Softening the blow of a diabetes diagnosis

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Help patients direct their energy into positive behaviors to manage their diabetes.

Softening the blow of a diabetes Dx
Softening the blow of a diabetes Dx

Receiving a diagnosis of type 2 diabetes can be devastating to patients. Some are so busy processing this unwelcome information that they have a difficult time focusing on what you, the clinician, are telling them. 

Yet in your short time with these individuals, you have to help them understand just how serious the disease is and what they need to do to remain as healthy as possible. 

Beyond teaching these new patients the basics regarding diabetes, including what causes the disease and its complications and what the various treatment options are, there are a few more ways to help them understand that they have the power to manage their diabetes well.


Stop patients from blaming themselves

Persons with type 2 diabetes who blame themselves for developing the disease are less likely to manage their diabetes well, according to a study published in the American Journal of Health Behavior (2011;35[2]:209-218). 

While stress, lack of activity, weight gain, and other specific factors can trigger diabetes, the disease also can be caused by other factors that are out of the person's control, including a family history of diabetes. It is important to help patients direct their energy into positive, self-empowering behaviors that address what they can do to manage their diabetes and live a more healthful life.

Redirect fear and misconception

Patients may be understandably fearful about complications of diabetes. Let them know that they can take steps to reduce their risk for complications. Ask patients what they know about diabetes; this will help you correct any misperceptions.

Teach healthful eating patterns

A dietitian or a diabetes educator should work with persons who have a new diagnosis of diabetes to adjust their diets. Patients will not have to give up their favorite foods entirely, but they may need to eat these items less often and in smaller portions. Advise patients to follow a few basic strategies that will go a long way:

  • Avoid sugar-sweetened beverages. We often see a 100-mg/dL drop in the blood glucose levels of patients who follow this advice.

  • Drink plenty of water and no-calorie beverages.

  • Eat 3 meals per day, 4 to 5 hours apart.

  • Avoid fried foods; instead, try baked, grilled, or broiled items. 

  • Eat smaller portions. A serving of meat should be no bigger than the palm of the hand, and a serving of starch should be no bigger than a fist.

  • Fill half the plate with non-starchy vegetables, and limit the amount of fat added to them.


Encourage activity

Whatever their activity level, persons with a new diagnosis of diabetes should be encouraged to be more active, starting with making such small changes as parking the car at the far end of the lot if they are not very active. Make it clear that being active has big payoffs, including lowering glucose levels; strengthening the heart, bones, and muscles; and facilitating weight loss.

Reassure patients that they are not alone

An interdisciplinary diabetes care team, including physician assistants, nurse practitioners, nurses, physicians, and specialists such as diabetes educators, should work with each new patient to develop a healthy-living plan that is tailored to the specific needs of the given individual. 

Diabetes education, which is covered by most insurance programs, has been proven to help patients manage their weight and reduce their cholesterol levels and blood pressure (Diabetes Educator . 2009;35[5]:752-760, and 2011;37[5]:638-657).

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