Newly Diagnosed With Diabetes? Here’s What to Expect

People newly diagnosed with diabetes experience a range of emotions and may feel overwhelmed and traumatized.

“There is fear of something they don’t know and disappointment and resentment that this is happening to them. All kinds of different feelings” says Betul Hatipoglu, MD, medical director of the Diabetes & Obesity Center at University Hospitals.

It’s important for patients to talk about these feelings and concerns with their doctor, Dr. Hatipoglu says. Patients typically have a lot of questions.

• Can I get rid of diabetes?
• What should I expect?
• What should I eat?
• What medications do I take?
• Am I going to lose a kidney or a leg?

Her first message to them is one of hope. If patients educate themselves, they can manage the disease and live their lives. And in the case of type 2 diabetes – the most common type – some patients are able to put diabetes in remission (sometimes referred to as reversing the disease).

“I tell these patients you are lucky because you have a second chance. If you eat healthy and exercise, you can put this in remission. It can still come back one day, but hopefully you can keep it quiet for many decades.”

“They feel very empowered and very hopeful,” Dr. Hatipoglu says. “A path to hope is very important.”

With type 2 diabetes, the body doesn’t use insulin efficiently to keep blood sugar (glucose) in a normal range. Type 2 usually develops later in life and is mostly due to being overweight or obese and genetic factors. Some patients require medications or insulin.

Type 1 diabetes is usually diagnosed early in life and is believed to be an auto-immune disease that causes your body to stop making insulin, a hormone produced by the pancreas that regulates blood sugar. People with Type 1 must take insulin to live.

Dr. Hatipoglu urges new patients to pace themselves because it takes time to digest information about the disease and how to manage it.

“Knowledge is the key to give confidence to the patient,” she says. “I always tell patients, ‘You have to know as much as I know.’ When they are educated, they don’t feel fearful and they are empowered knowing they can take care of themselves.”

Managing blood sugar is key to preventing diabetes complications, which include eye disease, heart disease, kidney disease, stroke and nerve damage that impairs blood flow to the feet.

Nerve damage can lead to foot ulcers. If the ulcers worsen and don’t heal, it may require surgery to amputate toes, part of the foot or leg.

Food, Exercise and Blood Sugar

Diet and physical activity play an important role in keeping blood sugar in a desirable range.

What should a diabetic patient eat? There isn’t a one-size-fits-all answer, Dr Hatipoglu says.

She recommends a healthy meal plan and heart-healthy diets, such as the Mediterranean diet or the DASH diet (designed to lower blood pressure), both of which promote whole grains, fruits and vegetables.

People with diabetes should limit saturated fat and trans fats, salt and added sugar. They need to pay attention to portion sizes and carbohydrates, in particular, because carbs affect blood sugar more than other foods.

That said, it’s important to personalize dietary recommendations as much as possible, reflecting cultural and family influences, Dr. Hatipoglu says. You can’t expect patients of varying racial and ethnic backgrounds to follow a cookie-cutter diet.

“You have to adjust and adapt to your patients to be culturally sensitive,” Dr. Hatipoglu says.

“We need to cater to the needs of the patient. You have to understand their level of their literacy and be careful and sensitive about those issues and their family dynamic. Are they the one who cooks the meal or is it someone else? We need to teach the family.”

Timing of meals also differs patient to patient. Patients who take medications or insulin may have to eat the same time each day. Physical activity lowers blood sugar, so timing of food in the context of physical activity must be considered.

Your doctor may advise you to eat a small snack before, during or after intense activity, so that your blood sugar doesn’t drop too low.

Illness and stress also can affect blood sugar.

Patients and their doctors should discuss how to monitor blood sugar, what type of monitor best suits their needs, and what to do when blood sugar is too high or too low.

Technology Helps Patients Manage Diabetes

• For those who need insulin, different delivery options are available. Some patients use insulin pumps, computerized devices that automatically deliver insulin when needed.
• Pumps may be paired with continuous glucose monitors, where a sensor beneath the skin tests blood sugar throughout the day.
• Smart insulin pens paired with a mobile app also help patients manage insulin delivery.
• A variety of mobile apps help patients track blood sugar and manage their diabetes. Some apps allow them to share health data with their medical providers.

“There are all these components to diabetes education that patient needs to be provided with by an experienced diabetes educator who is sensitive to their needs,” Dr. Hatipoglu says.

When patients do well, it’s important to acknowledge a victory, she says.

“If you do your best and minimize your fluctuation of blood sugar and the damaging effect of those blood sugars to the eyes, kidneys and the nerves, that is a success,” Dr. Hatipoglu says.

“You turn a corner by preventing a complication or the worsening of a complication. You are a success story.”

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Led by an experienced team of clinicians and researchers, the University Hospitals Diabetes & Obesity Center provides ongoing care, management and education for diabetes, obesity and related conditions.