Firsthand secrets that will make your life so much easier…

One of every four American adults age 65 or older has diabetes—and many don’t know it. Even so, every 19 seconds, an American is diagnosed with type 2 diabetes.

My story: After I was diagnosed with type 2 diabetes 20 years ago, I vowed to help people avoid some of the missteps that are commonly made when navigating the trickier aspects of this complex disease. Mistakes you can avoid…

MISTAKE #1: Assuming that you’ll have obvious symptoms. You may be able to name a few of the classic diabetes symptoms, such as excessive thirst, frequent urination and blurred vision. But maybe you don’t have any of these red flags.

Perhaps you do feel a little more tired than usual or have numbness or tingling in your hands or feet that you can’t explain. These could be subtle signs that your blood glucose levels are out of whack. The symptoms that I initially dismissed were frequent bathroom breaks, increasing nearsightedness and scratches on my arms that wouldn’t heal for more than a month.

Surprisingly, you could even be losing weight. Even though diabetes is commonly associated with being overweight, sometimes people drop a few pounds because they’re losing water weight when they are urinating frequently and/or their metabolism is not allowing them to properly absorb calories.

What you should know: If you notice any changes—even if they seem minor—write them down and be sure to discuss them at your next doctor visit.

Important: If your doctor doesn’t routinely test your blood glucose levels, ask him/her to do so at least every three years if you’re past age 45. If you have any risk factors, such as a family history (in a parent, sibling or child) or being overweight, you may need more frequent testing…and perhaps starting at an earlier age. Also: Be sure that you’re not fighting a cold or some other infection when you’re tested—such illnesses can elevate blood glucose levels.

MISTAKE #2: Worrying only about sugar. Lots of people assume that individuals with diabetes simply need to avoid sugar. The truth is, it’s much more complicated than that. In fact, virtually everything you eat affects your blood glucose in one way or another.

Carbohydrates (which include starchy foods, such as bread, rice and potatoes, that turn into sugar when they are digested) as well as sugar itself actually have the greatest effect on your blood glucose. Fiber (both soluble fiber, the type that slows down digestion and is found in oat bran, barley, nuts, seeds and beans…and insoluble fiber, the type that adds bulk to your stool and is found in wheat bran and whole grains) also plays a role. It’s soluble fiber that can be used to improve your blood glucose levels.

What you should know: Food labels are confusing. Because fiber is a healthy carbohydrate, food labels in the US include it in the total carbohydrate count—for example, a product with 34 g of carbohydrates and 14 g of fiber, has an actual carbohydrate content of 20 g. In other countries, such as those in Europe, the food label would list this same product as having 20 g of carbohydrates and 14 g of fiber. Understanding such quirks in food labeling will help ensure that you’re not getting more or less carbs than you think.

MISTAKE #3: Not keeping close tabs on your numbers. If you are diagnosed with diabetes, your doctor will no doubt explain that the condition is largely a numbers game—with the prime target being your blood glucose level. Whatever advice your doctor gives you in terms of testing, take it seriously.

Especially in the first year, it’s important for most people with diabetes to monitor these levels three to five times throughout the day. Don’t try to cut corners. It’s true that the test strips you use can be expensive if your insurance limits the number you receive, but the cost of diabetes complications is much greater. If you must economize on test strips, ask your doctor for advice on the best times to test during the day.

Frequent testing will help you understand what causes your blood glucose levels to become elevated. You can then develop strategies to keep them in the normal range—this is the single best way to prevent serious complications, such as kidney failure, diabetic neuropathy and amputation of lower limbs.

In addition to diet, there are other factors that affect blood glucose. Managing stress and increasing physical activity are also important. Aim for 30 minutes of aerobic exercise (such as brisk walking) at least five days a week, but be sure to add some weight lifting a few times a week—it also helps with blood glucose control.

What you should know: Even when your blood glucose levels improve, you can’t revert back to old behavior. The improvement simply means that you’re doing what you need to do to control your disease and now have the flexibility to make small modifications, such as adding a few more carbs to your diet if you’ve lost some extra weight. Be sure to keep testing to make sure you don’t overdo it. And never stop taking your diabetes medication without consulting your doctor!

MISTAKE #4: Settling for daily blood glucose testing alone. Even though your daily blood glucose levels are the main number you need to focus on, other tests are helpful. For example, your doctor should also order (usually quarterly) a hemoglobin A1c test, which measures your average blood glucose for the past two to three months. This will tell you how well your overall diabetes treatment is working. Closely tracking your blood pressure and lipid levels (including cholesterol and triglycerides) is also important.

What you should know: No matter what test you are receiving, always insist on knowing the normal range for the lab. Just asking for the result (without knowing the lab’s range) can be very misleading.

MISTAKE #5: Going it alone. Other diabetes patients can often provide crucial tips, insights and lifestyle advice that you won’t hear from a physician who doesn’t live with diabetes on a daily basis.

What you should know: You’ll save yourself time and trouble by going online for practical tips. In addition to support groups such as DLife.com and the American Diabetes Association’s online community at Diabetes.org, there’s an excellent resource that was founded by David Mendosa, a fellow diabetes patient—Mendosa.com/advice.htm. His site is especially useful because he reviews other websites so you can go directly to the ones that offer the best information.

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