The American Diabetes Association leads the fight against the deadly consequences of diabetes and advocates for those affected by diabetes. They fund research to prevent, cure, and manage diabetes, deliver services to hundreds of communities, and provide objective and credible information.

Introduction 1

About This Book 1

Foolish Assumptions 2

Icons Used in This Book 3

Beyond the Book 3

Where to Go from Here 4

Part 1: Getting Started with Diabetes 5

Chapter 1: Type 2 Diabetes: The Basics 7

What Exactly Is Diabetes? 7

Getting the lowdown on blood glucose 8

The mighty hormone insulin 8

Don’t forget glucagon 10

High blood glucose is not good 10

Paying attention to blood pressure 11

Different Types of Diabetes 11

Type 1 diabetes 12

Gestational diabetes 12

Other types of diabetes 13

Prediabetes 13

How Is Diabetes Diagnosed? 14

Understanding Risk Factors 15

Who Else Has Diabetes? 16

Chapter 2: Where Do I Begin? 17

Taking Care of Yourself 17

Feel better most days 18

Reduce the risk of complications 18

Healthy pregnancy, healthy baby 20

Managing Your Diabetes 20

Assembling a healthcare team 21

Taking medications 21

Checking blood glucose 21

Eating healthy and staying active 22

Finding support 22

Part 2: Your Healthcare Team and Medications 23

Chapter 3: Putting Together Your Healthcare Team 25

Starting with a Diabetes Care Provider 26

Choosing the right provider for you 27

Considering insurance coverage 28

Adding a Certified Diabetes Educator 29

Seeing Other Specialists 30

Dietitian: Helping you mind your meals 30

Ophthalmologist or optometrist: Keeping an eye on your eyes 31

Pharmacist: Filling you in on medication details 32

Dentist and dental hygienist: Keeping your mouth in tip-top shape 33

Exercise physiologist: Focusing on your fitness 33

Podiatrist: Standing up for your feet 34

Dermatologist: Helping your skin stay healthy 35

Mental health specialist: Minding your thoughts and emotions 35

Chapter 4: Your Checkups 37

What to Expect in a Checkup 37

Blood glucose roundup 38

Weight matters 39

Setting goals for food and exercise 39

Medication roundup 40

Targets for blood pressure and cholesterol 40

Kidney tests 41

Foot check 42

Vaccinations 42

Extra time for questions and concerns 43

Making Time for a Yearly Eye Exam 43

Your Checkup Schedule in a Nutshell 44

What to Bring with You 44

Communicating like a Pro 45

Chapter 5: Diabetes Education Classes 47

Getting Informed about Diabetes Education 48

When do I go? 48

Meeting the educator 49

Knowing What to Expect 50

Diabetes education at diagnosis 51

Keeping up with diabetes developments 52

Finding a class in your area 52

Investigating Insurance Coverage for the Cost of Classes 53

Chapter 6: Medications and Surgery 55

Why Do I Need to Take Medication? 56

Pills for Type 2 Diabetes 57

Biguanides 59

Sulfonylureas 59

Meglitinides 60

Dipeptidyl-peptidase 4 (DPP-4) inhibitors 60

Sodium-glucose cotransporter 2 (SGLT2) inhibitors 60

Alpha-glucosidase inhibitors 61

Thiazolidinediones (TZDs) 61

Bile acid sequestrants 62

Dopamine-2 agonists 62

Combination pills for type 2 diabetes 62

Injected Medications for Type 2 Diabetes (Besides Insulin) 63

GLP-1 agonists 64

Amylin analogs 64

All About Insulin 65

Insulin 101 65

Types of insulin 66

Buying and storing insulin 69

Injecting insulin: Syringes, pens, and more 69

Tips for injecting insulin 71

Insulin pumps 72

Being Cautious with Other Medications 74

Medication to lower blood pressure 74

Medication to treat cholesterol 75

Aspirin and other medications 75

Surgery for Type 2 Diabetes 76

Part 3: Checking Blood Glucose and Reducing Complications 79

Chapter 7: Checking Your Blood Glucose 81

Why, When, and How to Check Your Blood Glucose Level 82

Knowing when to check your glucose level 82

Checking your blood glucose in a snap 83

Eyeing your blood glucose targets 83

Blood Glucose Meters and Accessories 84

Checking out types of meters 84

Being aware of meter accuracy 85

Considering a multitude of meter features 86

Minding money matters 87

Looking at lancets and test strips 88

Keeping Track of Data 89

Choosing a tracking method that works for you 89

Putting the numbers to use 90

Chapter 8: Keeping Complications in Check 91

Looking Out for Lows 92

Knowing the warning signs of lows 92

