5 Tips for Dealing With Diabetes Complications
Being diagnosed with a diabetes-related condition doesn’t have to be tricky
1. Plan for Treatment
So you’ve been diagnosed with a diabetes-related complication. Your next step is determining who will handle your care. Many complications can be managed by an endocrinologist. These doctors are familiar with diabetes’ complexity and how it might progress or trigger other conditions. For some complications, however, you’ll need to see a specialist who has training in treating the specific condition. Retinopathy requires an ophthalmologist’s care. Late-stage kidney disease should be managed by a nephrologist.
Even if you don’t need to see a specialist right away, you might want to: A specialist can dedicate entire appointments to this single aspect of your health, unlike a primary care doctor, whose attention will be divided among other issues, such as yearly exams or the flu. A specialist can also set a baseline for your condition. “If you go as soon as you’re diagnosed, they’re [eventually] going to be able to say, ‘It’s been five years and it’s not so bad,’ or ‘It’s been five months and it’s progressed quite a bit,’ ” says Sandra Arevalo, MPH, RDN, CDE, coordinator of diabetes management programs at Community Pediatrics, a program of Montefiore Hospital in the Bronx, New York. Your primary care provider can make a referral. Or call the number on the back of your insurance card to find someone in network. Once you’ve secured a specialist, be sure your providers share their records of your care with one another. Be your best advocate and bring records and notes from other providers to each appointment.
2. Manage Blood Glucose
Having a high A1C for a long time can cause complications or make them worse. And some conditions, such as kidney disease or gastroparesis, can make blood glucose higher or less predictable. Pain can cause an increase in blood glucose, too: “Cortisol and adrenaline [prompted by pain] will directly increase your blood glucose levels,” says Elizabeth Halprin, MD, clinical director of adult diabetes at the Joslin Diabetes Center in Boston.
Pain also has an indirect effect. “If the pain interferes with your ability to be active or causes you to stress eat, then your glucose levels will increase for that reason,” Halprin says. Keeping your blood glucose within recommended levels can prevent or slow the progress of complications (retinopathy, nephropathy, and neuropathy), and, in some cases, neuropathy may improve. An endocrinologist or certified diabetes educator can help you make a plan to treat your diabetes. But if you’ve had a high A1C for a long time, gain control slowly with help from your diabetes care team. Going too quickly can make retinopathy and pain from neuropathy worse.
3. Find Help When You Need It
Some complications may come on without interfering with your day-to-day life. Others may progress slowly, changing your life little by little. And others may mean you suddenly can’t do things like you used to. But there are workarounds. For tasks related to medication dosing, blood glucose monitoring, and insulin injections, seek out tools that can help you manage with vision impairment or dexterity issues. (Check out our list of injection aids.) A family member, friend, or home health aide can step in to help sort medication into pill boxes, check your blood glucose, or give injections.
If you can’t do your job because of your health issues, you may qualify for disability benefits. Talk to your human resources representative about your disability insurance, as coverage varies among employers. Disability is reviewed every two to five years. Learn more at disability.gov. You can get information on diabetes and disability from the American Diabetes Association at 1-800-DIABETES (800-342-2383).
4. Feel Your Feelings
Changes in your health can be stressful and can trigger depression. Your health care providers can offer solutions or refer you to a mental health professional. Support groups, both in person and online, can also provide encouragement, give you role models for how to live with changes to your health, and help you feel less alone. “Because diabetes can impact all aspects of one’s life, such support and guidance is very important,” says Martha Elks, MD, PhD, senior associate dean of educational affairs and professor at Morehouse School of Medicine.
5. Exercise Regularly
If you’ve developed neuropathy, retinopathy, or kidney disease, your workouts may change. But keep moving! It’s important for blood glucose regulation. If you’re working with an injury, such as a wound on your foot, a physical therapist can help you rebuild strength. If you’re learning to live with a new complication, seek an exercise physiologist. Both are trained to work with people with diabetes and are covered by insurance if you can demonstrate need. “Physical therapists focus on rehab, whereas [exercise physiologists] focus on full exercise plans,” says Halprin. “We are trained to provide safe exercise prescriptions based on a patient’s medical history.” Most personal trainers are not trained in chronic diseases, so if you want to see a personal trainer, Halprin recommends first getting a plan from an exercise physiologist and having a personal trainer walk you through those moves safely.
If you’re working out on your own, chair exercises are safe, effective, and fun for those with neuropathy, vision impairment, and kidney disease. (Here's an easy routine.) Other options: swimming, water aerobics, or walking in a pool. Regardless of the type of physical activity you choose, talk to your health care team first. Some exercises might be inadvisable for certain conditions, such as advanced retinopathy.