Does your diabetes ever make you feel like you're going over the edge? If your diabetes feels out of control, it's time to call in a pro. There's absolutely no shame in saying “I need to get help for diabetes.” In fact, reaching out for help is the smart thing to do.
So many people feel ashamed of having type 2 diabetes, and they avoid getting the help they need. But diabetes is a chronic health condition just like any other, and there is no reason to feel like it's your fault. (Yes, I know…if you weighed less, and if you exercised more…but you are where you are right now.)
If you were diagnosed with arthritis or gallstones, you'd never blame yourself. There would be no guilt or shame. So, if you're still holding onto guilt or shame about diabetes, let that go, too, and let's move on to getting the help you need.
Find a primary healthcare provider you like and trust
Ninety percent of people with diabetes are managed by general physicians, including family medicine doctors, internists, nurse practitioners, and physician assistants. All of these types of healthcare providers are qualified to manage most cases of type 2 diabetes. If you don't have a primary healthcare provider that you like and trust, you need one.
Get help for prediabetes at a Diabetes Prevention Program
Diabetes Prevention Programs (DPPs) are year-long programs that use an approved set of lessons. DPPs are designed to help people exercise at least 150 minutes each week and lose at least five percent of their body weight. The reason DPP programs have these specific goals is that research has shown that those two things are enough to prevent people with prediabetes from moving into active diabetes. Diabetes Prevention Programs are available in-person and online. Medicare and private insurance will cover DPP services, and many health departments offer these programs at no charge.
Participate in a Diabetes Self-Management Education and Support Program
Diabetes Self-Management Education and Support (DSMES) is a ten-hour program designed to teach people with diabetes what they need to know to take care of themselves. The program touches on everything from carb counting to medications to stress management.
DSMES programs can be in-person or virtual, and they are structured differently at different sites. For example, one program might offer ten one-hour sessions for ten weeks in a row, and another program might offer one full-day ten-hour class on Saturdays. It's OK to find a program that fits your schedule, even if it's not local to you. (You may need to stay with a program inside of your state for insurance purposes.)
Medicare and private insurance cover DSMES. Medicare will pay for 10 hours of group DSMES the first year, and an additional 2 hours of individual DSMES every year thereafter with a healthcare provider's referral. Some health departments and Federally Qualified Health Centers provide DSMES services.
Get help for diabetes from a Registered Dietitian Nutritionist
If most of your diabetes questions are food-related, a Registered Dietitian Nutritionist (RDN) is your best bet. An RDN who is also a CDCES is even better (hint, hint, that's me!)
Medicare will cover three hours worth of visits with an RDN the first year that you're referred for diabetes, and two hours every year after that. Medicare will also cover an additional two hours any time you have a “change in status.” For example, if your A1c goes up from 7 to 9, that's a change in status that will qualify you for 2 additional hours with an RDN.
Many private insurance companies cover visits to an RDN, and some cover unlimited visits.
Health departments and Federally Qualified Health Centers employ RDNs and may have low or no-cost options.
See a Certified Diabetes Care and Education Specialist for help with diabetes
A Certified Diabetes Care and Education Specialist (CDCES) can be a Registered Dietitian Nutritionist, a pharmacist, a physician, a physical therapist, a physician's assistant, or a nurse. He or she must work in diabetes care for at least 1000 hours and then pass an examination that certifies him/her as competent to provide care for people with diabetes.
Getting help from an endocrinologist
Endocrinologists are physicians who specialize in diabetes as well as other problems, like thyroid disease. Most people with type 2 don't see an endocrinologist, but if you feel you've tried too many things and can't get your blood sugar under control, a trip to an endocrinologist may be in order. If you want to use an insulin pump, you will likely need to see an endocrinologist for that as well. Most endocrinologists require a referral from your primary healthcare provider.
The bottom line about how to get help for diabetes
Nobody else lives in your body, and nobody else knows how you feel. If you think you need more help than you have right now, you're absolutely right. Trust your instincts when it comes to your health. Reach out for the care you need, and don't stop until you feel satisfied. You deserve to feel good about your health.
Action Steps, Day 30:
- If you have prediabetes, consider a Diabetes Prevention Program. (I don't provide this service.)
- If you have active diabetes and you've never had Diabetes Self-Management Education, find a program here. (I provide this service in-person and virtually.)
- If you need an RDN or a CDCES, that's me! See this page for details about insurance coverage.
- If you're following the 30 Days to Tame Type 2 Diabetes series, today's physical activity goal is: walk at an easy pace for 35 minutes.
- Going forward, keep up with your walking program for at least 30 minutes every day. Now, give yourself a giant pat on the back. You made it all the way to the end, and I'm so proud of you!
This post is part of a series, Tame Type 2 Diabetes in 30 Days.
MPH, RDN, LDN, CDCES, IBCLC
I believe people with diabetes can enjoy good food and good health without feeling ashamed of their bodies.