Treating lows with the Rule of 15 93

Having glucagon available 95

Heading Off Highs 95

Diabetic ketoacidosis 96

Hyperosmolar hyperglycemic syndrome 97

Maintaining a Healthy Heart and Brain 98

Hardening of your arteries 98

Heart attacks 99

Strokes 99

Feeling Good in Your Skin 100

Keeping Your Mouth in Tip-Top Shape 101

Focusing on Your Eyes 101

Putting Your Best Foot Forward 103

Getting a leg up on caring for your lower extremities 103

Peripheral artery disease 104

Healthy Nerves All Over Your Body 105

Nerves that sense things 105

Nerves that automatically do things 106

Taking Care of Your Kidneys 106

Coping with Burnout, Stress, and Depression 107

Acknowledging diabetes burnout and stress 107

Recognizing depression 108

Being mindful of your emotions 108

Tuning In to Your Sexual Health 109

Chapter 9: Women and Type 2 Diabetes 111

Being Mindful of Menstrual Cycles 112

Watching for erratic numbers 112

Taking back control 112

Healthy Mom, Healthy Baby 113

Planning for pregnancy 114

Taking care of yourself and your baby during pregnancy 114

Screening for gestational diabetes 116

Delivering the baby 117

Postpartum 117

Breastfeeding 118

Menopause Can Throw You for a Loop 118

Preparing for unusual numbers 119

Recognizing that mood swings are normal 119

Facing hot flashes and night sweats 120

Coping with yeast infections 120

Addressing sexual discomfort 121

What Every Woman with Diabetes Should Know 121

Focus on your heart 122

Know the signs 122

Chapter 10: Men and Type 2 Diabetes 123

Addressing Erectile Dysfunction 124

Considering the causes 124

Treating erectile dysfunction 125

Don’t be embarrassed: Talking to your doctor 125

Tackling the Problem of Low Testosterone 126

Focusing on Emotional and Sexual Health 126

Paying Attention to Heart Health 127

Part 4: Eating Healthy and Staying Active 129

Chapter 11: Brushing Up on Nutrition and Food Basics 131

Knowing the Difference a Dietitian Can Make 132

What to look for in a dietitian 132

What dietitians do 133

When to see a dietitian 134

Paying for dietitian visits 135

Calories Count 135

Nutrients: Carbohydrates, Protein, and Fat 136

Carbohydrates 101 137

Types of carbohydrates 138

The lowdown on sugar 141

Artificial sweeteners 142

Proteins 101 143

Fats 101 144

Choosing healthy fats 144

Avoiding unhealthy fats 145

Finding Nutrition Facts on Food Labels 147

Paying attention to number of servings and serving size 147

Keeping track of calories 148

Nutrients up next 148

Listing ingredients: Most to least 150

Putting the information to work 150

A Little Salt Goes a Long Way 151

Satisfying Your Thirst 152

Drinking water, soda, and other beverages 152

Enjoying wine, beer, and spirits 153

Chapter 12: Planning Healthy Meals 155

Considering Your Goals 156

Eating a Variety of Wholesome, Nutritious Foods 157

Forget about a diabetes diet 157

Expanding the selection of foods you eat 157

Dishing Up Ideal Portions 159

Knowing what counts as one serving 160

Weighing and measuring food 160

Knowing how to create your plate 161

Meal Plans That Work for You 162

Forget about a diabetes meal plan 163

Turning to a dietitian for help 163

Coming up with your own meal plan 164

Intro to Carbohydrate Counting 167

Calling out carbohydrates 167

Portion matters 168

Reading food labels for carbohydrates 168

Planning, Shopping, and Cooking Smart 170

Planning smart 170

Shopping smart 171

Cooking smart 172

Tempting Your Taste Buds with Nutritious Nibbles 172

Eating Out with Confidence 174

Selecting restaurants with healthy choices 174

Ordering meals that mesh with your plan 175

Celebrating Holidays and Special Occasions 176

Chapter 13: Amping Up Your Exercise 177

1, 2, 3: Counting the Many Benefits of Exercise 178

First Steps to Physical Activity 179

Sitting less and moving more 180

Talking to your healthcare provider 181

Checking blood glucose during exercise 181

Thinking about your fitness goals 181

Considering Different Types of Exercise 182

Aerobic exercise: Getting the blood moving 183

Resistance exercise: Building strength 183

Flexibility and balance exercises: Improving range of motion 185

Completing a Well-Rounded Workout: Warm Up, Work Out, Cool Down 185

Warming up 186

Working out 186

Cooling down 187

Motivators to Keep You Going 187

