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Five Big Diabetes Fears—and What to Do About Them


Jul 24, 2013

Diabetes often comes with its own special set of fears

It's human to be afraid. As cave people, we scurried for safety at the slightest provocation- scared of wolves, and tigers, and thunderstorms. Even today, we jump when someone comes up behind us unexpectedly.

A certain level of fear is healthy. It keeps us alert and aware of a threatening world. But too much fear, that's dangerous. It shuts us down. It keeps us isolated inside our own heads, unable to experience reality.

For people with diabetes, fear can be especially dangerous. Make no mistake, this disease is scary. Both type 1s and type 2s face an array of worrying side effects, both from the condition itself and from the ways we have to treat it.

But if we allow our fears to dictate the way we live, we're going to be missing out on a lot. Here are five big diabetes fears, and ways we can deal with each. We might not be able to make them go away, but at the very least we should be able to tame the suckers.

1.) Low Blood Sugars

Hypoglycemia is the worst. For anybody with diabetes on medication, it's a constant possibility, lurking in the back of your mind. Was that too much insulin? Was I too active outside? Will my blood sugar dip? And will I be able to tell before I start to shake and sweat and get confused?

I didn't used to fear low blood sugars. Frankly, as a kid, I saw them as an opportunity to eat some candy or drink a glass of juice. I was also lucky that my body sent very clear warning signals as my numbers dropped.

But as I've gotten older, I've learned to be way more cautious of hypoglycemia. For one thing, I experience it more often as tiredness, which can be easily confused for, well, tiredness. For another, I'm now a parent. My son depends on me being alert and aware at all times. Anything else is unacceptable.

Thankfully, preventing low blood sugars is simple. Make sure your diet, medication, and physical activity schedules line up. Ask your doctor or diabetes educator for advice. After all, prevention is by far the easiest treatment.

And for emergencies, make sure you always carry fast-acting glucose tablets or gel. Wearing a medical alert bracelet can be helpful, too. And always remember to check your blood sugar before you head out for a drive or lengthy stretch away from home.

2.) Microvascular Complications

Microvascular (or small blood vessel) complications are the bogeymen most often used to frighten people with diabetes. And they're effective! After all, no one wants to lose his or her sight, or deal with nerve pain, or kidney damage. That's the classic cluster of diabetes side effects, and they can make life miserable.

But as scary as they are, you shouldn't obsess about these kind of complications. As scary as they are, treating them as potential monsters is counterproductive.

That's because modern diabetes treatment has evolved to both prevent and treat them. Tight control-that is, multiple injections or pump therapy, and multiple daily blood sugar checks- has been proven time and again to prevent, slow, or even reverse complications. And tight control is what nearly every type 1 these days is trained to do. Type 2s are also being urged to tighten their control, with similar effects.

What's more, if you see your health care providers regularly, you will be screened routinely for these complications. If detected early, nearly all of them have effective treatments. So don't be afraid. Just be smart.

3.) Macrovascular Complications

Both type 1s and type 2s are at increased risk for microvascular complications-heart attacks, strokes, and other cardiovascular diseases. At their worst they pose real risks to people with diabetes. But few of them are outright fatal, making this health concern an area where context is important. Macrovascular complications are a major problem in our society as a whole. Heart disease is our nation's leading killer of both men and women, according to the Centers for Disease Control and Prevention. So they are literally everyone's problem, not just diabetics'.

And this is also an area where research continues at a fast and furious pace, and where past research has yielded incredible rewards. Drugs such as statins can lower patients' cholesterol quickly and effectively, and reduce the risk of heart attacks. An array of cheap medicines can lower blood pressure with few side effects.

There are dozens upon dozens of good books and reliable websites with information about keeping your heart healthy. Use them. Get some exercise. Eat right. And then move onto the next worry ...

4.) Food Changes

For those newly diagnosed with diabetes, this fear looms large. This diagnosis means I'll have to totally change the way I eat, right? This disease is going to snatch away all of my favorite snacks and replace them with rice cakes and carob, right?

Calm down. Believe it or not, your diet will change as much or as little as you want it to. No one will take away any of your favorite foods. But you will be responsible for learning about them. You'll need to know how to read food labels. And you'll need to know how to adjust your insulin or other diabetes medication to cover what you eat.

Will you be better off if you cut out the fast food and sugary snacks? Of course. But it's pointless, ultimately, to forbid any particular food. Putting something off-limits is a surefire way to make it seem incredibly tempting. You should instead focus on eating more healthy things, and fewer unhealthy things. All of life is a balance, and what you eat is no different.

Again, use your doctor or diabetes educator as an ally and sounding board in this process. They're not interested in forbidding foods, or in making your life difficult. They just want to come up with a plan that you can follow.

5.) Medication Issues

Will I have to take shots? Will I have to take some sort of pill?

Nothing brings out people's irrational worries like medication. They might be suffering from pain and dizzy spells, bleeding out of their eyes and nose, and suffering from a full-body rash, but many people will refuse to take a pill. That means they're sick. That means they lose their imagined control of their body.

Well, get over it. We're talking about your health here, and denial doesn't do you or your loved ones any good. If you have type 1 diabetes, you will have to take insulin and check your blood sugar. You may also have to take medication to lower blood pressure or cholesterol. If you have type 2 diabetes, you'll probably start with oral medications, but you may eventually have to take insulin injections.

None of these treatments means that you've failed or make you a bad person or mean you have something to fear. They are actually good things, meant to keep you healthy and active. Embrace them for the lifesavers they are.

Wrapping It Up

Make no mistake. Diabetes is serious, and you must treat it with the respect it deserves. But you can't manage it well, or make good decisions, if you're living in a state of constant fear. That fear will warp your worldview and sap your strength.

Instead, take a deep breath and take stock. Listen to your health care providers, and do some reading and research on your own. Make the decisions that you need to make. Make the choices that you know are right.

Not satisfied with these five fears and our attempts to defuse them? Stay tuned for an upcoming Diabetes Health feature on five more fears that people with diabetes face.


Categories: Fear, Food, Hypoglycemia, Low Blood Sugars, Macrovascular Complications, Microvascular Complications, Tight Control



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