Newly Diagnosed

 

What is Diabetes?

A number of chronic diseases fall under the classification of Diabetes Mellitus. They all are metabolic disorders in which the body cannot properly metabolize carbohydrates, fats, and proteins because of defects in insulin secretion and or action. Diabetes develops when the body cannot produce or normally use insulin made by the body. Insulin is an essential hormone made in the pancreas. Insulin is necessary to move glucose (the key source of energy for metabolism) from the blood into most cells of your body. Exceptions include liver and brain cells, which are not insulin dependent.

When glucose builds up in the bloodstream, blood glucose (or blood sugar) rises, causing a condition known as hyperglycemia. When blood glucose gets high, people may experience a variety of symptoms.

  • Increased thirst
  • Frequent urination
  • Weight loss
  • Increased hunger
  • Blurred vision
  • Fatigue
  • Headache
  • Irritability
  • Tingling or numbness in the hands or feet
  • Frequent skin, bladder or gum infections
  • Wounds that do not heal
  • Extreme fatigue
  • Very dry skin
  • Breath with a fruity smelling odor
  • Nausea
  • Vomiting
  • Confusion and agitation
  • Abdominal Pain
  • Weakness
  • Coma

What Happens When You Have Diabetes?

When a person has type 2 diabetes, a number of systems may not be functioning normally. It sometimes takes up to 5-10 years for type 2 diabetes to develop. The following problems may happen over this time period:

  1. Beta cells in your pancreas may not be able to make enough insulin, or the insulin that is made is not as effective to control the blood glucose levels. Your fasting blood sugar slowly creeps up over the years (pre-diabetes) until the insulin can no longer keep the levels in check and then diabetes is diagnosed.
  2. Insulin resistance is when; the body makes insulin but the body is resistant to the insulin. This means it cannot use the insulin that is available effectively. In many cases the resistance/ occurs because of chronic inflammation related to excess weight and inactivity. There is also an increased demand for more insulin since it is less effective. When blood glucose is higher than normal but not high enough to diagnose diabetes the term for this is called impaired glucose tolerance or pre-diabetes.
  3. Hepatic glucose output—the liver, with its storage bank of glucose (called glycogen), will release extra glucose.. The result, fasting blood glucose rises.

Diabetes Self-Management

It is extremely important to take charge of your diabetes management. Day to day, meal to meal, blood sugar checks, doctor appointments to lab tests, you are determining the outcome of your own health. But, you are not alone. You have an informed team to guide you—your doctor (maybe this includes an endocrinologist), dietitian, certified diabetes educator, physical therapist, pharmacist and others. You have a support system—family, friends, and your support group here at DiabetesCare.net. There are many resources available—to help you take appropriate care of yourself and your diabetes. Diabetes care is non-stop and it will help you to learn everything you can about your diabetes.

Diabetes healthcare has moved to place the “patient” in the center of the treatment model, not the doctor. You as a person with diabetes are the head of your healthcare team. Share information about your blood glucose tracking, carbohydrates you consumed and questions to your healthcare providers. Be pro-active and speak up if you need more information or referrals to a diabetes program or a specific health care professional to complement your medical care.

Diabetes Self-Management Education (DSME)

Programs are available for people diagnosed with diabetes through Medicare and many health insurance plans. You can be referred to group classes specially designed and approved to empower you with all the basic information to manage your diabetes. If you need one-on-one education due to a special condition, this usually is possible as well. Call your insurance company to see what is covered and if there are preferred providers. Check with your local hospital or ask your doctor for a recommendation and a referral (if necessary) to see a diabetes educator. You also may have insurance coverage for individual appointments with the diabetes educator for medication management, insulin injection training, and use of an insulin pump. Call your insurance first to learn what is covered and how much will be expected for you to pay out of pocket.

Medical nutrition therapy (MNT)

Also available through Medicare and most health insurance plans. You can meet with a Registered Dietitian (RD) who may also be a Certified Diabetes Educator (CDE) and have individualized instruction on meal planning and diabetes care. Call your health insurance plan for information on the steps you should take to obtain this care.