Envisioning the health benefits 187

Getting help from a professional 188

Boosting your mood 188

Getting support from friends and family 189

Getting detailed feedback from fitness trackers and apps 189

Part 5: Finding Support 191

Chapter 14: Managing Your Emotions and Mental Health 193

Getting in Touch with How You Feel 194

Facing Feelings of Anger and Denial 195

Acknowledging feelings of anger 195

Dealing with feelings of denial 196

Managing Stress 196

Recognizing Diabetes Distress and Burnout 198

Looking at Depression and Anxiety Disorders 199

Knowing the symptoms of depression 200

Introduction to anxiety disorders 200

Treating depression and other mental health disorders 201

Reaching Out to Others 201

Joining a local support group 201

Connecting with others in online support groups 202

Being Kind to Yourself 202

Gaining education and empowerment 203

Taking time for yourself 203

Trying mindfulness and meditation 203

Chapter 15: Getting Support, Giving Support 205

Turning to Your Family for Support 206

Telling your friends and family about your diagnosis 206

Educating your family 206

Opening the lines of communication 207

Making healthy food choices together 208

Exercising together 209

Tips for Caregivers and Spouses 209

Educating yourself 209

Trying not to be pesky 210

Helping to build a diabetes care team 210

Seeking out your own support 211

Chapter 16: Raising Children and Teens with Type 2 Diabetes 213

Seeing How Type 2 Diabetes Is Different in Children and Teens 214

Helping Your Child or Teen Manage Her Condition 215

First steps 215

Family changes 216

Education and responsibility 217

Checkups 218

Acknowledging Challenges that Teens Face 218

Stress 219

Alcohol and tobacco 219

Sexual activity 220

Chapter 17: Debunking Diabetes Myths 221

Myth 1: Eating Too Much Sugar Causes Diabetes 222

Myth 2: People with Diabetes Can’t Eat Sweets and Chocolate 222

Myth 3: People with Diabetes Should Eat Special Diabetic Foods 223

Myth 4: People with Diabetes Are More Likely to Get a Cold or the Flu 224

Myth 5: You’ve Failed If Your Doctor Says You Need to Start Taking Insulin 225

Myth 6: Diabetes Is Not That Serious of a Disease 226

Part 6: Standing Up for Yourself 227

Chapter 18: Navigating Health Insurance and Other Healthcare Scenarios 229

Protecting People with Diabetes 230

Understanding Health Insurance: Employer, Government, and Individual 231

Employer-based health insurance 231

Government-based health insurance 231

Individual health insurance 234

Asking the Right Questions 234

Questions to ask about diabetes coverage 235

General questions to ask about plans 235

Finding Help for People Who Don’t Have Insurance 236

Primary and specialty care for the uninsured 236

Prescriptions for the uninsured 236

Diabetes supplies for the uninsured 237

Anticipating Other Healthcare Scenarios 237

ER visits and hospital stays 237

Home healthcare and long-term care 239

Chapter 19: Knowing Your Rights 241

Diabetes in the Workplace 242

Deciding whether to tell others 242

Knowing your rights 242

What are my protections? 243

Educating and communicating with others 244

Staying healthy on the job 244

Your Child with Diabetes at School 245

Knowing and advocating for your child’s rights 245

Putting care plans in writing 246

Planning Ahead for Travel 247

Talking to your physician 247

Preparing for airport security 247

Considering snacks and meals out 248

Taking care of your feet and skin 248

Ensuring Safety while Driving 249

Part 7: The Part of Tens 251

Chapter 20: Ten Fun Ways to Work Out for People Who Hate to Exercise 253

Get a Buddy 254

Play like a Kid 254

Start Walking 255

There’s an App (or Video) for That 255

Turn Up the Volume 256

Think Positive 256

Volunteer to Help Someone Else 257

Sign Up for a Walk to Raise Money 257

Set Realistic and Practical Goals 257

Just Dance 258

Chapter 21: Ten (Or So) Things to Do for Your Eyes 259

Keep Your Blood Glucose in Control 259

Lower Your Blood Pressure and Cholesterol 260

Stop Smoking or Never Start 261

Be Aware of Major Eye Diseases 261

Get Regular Dilated Eye Exams 262

Get the Treatment You Need 263

Consider Your Eyes during Pregnancy 263

Assess Your Risk Factors 264

Glossary 265

Index 291

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