Diabetes educators: putting patients behind the wheel | Total health

"There is a lot of denial with diabetes … downplaying it and thinking it's really not a problem," said Stainbrook, a Washington Health System nurse and diabetes educator.

But Stainbrook's work with patients in the Diabetes Education and Management Program has been helping people newly diagnosed with diabetes for decades.

In the United States, the majority of cases of diabetes are type 2, which means that patients have insulin resistance, but that their body can still produce insulin. Stainbrook's first task is to focus on a healthy lifestyle and let them know that they are taking responsibility for the driver's management of their diabetes.

"A lifestyle, a healthy diet and exercise will always contribute to the management of blood sugar," she said. "I always try to tell them that they are in charge because it is what they do every day that makes all the difference in the world with their results."

The problem, she said, is that type 2 diabetes is a progressive disease. By the time the diagnosis is made, a person has lost about 50% of his beta cells, which are the pancreatic cells that produce insulin.

"They will continue to lose about five percent more each year, so this is a gradual loss of the body's ability to produce insulin," Stainbrook said. "So, what works today will not be so in five years and it is not uncommon for them to need oral medications as time goes on and that 's the way it works. they may need insulin. "

The first information Stainbrook provides to new diabetic patients is the importance of healthy eating and increased physical activity.

"It can be a 10-minute walk after a meal or a thirty-minute walk every day," she said. "They do not have to spend money to subscribe to a gym. The best exercise to do is the one you like and if you hate any exercise, then I tell them (to) find the one that is the least reprehensible to them. They need to treat exercise as a medicine. "

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

Once patients move, they must then focus on their diet. However, what Stainbrook recommends for a diet should not be considered a "diet".

"I tell family members that all family members should eat the same way I tell you," Stainbrook said. "It's not a diet. That's what everyone in America should eat. Fresh whole foods, fresh and frozen fruits, vegetables and meats – try to stay away from bags, cans and canned cans and keep the simplicity in terms of the number of ingredients contained in the product. It's a healthy diet for everyone. "

When it comes to sugar and carbohydrate management, Stainbrook has some simple rules. She tells patients that when they look at the labels, look at the total carbohydrates and not just the grams of sugar.

"If you avoid all carbohydrates, all you have left is protein and fat. It's not always good, "she said. "Do not forget that fruits and vegetables are good carbs because they contain a lot of fiber and nutrients. Carbohydrates turn into sugar. Therefore, if they eat too much carbohydrate, their sugar levels will be high despite medications or insulin. "

Similarly, eating too little carbohydrate can lower blood sugar levels. Consistency is therefore the key to carbohydrate intake.

Stainbrook said that we tend to eat what is fast and convenient. If you have a bag of cookies on the counter, you will eat them rather than taking the time to chop vegetables or peel carrots. One of his tips is to keep fresh, healthy snacks full and ready to eat. She tells patients that no food is forbidden, but that everything is about moderation.

"Obviously, cakes and ice cream are not good, but it's about portion size," she said.

Another tip: it warns you not to drink carbohydrates in your sodas and sugary drinks, which can lead to a rapid increase in blood sugar and not add nutrition. Artificial sweeteners are better than regular sugar for diabetics, but the consumption of sugary drinks can also make them dream even more.

Stainbrook said the Diabetes Education Program offers individual and group education and includes a diabetes prevention course.

"The program is designed for people who have an immediate family member and this increases their risk," she added. "It's a weight loss program, but also for people who have a family history of the disease or other diabetes indicators."

The WHS Prevention Class meets weekly for 16 weeks, then moves to monthly meetings and aims to help prevent diabetes.

"If you can prevent an illness rather than treat it, you will save money and reduce your health," said Stainbrook.

His best advice to patients is not to feel helpless or hopeless. There are many resources available to help you manage your diabetes and many people willing and able to help with medical advice as well as manage the emotional aspect of the disease.

Stainbrook said, "Last week, a woman told me that she had diabetes for 30 years. She added, "You are the first person to have given me the hope that I can do it myself and make things better.