack plenty of snacks to eat along the way.”

“Be the CEO of your life with diabetes!”
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DAVID MINA
RIVERSIDE, CA

When it comes to his diabetes, David is keeping a positive attitude and controlling his anxiety and fear by taking it one day at a time and connecting with other patients. Here, he shares his tips.

David’s tips for dealing with diabetes distress

Shift your mindset. “We all one way or another tend to deal with diabetes mental health issues—diabetes burnout and distress, anxiety, depression and frustration,” says David, who connects with others who have diabetes on Instagram @type1livabetic. “I’ve had my own challenges with all of these. We sometimes look too far into the future and worry about the ‘what ifs’ of life with diabetes. That’s when you develop fear and anxiety. I like to say, take life with diabetes step-by-step, day-by-day. Deal with one diabetes task at a time, whether that’s checking your blood sugar, taking your medication, or anything else you do to manage your diabetes. This way, diabetes becomes more bearable and less of a burden.”

Be your own boss. “Going into 2021, I wanted something that was going to be my mantra to get me going when it came to diabetes,” says David. “I started telling myself: You are the CEO of your life with diabetes. You get to choose how you go about things. I don’t have to set limitations for myself—saying, no, I can’t do this or that. It means making plans, sticking to them, and not letting diabetes be the boss!”

Connect with the diabetes community. “One big thing that has helped me on my journey with diabetes has been getting involved with the diabetes community,” says David, who plans on becoming a certified diabetes care and education specialist. “It’s such a powerful tool for anyone living with the disease, no matter what type of diabetes you have. Whether you connect with the diabetes community online or in-person at a meetup, you see that you’re not alone with diabetes. You’re not the only person experiencing certain things. You can be having the worst day when it comes to your diabetes, but you will have a community who understands and supports you.”

Quiz

Special thanks to our medical reviewer:
Rachel Pessah-Pollack, MD, FACE,
Clinical Associate Professor, Division of Endocrinology, Diabetes & Metabolism, NYU School of Medicine, NYU Langone Health

And thanks to the Association of Diabetes Care & Education Specialists for their review of this publication.

Health Monitor Network is the nation’s leading multimedia patient-education company, with websites and publications such as Health Monitor®.

For more information: Health Monitor Network, 11 Philips Parkway, Montvale, NJ 07645; 201-391-1911; healthmonitornetwork.com ©2022 Data Centrum Communications, Inc. Questions? Contact us at customerservice@healthmonitor.com

This publication is not intended to provide advice on personal matters, or to substitute for consultation with a physician.

CED22-DG-D1

Health Monitor Medical Advisory Board

Michael J. Blaha, MD, Director of Clinical Research, Ciccarone Center for the Prevention of Cardiovascular Disease; Professor of Medicine; Johns Hopkins

Leslie S. Eldeiry, MD, FACE, Clinical Assistant Professor, Part-time, Department of Medicine, Harvard Medical School; Department of Endocrinology, Harvard Vanguard Medical Associates/Atrius Health, Boston, MA; Chair, Diversity, Equity and Inclusion Committee, and Board Member, American Association of Clinical Endocrinology

Angela Golden, DNP, FAANP, Family Nurse Practitoner, former president of the American Association of Nurse Practitioners (AANP)

Mark W. Green, MD, FAAN, Emeritus Director of the Center for Headache and Pain Medicine and Professor of Neurology, Anesthesiology, and Rehabilitation at the Icahn School of Medicine at Mount Sinai

Mark G. Lebwohl, MD, Dean for Clinical Therapeutics, professor and chairman emeritus at Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York

Mary Jane Minkin, MD, FACOG, Clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine

Rachel Pessah-Pollack, MD, FACE, Clinical Associate Professor, Division of Endocrinology, Diabetes & Metabolism, NYU School of Medicine, NYU Langone Health

Julius M. Wilder, MD, PhD, Assistant Professor of Medicine; Chair, Duke Dept of Medicine Diversity, Equity, Inclusion, and Anti-racism Committee; Vice Chair, Duke Dept of Medicine Minority Retention and Recruitment Committee; Co-Director for the Duke CTSI- Community Engaged Research Initiative