Friends and coworkers:
Keep it simple. Don't overexplain. Think of sharing this information in the same way as you would share where you grew up, how many kids you have, what you do for fun and, oh yeah, you have diabetes.
■ Expect questions, strange reactions, or even no reaction.
■ When telling your boss and/or coworkers be prepared to explain that you may need accommodations at work (more on this in Chapter 7).
■ Explain what a low blood sugar episode looks like, describe the symptoms, and what they can do to help. People like to be needed and to be asked for help.
Diabetes is a disease that can affect the whole family from food choices to eating out to helping with low blood sugar. Discussions with family members will be different than discussions with friends and coworkers.
■ Share/suggest a reading material.
■ Bring the family to doctor appointments so they can learn from someone other than you and ask questions.
■ In the book, When You're a Parent with Diabetes, Kathryn Gregorio Palmer (2006) says simply, "Honest statements work best when telling younger children. Read books about diabetes, role play with stuffed animals and with older children, and let them participate in your care, such as, by inserting a test strip into the blood glucose machine and guessing what your number will be."4
dates, boyfriends, Partners, and others:
Diabetes is easy to hide and many women will hold off on sharing the information with a romantic partner for fear of rejection.
■ Tell your date/boyfriend when you are ready; don't feel like you have to share this personal information right away.
■ Remember that being honest can foster intimacy.
Heather Jacobs says that her experience in sharing the news of her diagnosis with classmates in third grade was not a success:
After spending a couple of weeks in the hospital and some time at home adjusting, I was allowed to return to school. My teacher asked me if I would share my experience with my class, which I did happily. I even brought props! I told my classmates what happened, what I knew about diabetes (basically, I wasn't allowed to eat sugar and I had to take insulin shots), and demonstrated how to draw up insulin, hence the props. I realized by recess that my classmates did not receive the information well, as I was treated like I had the worst case of "cooties" ever to hit Mission Elementary. The children did not want to touch me, drink out of the water fountain after me, because they were afraid they would "catch diabetes" and would have to take shots and not be allowed to eat candy. It really traumatized me and taught me a lesson that took years to unlearn. Fortunately, I moved A LOT and ended up in a new town and new school less than a year later, but I never forgot what I learned.
Heather says having diabetes taught her to lie and how to show people what they wanted to see while doing as she pleased. She says that she now has a much different view of diabetes that she shares with others:
In my opinion, I may not have power over diabetes, but I do have influence over how diabetes affects my life. Today, I cherish my ability to influence this aspect of my life. This influence is panning out in my life, as I have lived with diabetes for nearly 32 years and have reversed many of my complications associated with my years of trying to die young. For the record, I turned 40 this past year and can honestly say that I am living well with diabetes!
Lesley Hoffman Goldenberg was overwhelmed with the positive reaction she received from family and friends:
My family and friends were amazingly supportive. People cooked healthy dinners for my family and dropped them off, my friends wanted to learn everything about diabetes so they could help me, neighbors brought over a bouquet of sugar-free candy because they knew I could eat that. For the most part, friends and family were supportive, curious, and wonderful. However, I do remember once in seventh grade, one of my friends accidentally touched my blood monitor—not the needle part—but the actual monitor. Her mom called my mom the next day to see how I was feeling and doing and just to chat. Somewhere in the conversation, she worked in that her daughter (my friend) had accidentally touched my blood sugar monitor and asked if diabetes was contagious and if her daughter was now at risk. My mom patiently told her that her daughter would be fine and handled it very well—but we still make fun of her for asking that question and it's 16years later!
A major factor in creating a foundation of understanding and acceptance of diabetes in oneself and in others can depend on the way a woman's diagnosis is managed from the beginning. Meeting with a team of professionals that includes an endocrinologist, a nutritionist, a therapist, and an educator will allow for the greatest success in managing and taking responsibility of the disease.
After graduating from college, I drove across the country from Colorado to South Carolina where my mom had recently moved with my stepfather. Up until that time, I'd been working with my pediatrician, the same doctor who diagnosed me at 14 years old. After a dismal appointment with an endocrinologist in South Carolina (the doctor's waiting room was filled with old, very sick-looking people and the female doctor was way too perky for my taste), a family friend gave my mom the name of another endocrinologist in Charleston where we lived. I loved Dr. Colwell from the first visit. He was an older man with white hair and a warm smile. He was also involved in the Diabetes Control and Complications Trial (DCCT) research and had started a multidisciplinary team approach to living with diabetes called the Intensive Diabetes Education and Awareness Lifestyle (IDEAL) program. I hadn't been taking care of myself for years, but with his nonjudgmental and warm, intelligent manner, Dr. Colwell got me started on the right track. He was my doctor for more than 10 years, supporting me through some bad low blood sugar episodes and two of my three pregnancies.
When he retired several years ago, I was lost. Who would I see, and where would I go? I didn't want to start all over with someone new. Dr. Colwell knew everything about me, I didn't have to explain to him about the ridiculous notion of counting carbs, he knew that I took care of myself and gave me all kinds of kudos for my good A1cs. Thankfully, I used my contacts and was able to find another wonderful doctor. She was even able to steer me toward the insulin pump, something I'd refused with Dr. Colwell.
Women with diabetes need specialized care, and because living with diabetes is like a full-time job, we need a solid team of medical professionals as a support system. Many studies show that the best way to stay healthy is with the support of a team that includes a doctor, an educator, a nutritionist, and a therapist. However, there are currently about 3,000 endocrinologists and about 25 million people with diabetes in the United States, and of the 3,000 endocrinologists, only about half specialize in diabetes care.
TiPS on FiNDiNG THE RiGHT DocTOR
■ Search websites and blogs from fellow people with diabetes in your area and ask who they recommend.
■ Look at the ADA provider listings to find a physician who has met the criteria of the ADA's Provider Recognition Program.
■ Call (800) TEAMUP4, a service of the American Association of Diabetes Educators. They have listings of doctors who are diabetes educators, as well as diabetes nurses and other health professionals who can help you find an appropriate diabetes doctor.
■ Search for a diabetes support group and ask the members for referrals.
Many women are natural people pleasers, which can set up an unequal relationship with the doctor. We can be too concerned with getting a virtual pat on the head for a good A1c and avoid discussing the frequent highs or lows. With the numbers, highs and lows, and patient responsibility, diabetes can create a "good girl, bad girl" pattern. When our blood sugar is high, we are the ones to blame. When it gets low, it's because we gave ourselves too much insulin or didn't eat enough lunch; the responsibility falls largely on our shoulders, which can result in frustration and self-blame. That's one of the reasons why it's so important to not only find a good doctor, whether it's an endocrinologist or a general practitioner, but also a therapist, a nutritionist, and an educator.
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