How to Cope With a Diabetes Diagnosis

The numbers are staggering: More than 100 million U.S. adults are now living with diabetes or prediabetes, according to the Centers for Disease Control and Prevention. Diabetes is the seventh-leading cause of death in the U.S., and the rate of new diagnoses remains steady.

Living with diabetes requires a lot of work. It means visiting the doctor regularly, monitoring blood sugar levels daily, diligently taking medications, exercising regularly, and watching what you eat every day.

No doubt, a diabetes diagnosis can be a shock — both physically and emotionally. To explore how people can better cope with living with the disease, Health Matters spoke with Dr. Jason Baker, an endocrinologist at NewYork-Presbyterian/Weill Cornell Medical Center and an assistant professor of medicine at Weill Cornell Medicine, who has not only medical but also firsthand experience. When he was 24, Dr. Baker was diagnosed with type 1 diabetes.

Here, he provides the coping strategies that have worked best for his patients, as well as for himself.

What was the biggest adjustment for you when you were diagnosed?
I had to learn to be open about my diabetes and not view it as a weakness, but rather as a strength. I also learned how to build a healthier relationship with food. I made sure I struck a balance with what I was eating and wasn’t overly restrictive of carbohydrates.

What are some coping mechanisms you discuss with your patients who have been recently diagnosed?
First things first: Breathe. This is a shock that will pass.

Second: Go slowly. You don’t need to fix everything overnight.

Third: Think outside your comfort zone. You may need to incorporate foods that you thought you didn’t enjoy into your diet, exercise regularly, and learn to manage periods of stress or depression.

Coping with a new diagnosis will take some time, but with the right support network — both social, such as family, friends, and co-workers, and your medical team — you can sail through this.

What lifestyle changes can one expect to have to make after a diabetes diagnosis?
People will have to become more aware of the impact of the food they eat. They’ll also need to understand the importance of regular exercise, which can help lower blood glucose. Those with diabetes will need to be more physically active if they weren’t before, so taking some time to find a sport or exercise routine that works for you — and that you enjoy — is crucial.

How do stress and anxiety play a part in blood glucose levels?
Tremendously. Anxiety and depression are much more common in people who have diabetes. They also fuel higher blood glucose levels. Exercise, meditation, and being open to talking to a mental health professional are important ways to manage diabetes stress. Also, don’t be in the diabetes closet: Don’t spend your energy hiding diabetes. Instead, share your experience with others and use your energy to fight it.

What is the difference between type 1 and type 2 diabetes?
While there is a growing understanding that there is overlap in terms of symptoms and causes of type 1 and type 2 diabetes, in general we think of type 1 diabetes as resulting from the destruction of insulin-producing beta cells in the pancreas, which leaves a person dependent on insulin to control their blood sugar levels. Diet and exercise help to manage this, but they do not prevent it.

We think of type 2 diabetes as being a state of making insulin but not responding to it, often due to obesity or being overweight. Diet and exercise can both help treat as well as prevent, and in many cases reverse, type 2 diabetes. That said, many type 1 patients are overweight and display resistance to insulin just like type 2 patients.

Since both type 1 and type 2 diabetes have the potential to affect younger patients, what advice would you give to a child who’s just been diagnosed?

I’d stress to them that diabetes is now a part of who you are, and with proper care, you should never have problems or complications. Embrace it, and let it empower you. Don’t forget about it, as it never forgets you, and stay positive. We have many tools to fight the disease and many more are still to come. Your life should be just as long and healthy as before your diagnosis. Also, remember, those with diabetes are a community, which you are now a part of, so give back to it by helping others who may have fewer resources than you. By helping them join the fight against diabetes, you will also help yourself stay motivated to fight.

How can parents or caregivers provide support to a child who has diabetes?
I’d urge them to listen, and encourage them to participate in their management of the disease. At the right age — before college, usually around 16-17 years of age — start to transition them away from a pediatrician managing their diabetes to an endocrinologist who treats adults. This gets them ready to assume full self-care before they move out of their home and outside the daily support network of their parents. Also, encourage them to share their experience and have a social network of others with diabetes whom they can learn from and get support from.

What external resources are available?
There are many organizations that provide support, including the American Diabetes Association, International Diabetes Federation, American Association of Clinical Endocrinologists, JDRF, College Diabetes Network, and an online community called T1D Exchange Glu, just to name a few. NewYork-Presbyterian also provides diabetes support groups and educational opportunities for patients with both type 1 and type 2.

If someone thinks they may be prediabetic, how can they find out for sure?
If a person thinks they are prediabetic or they have a family history of diabetes, they should have a hemoglobin A1C test, which measures your average level of blood sugar over the past two to three months. Another option is to have an oral glucose tolerance test. Both can be done at your primary care doctor’s office.

Learn more about NewYork-Presbyterian’s diabetes care and services or schedule an appointment.

Dr. Jason Baker is an endocrinologist at NewYork-Presbyterian/Weill Cornell Medical Center and an assistant professor of medicine at Weill Cornell Medicine. He is involved in numerous global health diabetes projects and has founded the nonprofit organization Marjorie’s Fund, a type 1 diabetes global initiative dedicated to education, care, and research of type 1 diabetes in the developing world. Dr. Baker also serves as a contributing author to The Medical Letter and contributing editor to dLife.com.