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Tuesday, November 22, 2016

Biggest Myths About Type 2 Diabetes Treatment

 "At least it's not as bad as cancer."
You may have heard that statement after you've aired your complaints about the challenges of managing type 2 diabetes. While it's usually meant well, this type of response is misleading, since it promotes the unfounded idea — the myth — that diabetes isn't as serious as other chronic conditions. But type 2 diabetes raises your risk of dying prematurely by 50 percent, and according to the CDC it's a leading cause of death in the United States.
The good news is that diabetes "is absolutely manageable with proper diet, exercise, and medication," says Jenny Champion, a registered dietitian, diabetes educator, and personal trainer in New York City.
As you manage the various aspects of your medical care — the healthy lifestyle habits, the self-monitoring of blood glucose, and any medication regimen — don't be waylaid by these nine other diabetes myths, any or all of which might be keeping you from getting the most out of your treatment.
Myth: You can feel when blood sugar is high or low, so you don't have to check it often.
Waiting to feel physical effects of blood sugar (glucose) that is too high or too low is dangerous: According to the American Diabetes Association (ADA), this can lead to accidents, injuries, coma, and even death.
"Many good studies have been conducted on the ability of people to sense blood sugar levels, and most people are woefully inaccurate," says Amber Taylor, MD, an endocrinologist and the director of the Diabetes Center at Mercy Medical Center, in Baltimore. Says Champion, "By the time you end up feeling the telltale signs of low blood sugar, or hypoglycemia, your levels have already sunk too far."
Aside from determining whether your blood sugar levels are within a healthy range, regular glucose monitoring offers psychological benefits: A study that was presented at the American Association of Diabetes Educators Annual Meeting and Exhibition, in August 2015, showed that participants with diabetes who stuck to a regular self-monitoring schedule not only had better-controlled blood sugar levels but felt more in control of their condition than before the study.
As for how often you should check your blood sugar levels, Dr. Taylor recommends three to four times daily for those who take insulin, and once a day for those who use oral medication. However, there are exceptions to these general recommendations, so Taylor emphasizes that your specific schedule for testing and timing should come from your diabetes care team.
Myth: Needing insulin means you're failing to take care of your diabetes properly.
Insulin is a naturally occurring hormone produced by the pancreas that allows your body either to use sugar from food as energy or to store it for later use. When you have type 2 diabetes, your body isn't able to use insulin properly. And because diabetes is progressive, the body may eventually lose its ability to make enough insulin on its own. Insulin therapy is a viable treatment option in these cases —  whether the person is newly diagnosed with diabetes or has been managing for 15 years or more.
Says Champion, "If your doctor suggests you start using insulin, it doesn't mean you're failing. It just means your body needs a different treatment so that you can continue to stay healthy."
Myth: Managing diabetes is painful and complicated.
People with diabetes used to have to follow strict mealtime schedules and endure painful insulin injections, but that's not so anymore. "There have been huge advances in diabetes technology over the past 50 years," says Taylor. "Tiny needles, fast glucometers, and new medications have made the management of diabetes easier and more convenient."
A variety of insulin delivery methods are available nowadays, and needles are so small that injections don't hurt. Pain and complication should belong to the past, so talk to your doctor if you find that any part of your treatment plan is too challenging or uncomfortable.
Myth: Medication controls your blood sugar, so you can eat whatever you want.
Dietary recommendations for people who don't have diabetes apply just as strongly to those who do. "Just because you take medication doesn't mean you can eat an unhealthy diet," says Taylor. "We should all eat healthier foods, whether we have diabetes or not."
To minimize your risk of health problems and diabetes complications, plan balanced meals ahead and include protein, fat, and carbs, and keep processed foods to a minimum.
"Remember that what you eat influences the efficacy of your medication and how much of the medication you need," says Champion, "so it's important to continue eating healthfully, even after starting a medication regimen."
Myth: You can't lead an active life when you have diabetes.
"Being active is actually a fantastic way to manage blood sugar and help prevent complications in the future," says Champion. The ADA recommends 30 minutes of moderate to vigorous aerobic exercise at least five days a week. If you can't set aside 30 minutes every day, you can break up your activity into several 10-minute workouts. According to the ADA, effective workouts include brisk walking, stair-climbing, swimming, and dancing.
You can also try soccer. In a study published in December 2013 in the journal Medicine & Science in Sports & Exercise, the heart muscle tissue of the participants, who all had been diagnosed with type 2 diabetes, was found to work up to 29 percent faster after six months of regular soccer training, and their exercise capacity had increased by 42 percent.
Keep in mind that exercise can lower blood sugar, so you might need to eat a snack before you work out, especially if you're taking medication that lowers your blood sugar. Talk to your doctor before starting any new exercise regimen, and ask about smart steps you can take to help prevent low blood sugar.
Myth: Using insulin causes complications like amputations and even death.
Quite the opposite, says Champion. Insulin can be a lifesaver. It allows cells to absorb and use glucose that can build up in the body — in effect, lowering blood sugar and preventing long-term organ damage and other complications of diabetes.
"Insulin may get a bad name because some people wait much too long to start it," says Taylor, "and once damage has been done from years of high blood sugar, people incorrectly attribute it to the insulin. For example, a patient who comes to the hospital with very high blood sugar and gangrene may start insulin at the hospital but ultimately lose the affected limb — the patient might think the amputation was related to the insulin, but in reality, insulin might have prevented the complication if the treatment had been started earlier."
Myth: If my relative is on a certain medication, I should be on it, too.
"Diabetes is not treated with a one-size-fits-all approach," says Taylor. The specific recommendations for which medication you should take are based on various factors, she explains, including how long you've had diabetes and what other medications you're taking, as well as other risk factors and health conditions — all of which may be very different from your relative's.
In addition, says Champion, "people respond differently to different medications, so what works for your relative may not be right for you. Each person with type 2 diabetes is different, so naturally, treatment is individualized."
Myth: You have to lose a lot of weight for your diabetes to improve.
Being overweight or obese does increase your risk of diabetes complications. The good news, says Champion, is that even a small amount of weight loss can significantly improve your diabetes. Says Taylor, "Usually, 5 to 10 percent of your body weight is sufficient, and many people notice better blood sugar levels immediately after they change their diet."
The ADA recommends that you lose weight gradually, by setting a few realistic goals and working toward them steadily. A good place to start is to incorporate one healthful change into your diet and make one tweak to increase your physical activity.
Myth: No matter what I do, I'll eventually end up with disabling complications.
This is perhaps the biggest myth of all — that if you have diabetes, it's guaranteed that you'll develop serious health issues, such as vision loss, nerve damage, or kidney failure. Fortunately, that's not the case. "We work really hard to avoid reaching that stage," says Taylor. "People can have insulin-requiring diabetes for many years and never develop complications."
Taking steps to keep your blood sugar under control, continuing to learn as much as you can about diabetes, and communicating regularly with your health care team — these are the best ways to protect your health. If you're doing all that but you still feel that there's no hope, talk to your doctor, says Taylor. "You may be suffering from diabetes burnout," she says. Fortunately, your care team will be able to come up with a plan to help you manage that, too.
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