Dana Stainbrook is used to meeting people who feel overwhelmed.
"There is a lot of denial in diabetes … minimizing it and thinking that it really is not a problem," said Stainbrook, nurse and diabetes educator at Washington Health System.
However, Stainbrook's work with patients under the Diabetes Education & Management program helps people who have both been newly diagnosed and have been suffering from diabetes for decades.
Most diabetes cases in the United States are type 2, which means that patients have insulin resistance but their body can produce insulin. Stainbrook's first mission is to focus on a healthy lifestyle and to tell them that they are in the driver's seat when dealing with diabetes.
"Lifestyle, healthy eating and exercise will always help blood sugar management," she said. "I always try to tell them that they are in the driver's seat, because that's what they do every day, what makes the difference in the world with their results."
The problem, she said, is that type 2 diabetes is a progressive disease. In diagnosing a person, they have lost about 50 percent of their beta cells. These are the cells in the pancreas that make insulin.
"They will lose about five percent more each year, so the body's ability to produce insulin will gradually decline," Stainbrook said. "So what works today will not work in five years, and it's not uncommon for them to need extra oral medications and eventually insulin over time."
The first information that Stainbrook gives new diabetes patients is the importance of healthy eating and increasing physical activity.
"That can be a 10-minute walk after a meal or a 30-minute walk every day," she said. "You do not have to spend money on a gym membership. The best exercise is the one that you enjoy, and if you hate every exercise, I tell them that they will find the one that bumps them the least. You have to treat movement like a drug. "
Something as simple as parking at the other end of the parking lot or walking in the business, kicking instead of the elevator and increasing the total number of steps during the day can make a noticeable difference in reducing insulin resistance and glycemic control, Stainbrook said.
As soon as patients get moving they need to focus on their diets. However, what Stainbrook recommends for a nutritional plan should not be considered a "diet."
"I tell people that everyone in the family should eat like I tell you," Stainbrook said. "It's not a diet. It's the way everyone in America should eat. Fresh whole foods, fresh and frozen fruits, vegetables and meat – try to keep away the bags, boxes and cans, and keep the number of ingredients in the product simple. That's just healthy eating for everyone. "
Regarding sugar and carbohydrates, Stainbrook has some simple rules. She tells patients that when looking at labels, they look at total carbohydrates and not just grams of sugar.
"If you avoid all carbohydrates, all that remains is protein and fat. That's not always good, "she said. "Remember that fruits and vegetables are good carbohydrates because they are high in fiber and nutrients. Carbohydrates become sugar. If they consume too many carbohydrates, their sugar will be too high despite medication or insulin. "
Similarly, consuming too few carbohydrates can lower blood sugar levels too much. Therefore, consistency is the key to carbohydrate intake.
Stainbrook said we tend to eat what is quick and convenient. If you have a bag of cookies on the counter, eat them instead of taking the time to chop vegetables or peel carrots. Her tips include preparing fresh, healthy snacks in abundance. She tells patients that no food is banned, but it's all about moderation.
"Of course, cake and ice cream are not good, but the portion size is enough," she said.
One more tip: It warns you to drink your carbohydrates in lemonade and sweetened drinks that can quickly shoot up blood sugar and not add nutrients. Artificial sweeteners are better for diabetics than regular sugar, but sweet drinks can also make you crave more.
Stainbrook said the diabetes education program offers individual and group education and includes a diabetes prevention class.
"The program is aimed at people who have an immediate family member, and that increases their risk," she adds. "It is a weight loss program, but also for people with a family history or other diabetes indicators."
The WHS prevention course meets weekly for 16 weeks, then switches to monthly meetings to help prevent diabetes.
"If you can prevent illness rather than treat it, you save money and health," said Stainbrook.
Your best advice for patients is that you do not feel helpless or hopeless. There are many resources that can help you deal with diabetes, and there are many people who are ready and able to help with medical advice and with the emotional aspect of the disease.
Stainbrook said, "I heard from a lady last week that she has been suffering from diabetes for 30 years, and she said, 'You're the first person to give me the hope that I can do it on my own and I can do it things better.