Keep calm and learn to deal with it

So you just found out that you have diabetes and you’re freaking out! Insulin pumps? Needle sticks? Blood glucose levels? Fruit or candy? What do you do?

Educate yourself!

Diabetes can be a complicated and even deadly disease, but stay calm and do what the diabetes educator at St. Luke’s Hospital tells you do. That is what Polk County resident Kim Baker-Hudgins is doing, and she’s doing okay.

“Diabetes is one of the most treatable diseases we face,” she said. “If you think you might have it, talk to your doctor and get tested. If you do have it, go to St. Luke’s diabetic education program and follow through with the lifestyle changes needed to live a long and healthy life.”

The 55-year-old wife, mother of two adult children, and certified public accountant had known for years that she was at risk. Diabetes runs in her family: her father had diabetes and so did many other blood relatives. Actually, she had been diagnosed as “pre-diabetic,” but she did not do anything about it until it was too late. In October 2016, Baker-Hudgins found out she had Adult-Onset Type 2 Diabetes.

“I didn’t freak out in the normal sense of the word. I freaked into action,” she said. “I had been talking about doing something about the pre-diabetic condition. Now, I was forced to do something because I was a full-blown diabetic.”

Baker-Hudgins said that on a scale of 1 to 10 measuring her stress levels when she found out, she gives herself a nine. Baker-Hudgins is hardly alone. Current professional literature identifies a common psychological issue facing people with diabetes, namely ‘diabetes distress.’

Diabetes distress is described as ‘significant negative emotional reactions to the diagnosis of diabetes, threat of complications, self-management demands, unresponsive providers, and/or unsupportive interpersonal relationships.

It’s a legitimately recognized anxiety, according to St. Luke’s certified diabetes  educator and registered nurse, Melissa Melum. She quoted from the article Depression in Diabetes: Have We Been Missing Something Important? which was published in Diabetes Care in January 2011.

“A key intervention for someone experiencing diabetes distress is diabetes self-management education,” Melum continued. “A self-management program helps the individual to better understand the disease and treatment options, and to formulate their own plans for addressing their specific needs in consultation with the educator.”

Melum stressed that detailed communication between the educator and the referring medical provider is an important component, with ultimate decision-making about medications and other medical decisions taking place between the patient and that provider. Empowering people through knowledge, planning and education helps Melum’s patients.

“Ongoing self-management helps the person to sustain positive changes and continue to make improvements in a knowledgeable and supportive environment,” Melum said, and she refers patients who completed her program to another program that includes additional support for diet and meal planning.

“This collaboration centers around diet and meal planning with Jimmi Buell, family and consumer science agent with the Polk County Extension Service, Nancy Chapman, RD, LDN, St. Luke’s Hospital dietitian and me,” she explained.

Melum came to St. Luke’s Hospital almost five years ago from Maryland to work on “optimizing inpatient diabetes management per current standards,” she explained. “I started an outpatient Diabetes Self-Management Education (DSME) program at Polk Wellness Center in collaboration with St. Luke’s Hospital. In January 2016, after the closing of Polk Wellness Center, the program moved to St. Luke’s Hospital.”

Melum’s DSME program, accredited by the National Association of Diabetes Educators, is a comprehensive, highly individualized program that includes informal discussion-based classes followed by one-on-one meetings with Melum in which they review blood glucose logs and set patient-centered goals.

“St. Luke’s diabetic education program and diabetic educator, Melissa, were the most important part of my treatment,” Baker-Hudgins said. “She helped me go from knowing about to understanding diabetes management. The program was thorough and compact; and, it helped hold me accountable with one-on-one sessions with Melissa. I started monitoring my blood sugar, charting my meals, and losing weight through the Diabetes Education program at St. Luke’s Hospital.”

By taking responsibility and action, Baker-Hudgins has lost 25 pounds and is working to lose another 10. “I am on a low-dose of Metformin and monitoring my blood sugar and intake. And, I am trying to lower my stress and increase my exercise. Basically, I am following the St. Luke’s diabetes education program. The program helped me know how to properly channel my energies into actions to overcome the freaking out.”

Other patients who have worked with Melum have made it clear through feedback that they really appreciate and feel better because of the help they get from the program.

According to Melum, “Diabetes is a very complex illness, both physiologically and psychologically. First of all, there are multiple specific forms of diabetes, the most common being Type 2. Type 2 diabetes is a metabolic illness caused by issues with the very complex biological processes involving the use of nutrients, particularly glucose, by the body. It is really a continuum of illness, so the specific issues and needs vary from person to person.”

About 30 million Americans or 9.4 percent of the population have Type 2 diabetes, causing about 70,000 deaths annually, according the American Diabetes Association. And counties in the southern and Appalachian regions of the United States (the South) tend to have the highest prevalence of diagnosed diabetes, according to National Center for Chronic Disease’s 2017 National Diabetes Statistics Report.

In North Carolina, one out of three people may be pre-diabetic with a likelihood of 15 to 30 percent developing Type 2 diabetes within five years. Polk County residents are in the group of second-most-diabetes-prevalent-counties category in North Carolina with 13.1 to 14.5 percent of the population at risk.

“Very often, a diagnosis of diabetes is a positive wake-up call for an overall healthier lifestyle which will significantly decrease risk for a host of serious illnesses down the road,” Melum said. “Diabetes is associated with higher risk for cardiovascular disease, neurological disease and other issues — but those risks can be greatly controlled with changes in diet, exercise and adequate sleep, as well as medication. There are no hard and fast rules for what people with diabetes can eat and what kind of exercise they get. Those are individualized decisions based on each person’s baseline condition and specific needs.”

With her specific plan to manage diabetes, Baker-Hudgins advises, “Have your A1C level checked. If you are pre-diabetic, seek diabetes education. I wish I had known about St. Luke’s program while I was still pre-diabetic. (St. Luke’s Hospital and the Foothills Health Network sponsor a prediabetes program for people at risk. This program, too, offers information, encouragement, exercise and support. The goal of this class is to lower A1C levels, lose weight and get regular exercise to prevent diabetes and the health problems that follow.)

A diagnosis of diabetes, Baker-Hudgins said, “has actually forced me to take action that I had been putting off and meaning to get around to, before I was diagnosed. I think if I had started their program before I crossed the line, I would never have become a diabetic.”

With education and knowledge and healthy lifestyle changes, that diagnosis of diabetes can be prevented. •