Common Diabetes Questions
Over the past decade we have been asked many questions about life with diabetes. It is our commitment to provide an individualised email counselling service to everyone that asks for our help, not “cut and paste” answers or automated replies. This is what makes our services unique.
However we also thought it may be helpful for us to list some of the more commonly asked questions and answers here so that you can read through them in your own time.
Why did I or my loved one get diabetes and is it my fault?
The first thing is that it is never anyone’s fault they got diabetes.
We know there are certain risk factors for type 2 diabetes that we can try to reduce. In particular, staying active and eating a healthy diet can help prevent or delay the development of type 2 diabetes. We also know there are risk factors for type 2 diabetes that can not be modified. These include age, culture, genes and family history.
These are not things you can do anything about.
Each individual risk factor puts you at higher risk than someone who has none of these. Some people get type 2 diabetes where there are no apparent risk factors.
People who are overweight and obese often have complex histories with food and emotions that play a big part in their weight. There should be no blame here. Blaming people for being overweight, or for having diabetes, does not help anyone.
With type 1 diabetes there are no currently known hard facts for why this occurs. There are some genetic factors and may be some environmental factors. Type 1 diabetes never happens due to something you or anyone else did or did not do.
So while we know many people worry and feel guilty about why they or their child in particular, developed type 1 diabetes – you can get that guilt factor right out of your life.
And if someone tells you your child must have eaten too much sugar, feel free to educate them in an assertive manner!
If I have type 2 diabetes can it “turn into” type 1 diabetes?
NO. Type 1 and type 2 diabetes are totally different diseases.
There should be different names to avoid confusion. Many people with type 2 diabetes will eventually require insulin as part of their management, but they have not become a type 1. It is just the progressive nature of type 2 diabetes.
How often should I be checking my blood glucose levels?
This is a very individual thing. It depends on your type of diabetes, length of time you have had diabetes, the way you manage it and what you and your health care team decide is best for you.
Some people with type 2 diabetes who have not had it for very long may need to do some regular checks at first, to get a guide about how things are going.
If not on medication, you may not need to check at all at home, or just every now and then. At times of change with management more checks may need to be done to see how things are working out. Many people with type 2 diabetes do from a couple of checks a day, to a couple a week, to the occasional check.
It is important to make sure you are not “checking for checking’s sake” and that there is a purpose for the number of times you are checking.
People with type 1 diabetes are on average doing 4 checks a day, with many doing a lot more than this.
It really depends again on your age , how long you have been diagnosed and type of management. People on Insulin Pumps must do more regular checks as there is no long acting insulin on board and it is important to keep an eye on the levels across the day. At times of illlness, high activity or stress, people may find they need to check more often. Driving and situations where you are out of your usual routine often require more checks as well, such as when travelling.
Am I an awful person for not checking my blood glucose as often as I feel I “should”?
No! This is a common experience.
Some people decide not to check their blood glucose levels as they keep seeing high or low numbers and become frustrated. They say “what is the point” and essentially give up trying to manage. You are not alone.
If you are finding your results are often out of your target range the best thing is to seek help. Ask your diabetes team to help you work out why this is happening. Sometimes it is not easy to work out why. But there are tools that can guide us, such as using a continuous glucose monitor for a few days, tracking trends and thinking together about what areas may be tweaked. More heads make for better answers!
So if you are feeling like things are out of control the best thing is to ask for help. You may also be dealing with burnout – have a look on our pages here for more information.
Should I be recording my Blood Glucose Levels?
Again this is really between you and your health care team.
Many people record blood glucose levels at home when first diagnosed and when there are significant changes. Some may use a paper method and there are various log books available, or just an exercise book will do. Others now rely on downloads of their monitors or the various software programmes, or even Apps to track their levels.
However some people find it pointless and tiring to write their levels down or record them electronically and prefer not to worry about this in the long run.
It really depends again on why you are recording the information. If it is useful to you and/or your health care team in making changes to your management and keeping track of how things are going, this can be a very useful tool. If it is just another stress and nobody ever uses or even looks at your results, it may not be all that helpful. It is a very individual thing with no wrong or right answers.
Why are my levels always high in the morning?
Lots of people ask us this question and say that they did not eat much the night before and can not understand why their levels would be so high.
The answer is that it is usually not related to what you ate the night before, although of course if you ate a large amount of carbohydrates the night before and did not have adequate insulin (particularly if you have type 1 diabetes) and are going to bed with higher levels, then you may find you wake with high blood glucose. The answer here it to make sure you are taking the right insulin dose to match your food intake.
Some people may find they have issues with blood glucose overnight when they are suffering with gastroparesis. This is a complication of diabetes which causes damage to the nerves of the stomach and digestive system and can lead to delayed emptying of food, which causes swings in blood glucose. Symptoms often include bloating and feeling full after eating small amounts of food. Talk to your doctor if you are concerned about this.
