A Type 2 diabetes diagnosis does not mean ‘game over’

Gina DiPietro 0:00
Welcome to Novant Health Healthy Headlines. I'm Gina DiPietro. More than 34 million Americans have diabetes, and about 90% of them have type 2 diabetes. In this episode, Roland Wilkerson speaks with Dr. Cathy Rolih, a clinical physician executive for the Novant Health Diabetes Center of Excellence, about a patient’s path forward after a doctor has told them about their diagnosis. And there’s good news - unlike a lot of diseases, the patient is in the driver’s seat.

Dr. Cathy Rolih 0:01
I think the first thing to do is to take a deep breath. Diabetes is an incredibly prevalent problem. Probably all of us know someone who has type two diabetes, either a parent or a sibling, or a spouse or a friend. And we've heard about all the negative outcomes that can happen related to diabetes. And therefore, many people come into the discussion with a high degree of fear and concern. And I have had patients break down in tears in my office, when I tell them that they have diabetes, because they have internalized all the negative messages in the world around them about diabetes. So first thing to do is take a deeper, second thing to do is to learn as much as you can, and educate yourself information from a reliable source. So don't go to Dr. Google and search diabetes, what do I do go to a source of reliable information. And the two places that I tell my patients to go to is the American Diabetes Association for both type one and type two diabetes, and to the jdrf. For patients with type one diabetes, those are national organizations, which really collect evidence based information, and authoritative and well founded recommendations for patients. So the American Diabetes Association website is diabetes.org. And the jdrf website is jdrf.org. So those are good places to start.

Roland Wilkerson 1:40
So we all Google everything. What's wrong with googling type two diabetes, when you've gotten some really sad and surprising news,

Dr. Cathy Rolih 1:49
probably googling type two diabetes is the same problem as googling anything, you don't know what you're going to get. Right. You know, just because it's on the internet doesn't mean it's true. And for people who are looking for information in a heightened state of concern, and high emotional state, they may not have as much ability to filter and critically evaluate the information that they're receiving. So that becomes important anytime, really, that you have a new health diagnosis is go to the most authoritative source. And your health care provider can also direct you to sources. So ask them where should I go to find more information, that's a good thing. Another place to find good information is to be from a diabetes education program. So people with type two diabetes in particular, who are newly diagnosed, should make sure that they're referred to a certified diabetes educator, and most communities, we can have places for people to receive that information.

Roland Wilkerson 2:53
We talked about the best thing to do when you've gotten a diagnosis, what's the worst thing you can do besides looking for information and all the wrong places?

Dr. Cathy Rolih 3:01
I think the worst thing to do is to panic and take on a fatalistic attitude. I have interacted with a lot of patients who have had family members with diabetes who have had bad health outcomes, and who's feeling has been when they found out that they were diabetic as well, that doesn't matter. Doesn't matter what I do, this was inevitable. My mother had a heart attack and stroke and my father developed kidney failure. So it's inevitable that that will happen to me too, and they just kind of threw in the towel from the beginning. That's the worst thing that you can do. So there are things as an individual with diabetes that you can do to improve your health. Those include learning as much as you can, about the disease process, working on increasing your physical activity. If even if you're not an athlete, or a jock, any kind of physical activity can help. Don't, don't think anything is too small. So even small changes are important. If you are completely sedentary, walking down to the end of the block, and back once a day is more than a good start. Another thing to do for patients with type two diabetes is to find a way to lose weight. I tell that to all of my patients. And I also add that's an easy thing to say and a difficult thing to do. But weight management really is critical for controlling diabetes, and the better you control your diabetes from the beginning, the better your outcome really is over the long run. And then the third tip thing is to listen to your healthcare provider regarding their recommendations regarding medication therapy, so not everybody needs to be on medication from the beginning, but some people do and sometimes that includes insulin, and oftentimes for People who have very high blood sugar elevation, insulin is the only choice we have, initially to manage their blood sugar. And with time, with changes in lifestyle, and improvement in weight, many patients can cut back or even eliminate their insulin therapy or even if they're on it immediately after diagnosis.

Roland Wilkerson 5:21
Yeah, in some cases, can't you reverse your type two diabetes, or at least substantially improve your condition? Yeah, I

Dr. Cathy Rolih 5:31
don't think it's over. I think that's a good statement. I myself have seen quite a number of patients who have made some very significant lifestyle changes and have been able to, and who had diabetes for a long time, actually, who've been able to, quote unquote, reverse their diabetes, particularly, to things weight reduction, sometimes not a lot, sometimes 15 or 20 pounds, sometimes more 50 or 60 pounds, depending on where the patient is in the course of their disease, and significantly decreasing their carbohydrate intake. So people who are on very high carb diets who drink lots of sugar sweetened beverages who eat a lot of starchy food, by making changes and significantly cutting back on the carb content of their diet can have significant improvement in their diabetes control.

Roland Wilkerson 6:26
What are some of the key risk factors for type two diabetes,

Dr. Cathy Rolih 6:31
there are several things to think about probably the number one thing to think about is body mass index. That's the calculated number that's kind of correlates your, your weight with your height, the higher the BMI, the worse. So if you have a BMI of over 30, year at an increased risk for diabetes, so know what your BMI is,

Roland Wilkerson 6:53
and that's something that we can all look up there.

Dr. Cathy Rolih 6:56
That's where Google comes, yeah,

Roland Wilkerson 6:58
go to the CDC website, they've got a calculator if you're worried about other calculators, so this is something we anybody can do.

Dr. Cathy Rolih 7:05
That's easy to do, you can do that yourself. So find your BMI number one. Number two is know your family history. People who have a first degree relative that is a parent or a sibling with type two diabetes have an increased risk of type two diabetes themselves. Those are people who, who should be aware and should be screened a third group is, well, it just is as you get older. So the American Diabetes Association recommends screening people after age 45. Because of prevalence of diabetes, type two diabetes increases with age,

Roland Wilkerson 7:43
it is there a specific test for type two diabetes,

Dr. Cathy Rolih 7:46
there are different ways to look for diabetes. In general, a fasting blood glucose value can be done basic...