Diabetes educators: Putting patients in the driver’s seat | Total Health

Dana Stainbrook is used to meeting with people who feel overwhelmed.

“There is a lot of denial with diabetes … minimizing it and thinking it’s really not a problem,” said Stainbrook, a nurse and diabetes educator with Washington Health System.

But Stainbrook’s work with patients through the Diabetes Education & Management Program helps people who are both newly diagnosed and who have been living with diabetes for decades.

The majority of diabetes cases in the United States are Type 2, which means patients have insulin resistance, but their bodies can still produce insulin. Stainbrook’s first order of business is to focus on a healthy lifestyle and to let them know that they are in the driver’s seat when it comes to managing their diabetes.

“Lifestyle, healthy eating and exercising is always going to help blood sugar management,” she said. “I always try to tell them that they’re in the driver’s seat, because it’s what they do everyday that makes all the difference in the world with their outcomes.”

The problem, she said, is that Type 2 diabetes is a progressive disease. By the time someone is diagnosed, they’ve lost about 50 percent of their beta cells, which are the cells in the pancreas that make insulin.

“They’ll continue to lose about five percent more every year, so it’s a gradual loss of the body’s ability to produce insulin,” said Stainbrook. “So what works today is not going to be working five years from now, and it’s not unusual for them to require additional oral medication as time goes by and to eventually require insulin.”

The first pieces of information Stainbrook gives to new diabetes patient are the importance of healthy eating and increasing physical activity.

“That can be a 10-minute walk after a meal or a thirty minute walk every day,” she said. “They don’t have to spend money on a gym membership. The best exercise to do is the one you enjoy, and if you hate all exercise, then I tell them (to) find the one that is least objectionable to them. They need to treat exercise like a medication.”

Something as simple as parking at the far end of the parking lot or walking at the store, taking the steps instead of the elevator and increasing the number of total steps throughout the day can make a remarkable difference in reducing insulin resistance and increasing blood sugar control, Stainbrook said.

Once patients get moving, they next need to focus on their diet. However, what Stainbrook recommends for an eating plan shouldn’t be considered a “diet.”

“I tell people everybody in the family should be eating the way I’m telling you to eat,” Stainbrook said. “It’s not a diet. It’s the way everybody in America should be eating. Fresh whole foods, fresh and frozen fruits, vegetables and meats – try to stay away from the bags, boxes and cans, and keep it simple as far as the number of ingredients in the product. That’s just healthy eating for everybody.”

As for managing sugar and carbohydrates, Stainbrook has some simple rules. She tells patients that when they look at labels, look at total carbohydrates and not just the grams of sugar.

“If you’re avoiding all carbs, all that’s left is protein and fat. That’s not always good,” she said. “Remember that fruits and vegetables are good carbs because they have plenty of fiber and nutrients. Carbs turn to sugar, so if they eat too many carbs, their sugar will run high despite medication or insulin.”

Likewise, eating too few carbs can lower blood sugar too much, so consistency is the key with carbohydrate intake.

Stainbrook said we tend to eat what’s fast and convenient. If you have a bag of cookies on the counter, you’ll eat them rather than taking time to chop up vegetables or peel carrots. Her tips include keeping fresh, healthy snacks in abundance and ready to eat. She tells patients that no food is forbidden, but it’s all about moderation.

“Obviously, cake and ice cream are not good, but it’s up to portion size,” she said.

One more tip: she warns not to drink your carbs in soda and sweetened drinks, which can shoot blood sugar up quickly and not add any nutrition. Artificial sweeteners are better than regular sugar for diabetics, but having sweet drinks can also cause you to crave them even more.

Stainbrook said the diabetes education program offers individual and group education and includes a diabetes prevention clbad.

“The program is designed for people who have an immediate family member and that increases their risk,” she adds. “It’s a weight-loss program but also for people who have a family history of the disease or other indicators for diabetes.”

The WHS prevention clbad meets weekly for 16 weeks, then moves into monthly meetings and is meant to help prevent diabetes.

“If you can prevent a disease as opposed to treating it, that saves everybody money and their health,” said Stainbrook.

Her best advice for patients is don’t feel helpless or hopeless. There are many resources available to help you manage diabetes and there are plenty of people willing and able to help with medical advice as well as coping with the emotional aspect of the disease.

Stainbrook said, “I had a lady tell me last week that she’d had diabetes for 30 years, and she said, ‘You’re the first person who has given me hope that I can actually do this on my own and I can make things better.’”