Coping with a Diabetes Diagnosis

When a person is first diagnosed with diabetes, it’s natural to experience a range of emotions. These may include; anger, sadness, depression, denial, fear, frustration and stress. Discuss these feelings with your diabetes health team. Sometimes it is beneficial to see a psychologist. According to the American Psychological Association a psychologist can help you cope with stress. Successful management of stress can help to regulate blood glucose. They are also trained to help people accept their diagnosis if needed and help overcome feelings of depression. They can be part of your health care team along with your doctor, dietitian, certified diabetes educator nurse and if needed physical or occupational therapist. These health professionals can work with you to create a program that meets your needs and helps you cope with the changes in your life. Enlist the support of family and friends who can help you stay on track. You can also tap into many other sources of support to help you manage the physical and emotional effects of living with this disease. Check with your local hospital and/or health department for support groups or ask your physician.

In 2014, after paying your part B deductible, Original Medicare will help pay for the following:

  • Diabetes screening, 80 percent of diabetes self-management training and education for 10 hours in the first year and up to 2 hours in the following years.
  • They help pay for yearly glaucoma screenings carried out or supervised by a doctor that can do this in your state.
  • May help with insulin used in a pump if the insulin comes from an approved provider.
  • Medicare part B may also help with the cost of your blood glucose meter and strips as well as lancets and control solution. When using mail order you must use a national mail order contract supplier.
  • Foot care by a specialist is partially covered every 6 months as long as you did not see a foot care specialist in-between visits. If you have diabetes foot disease, Medicare will help pay for one pair of shoes per year as long as you buy them from a Medicare approved podiatrist, orthotist, prosthetist, or pedorthist.
  • If your doctor gives you a prescription for Medical Nutrition Therapy, you can get up to three hours of counseling by a Medicare approved registered dietitian. Each year after the first you can get an additional two hours with a doctor’s order. Contact Medicare at 800-Medicare or visit www.medicare.gov/supplier to see what providers can accept payment from Medicare.
  • Medicare part D (for prescription drugs) helps pay for insulin if injected as well as other diabetes medications and the supplies needed to use the medication if on the formulary of your insurance plan.
  • Medicare Advantage and other private insurers may also provide partial payment for the benefits mentioned above. Check with your plan and ask what benefits are covered for pre-diabetes or diabetes. Refer to the section on Medicare (see above) and ask if they also cover the benefit you are interested in. Insurances vary widely as to coverage. Some even cover more than Medicare.
  • Living with diabetes is a challenge you didn’t ask for, but it can be an opportunity to take a fresh look at your lifestyle and make positive changes. Exercise and diet play a major role in managing diabetes. You have the power to take control of your health and minimize diabetes’ effects on your wellbeing.

Where to Get Support for a Diabetes Diagnosis

With 25.8 million Americans diagnosed with diabetes – eight percent of the population – many resources exist for managing the disease. Support groups exist, both in-person and online programs that deal with the practical and emotional aspects of the disease. Message boards and forums give you a place to ask for advice about general or specific topics and benefit from the experiences of a community of others like yourself. There are many publications and products on the market that make diabetes management easier.

Simple Steps for Self-Testing

  • It is best to read the instructions supplied with your home blood glucose meter. If you have specific questions, do not hesitate to call the manufacturer for assistance. General instructions for many meters are as follows:
  • Wash your hands with soap and water and dry thoroughly.
  • Put a test strip in the blood glucose meter.
  • To draw blood from a finger you can massage your finger outward or shake your hand from the wrist. (To draw blood from alternative sites, follow the manufacturer’s instructions.)
  • Poke the side of one of your fingers with the lancet. You may need to milk your finger a little for the droplet to form. Select a different finger each time. Remember to try to using the side of your finger rather than the tip as it is less painful
  • Touch the drop of blood to the specific site on the test strip that accepts the blood.
  • Wait for the result to display, and record the results in your log book.

Points to remember to care for your meter and for testing :

  • Read your meter pamphlet or call the manufacturer to find out the temperature limits of both your meter and test strips.
  • Take care to keep your meter and supplies within this range
  • Test your meter (if needed) with control solution as advised by your meter company
  • Use your strips within the time period recommended by the manufacturer after opening. Do not use expired strips
  • Use a new lancet at each testing and properly dispose of the old one. Never use a lancet after another person has used it
  • It is recommended to test the fingers when hypoglycemia is suspected
  • Bring your meter with you when you go for blood work. Test your blood glucose at the same time as your draw and match the numbers for accuracy. Call your manufacturer to see what the accepted level of error is for your meter
  • If you feel the number that is shown on your meter is not correct, wash your hands again and test. If you still question the number, test with another meter if possible. Call for medical help if needed.