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My doctor says I have a little diabetes... now what?

Newly diagnosed with diabetes and unsure where to start?  Read on to learn about the steps you should take to control diabetes.

How did I get diabetes?

  • Genetics - If you have a close relative with diabetes your risk is increased.  Some ethnic groups such as Native Americans, Hispanics, and African Americans are at increased risk too.  
  • Lifestyle - Lifestyle or environmental factors that may lead to diabetes.  Foods consumed, activity level, and obesity are directly linked to type 2 diabetes.

What should I do now? (0-3 months)

How well you control diabetes is up to you.  You can choose to take steps to modify your lifestyle to control blood sugar and minimize complications.  It comes down to setting goals, organization, planning, and following through with your plan.  There are probably a few things your are wondering about... exercise, diet, testing blood sugar, medications, and specialists, to name a few.  

  • Start with speaking with your physician.  Learn about your medications, how often, and when you should take them.  Ask about an exercise program.  You will want to know how much exercise and how often your doctor recommends for you based on health concerns.  Ask your doctor about your blood pressure.  You will want to know if your blood pressure is high and the steps to lower it.  Ask to see a diabetes educator and a registered dietitian.
  • A diabetes educator can help you with when and how often you should be testing your blood sugar.  They can also help you to set blood sugar goals.  In the beginning, you may be asked to test blood sugar about 4 times per day including when you first wake up and are fasted, before meals, after meals, and prior to bedtime.  It is a good idea to keep a log of your blood sugar so that you can share these with your doctor.
  • A registered dietitian can help you design a meal plan based on your dietary needs.  A RD can also help you learn which foods will affect your blood sugar.

Now you have something to build upon.  Begin to implement your exercise program, meal plan, blood sugar testing, and take your medications regularly.

What's next? (3-6 months)

  • At your next doctor's visit, ask about having an A1c test.  An A1c test is a blood test that reveals how your blood sugar has been over the past few months.  This test can show high blood sugar you are not aware of as a result of blood sugar testing times.  
  • Look into attending a diabetes class.  These classes can help to learn more about meal plans (including carbohydrate counting), exercise programs, sick days, complications, and offer support from others that are newly diagnosed as well.
  • Begin to increase your duration of exercise.  For example, if you swim for 25 minutes each day, strive to swim for 30-40 minutes.  Set aside time everyday for physical activity.  In addition to the actual workout, factor in time for stretching, showering, etc.

And then? (6-9 months)

  • Again, at your doctor's visit, ask about another A1c test.  Assess the frequency of blood sugar testing - if you are well controlled, you may be able to decrease how often you test your blood sugar.  Ask about visiting an eye doctor for a diabetes eye exam and a foot doctor if needed.
  • Assess your dietary goals.  Are you eating enough fiber?  Are you limiting your fat intake?  Do you need to lose weight and if so should you re-evaluate your calorie intake?
  • Increase the duration of your exercise program.  Begin to increase the intensity of your exercise as well.  For example if you choose to walk for physical exercise, you might choose to increase your pace or walk on an incline to increase intensity.

Now what? (9-12 months)

Continue to monitor your blood sugar and meal plan.  Assess body weight and stick with your exercise plan.  You've taken control of your diabetes and you are on your way to a healthier lifestyle with decreased risk of complications because of it.

Is there a list of healthcare professionals I should consider seeing?

Below, we have compiled a list of professionals you will want to consider visiting to control your diabetes and prevent complications.

Physician - you probably already have a primary care physician, but you may want to see a specialist in diabetes.  This specialist can help you with management of diabetes including medications.   Look for a specialization in diabetes such as board certified in endocrinology.  This professional should have a medical degree indicated by MD or DO.  You will probably want to visit your physician every 6 months depending on your treatment.  Ask about having the following tests conducted:  HbA1c - every 6 months, HDL/cholesterol test (every year), and kidney microalbumin test (every year).
Dietitian - ask to see a dietitian to help you with your meal plan.  A dietitian should have the initials RD after their name indicating they are a registered dietitian.  Some dietitians are also Certified Diabetes Educators (CDE) as well.
Nurse educator - a nurse educator can help you with taking medications, blood sugar testing, and diabetes management.  Look for credentials including RN, BSN, or MSN.  Some nurse educators are Certified Diabetes Educators as well.
Eye doctor - this is a medical doctor specializing in ophthalmology.  This doctor can diagnose and treat eye complications associated with diabetes.  If you are over 30, you should have an eye exam upon diabetes diagnosis and every year thereafter.  If you are between 12 and 30 and have had diabetes for more than 5 years, you should have an eye exam yearly.
Pharmacist - a pharmacist can help you with medication and glucose testing questions.  Look for the credential of RPh or PharmD after their name. 
Podiatrist - this is a foot doctor and should have the credential DPM after their name.  A podiatrist can help treat and/or prevent any foot problems including calluses, ulcers, or sores.  You should probably have a doctor examine your feet once each year, more often if you have foot problems.

Diet and exercise are vital to maintaining health and treating diabetes.  Exercise regularly and follow a balanced meal plan as advised by your healthcare team.

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