High levels in the morning are often due more to the fact our body releases hormones overnight that make it harder for us to use insulin. The liver releases stores of glucose to prepare us for waking up. And when insulin does not work effectively, you wake up with high blood glucose levels. Sometimes this can be called the “Dawn Phenomenon”. The Dawn Phenomenon, also sometimes called the dawn effect, is the term used to describe an abnormal early-morning increase in blood glucose — usually between 2 a.m. and 8 a.m. — in people with diabetes. For people taking insulin this can sometimes be the result of an overnight hypo (low blood glucose) leading to a rebound high.
If you are finding this is happening regularly then you should talk with your doctor or diabetes educator. Some steps that can help include checking your blood glucose overnight for a week or so to see any emerging patterns, or using a continuous blood glucose monitor for a few days to see the trends.
Some people with type 2 diabetes who are still producing some of their own insulin find a small, low glycemic index snack before bed can help their pancreas to produce enough insulin overnight to help with this issue.
Some people may find they need to adjust their medications and/or bedtime insulin to reduce their morning levels; or if you have type 2 diabetes, that it is time to change your medication or introduce insulin at bedtime.
Since getting diabetes my loved one has withdrawn from me and everyone else, what can I do?
Many people with diabetes experience this and so do family members and support people. It is normal and can simply be a way for the person to take time out to deal with a range of difficult emotions. It may also signal there are more serious problems such as depression that need to be addressed.
After diagnosis many people will go through a range of difficult emotions and this is normal and most of the time will settle after a while. The time varies from person to person. After a few months or so it is easy for people around the person who has diabetes to presume they are ok and get on with life. For parents of a child with type 1 diabetes this of course does not happen, as they remain well and truly in the centre of diabetes management and therefore any diabetes worries.
However for lots of people, down the track they can find that people around them have moved on with life, but they feel “stuck” with their diabetes. Diabetes Burn Out is common and depression is more of a risk for people with diabetes.
If a you or a person you care about has withdrawn from usual activities and people they love, it is important to raise this with them and make sure they are ok. Asking someone how they are feeling about things can open a door for them to tell you they are struggling. Of course people do not always share their feelings and if they are depressed and withdrawn they may find this difficult to do. In this case it is important to let them know you are there if they need you and keep communicating with them. When they feel ready they will be able to reach out to you for some support.
Finding support for yourself is also important. We can offer counselling for both people with diabetes and their family members. Just hop on to our counselling pages.
Remember diabetes is not an easy disease to live with for anybody but with good support systems and information most people live happy and healthy lives.
I feel like diabetes is taking over every part of my life and I can not deal with it – am I normal?
Yes you are! Diabetes can take over every part of your life. It requires self management by you on a daily basis – this means you need to be in the driver’s seat. As diabetes is often an unpredictable and tricky disease to manage, it can be frustrating & feel “pointless” as diabetes can be difficult to control no matter what sometimes and it can complicate life in general.
Targets in diabetes are important, such as blood glucose levels (BGL), HbA1c (the average BGL over the past 6 – 8 weeks), blood pressure and so on – but some people feel like they are “sitting an exam” every day. The results of BGL checks, managing your weight, choosing healthy foods and so on can lead to guilt, anger & fear if you feel you are “not doing the right thing” or “not getting the right results” – this can in turn lead to more stress about diabetes and your long term health and blaming yourself.
Talking about “high and low” blood glucose and not “good and bad” can be a good place to start.
It is important to remember that these targets are guides to your health and diabetes management. The results on your home blood glucose monitor are a tool to helping you and your health care team to make adjustments and work towards a healthy you. These numbers are not ends in themselves.
Living with the threat of diabetes complications can lead to increased stress, therefore doing all you can to minimise these complications can minimise your stress. Daily life and general stress levels also affect your diabetes control and how well your diabetes is going can affect your general stress levels – it is a bit of a chicken and egg situation at times.
It is very important to get the general stress in your life under control, as this will assist with your diabetes managment.
Diabetes may cause of specific problems which we sometimes call “diabetes distress”. These are experiences, feelings and situations that people who do not live with diabetes do not have to deal with, or manage. And these things are piled upon all the usual tasks and worries of everyday life.
Diabetes may also be affected by other problems/ stress in your life – this means that if you are struggling with stress at work, or in your personal life, it can be harder to manage diabetes and it suffers. We all experience stress & life would be boring without some stress! People say they would rather not have stress in their lives, but in fact we need a balance between just enough stress and not too much, to keep us alive and active. Not all stress is bad believe it or not. Regular time out and relaxation can really help. Mindfulness practices which teach us to be present in the here and now and not so caught up in our thinking, can be key.
Hop across and have a look at our Wellbeing pages to read more.