Transcript for Podcast: Equal Treatment: Managing Diabetes and Mental Illness
Have you wondered why there is so much emphasis on diabetes these days? Have you ever been screened for diabetes? Have you been diagnosed with a mental illness too? If so, then my story might be of help to you.
I was diagnosed with a mental illness at the age of 17. I was diagnosed with diabetes Type 1, about a decade later, at the age of 28. My diabetes was detected because of a suspicious infection that would not go away, even with IV antibiotics. I was continually thirsty. But, it was hot outside so I didn’t think much of it. I drank lots and lots of soda. It did taste good, and I was thirsty. I constantly had to urinate. But, if you drank as much as I did, you would have to urinate, too! Yes, I was tired. I was working 70 hours a week as a Nurse. My vision was blurry and was I tired! But, who wouldn’t be with how hard I was working?
Then, something dramatic happened. I had to be hospitalized because of the ongoing infection and a bout of asthma that required steroid treatment. I brought a 12-pack of soda and change of clothes to the hospital. After all, I was only going to be there one day and was sure I could get more soda.
While there, I had a urine test done. The nurse came back to my room, and asked, “Do you have diabetes?” I was surprised and stated, “Me? No, of course not. Why?” The nurse let me know that I had a lot of ketones in my urine, which is a chemical the body makes when it doesn’t have enough insulin in the blood. She said I’d need to get blood work done right away because the ketones meant I was in danger. My blood sugar test result came back. Wow! Even as a nurse, I had never heard of a blood sugar level that high! The doctor immediately started me on insulin and taught me how to give it to myself. I was told that I would have to do this for the rest of my life. After two weeks of hospitalization, I was stabilized on insulin and discharged home.
I thought I knew all there was to know about diabetes and my mental illness. After all, I am a nurse and I had the diagnoses. I got all “A’s” in class and passed my state boards with flying colors. I had also read many self-help books on various mental health issues. But, I was so wrong! Here are some things I learned along the way that may help you.
First, I recognized the things that increased my risk for developing diabetes in the first place.[i][ii]
- I was overweight and was inactive. My work required a lot of sitting and writing.
- I had a family history of diabetes. All 5 of my uncles and my mother developed diabetes between the ages of 65 and 68.
- My blood pressure was frequently higher than 140/90.
- My HDL cholesterol level, or good cholesterol, was below 35. My LDL cholesterol, or bad cholesterol, was more than 150.
- And, I had a mental illness! As a “mental health consumer,” I learned that I was twice as likely to have diabetes.
- As a diabetic, I learned I was 50% more likely to have a mental illness!
Today, here’s how I manage my diabetes and my mental illness for a good life. I have learned that I need to maintain physical health to manage my mental health, and I need to maintain my mental health to manage my physical health. Maintaining physical health is just as important as mental health!
- I receive insulin continuously through an insulin pump. I take my medications as prescribed by my psychiatrist.
- I monitor my blood sugar at least 6 times a day. I make adjustments in my insulin dose as needed and directed by my Diabetes Specialist and my Diabetes Educator.
- I get routine dental check-ups and follow up with the dentist as needed for urgent dental problem. Remember, if you ignore your teeth, they’ll go away!
- I see my Diabetes Educator monthly.
- I see my Diabetes Specialist (called an endocrinologist) every 3 months.
- I avoid fast foods and especially all-you-can-eat buffets.
- I walk 3 times a day for 30 minutes with my wonderful dog, Kaylie.
- I eat smaller portions of food, and choose fresh vegetables and fruit.
- I do not buy junk food or keep it in my home.
- I stop eating when I am full not when the plate is empty.
- I try to get sufficient rest every night.
- I monitor my skin daily, especially my feet for sores or open wounds. I use a mirror to view my feet, and
- I admit when I need additional help. Sometimes this is the hardest part, but I have a circle of family, friends, professionals, and mentors who care about me and will share the journey together with me.
The American Diabetes Association recommends that the following types of individuals be screened for Diabetes:[iii] Could you be one of these?
- Anyone over the age of 45 is advised to receive an initial blood sugar screening, and then, if the results are normal, to be screened every three years thereafter.
- Anyone with a blood pressure reading greater than 135/80 should get a blood sugar screening.[iv]
- Anyone with a Body Mass Index or BMI - over 25. BMI is your weight in relation to your height. If your BMI is over 25, you should be screened for diabetes regardless of your age, especially if you have additional risk factors like high cholesterol, a history of heart disease, or you have a close relative with diabetes.
You may wonder, “Why should I be screened for diabetes? I don’t feel sick or unwell.” Diabetes is a very serious disease. Left untreated, diabetes can lead to serious health problems, including blindness, kidney disease, amputations, heart disease, and stroke. But, when people are diagnosed with diabetes and follow their treatment plans, they can greatly reduce their chances of experiencing these and other, terrible health problems.[v]
Diabetes is frequently not diagnosed until complications appear, and approximately one-third of all people with diabetes may be undiagnosed.[vi]
Having diabetes means making some changes in your everyday life. These changes may seem hard at first, but the goal is to keep your blood sugar (glucose) under control to keep you healthier longer and to help you feel better.[vii]
As a nurse when screening people for their health, I’ve heard more than one person say, “It’s impossible to manage diabetes when you have a mental illness!” Yes, it’s true that managing diabetes and mental illness is a challenge that takes time, patience, and a willingness to learn. But, remember -- you are worth the effort!
The best way to manage diabetes and mental illness is to take advantage of any learning opportunities you can. Checking your blood sugar, eating healthy, and exercising each day can help manage your diabetes and make you feel so much stronger mentally. Creating a Diabetes Management Plan to include monitoring, meal planning, and physical activity also is crucial. Sometimes, taking diabetes pills or insulin is also needed. Some Diabetes Management Plans include oral medications or insulin. Even if you have not been diagnosed with diabetes, it’s important to learn about the many things you can do to improve your mental and physical health.
Your treatment plan will be based on what your body needs to become physically and mentally healthier. Also, your plan will change over time as your lifestyle and body are improving. Importantly, the best treatment plan is the one that keeps your blood sugar levels in control.
And remember, in the wise words of Paula Deen the celebrity chef you may have seen on TV, diabetes is NOT a death sentence! She ought to know because she manages her diabetes while also cooking for a living. In my experience, diabetes gave me my life back. Because I was diagnosed with diabetes, I became more aware of the many choices I had. I realized that my choices could improve my health or put me at risk for further problems in the near future. I am choosing to live!
Thank you for listening. I wish you well on your journey to health. If you’d like to learn more about diabetes and how it is treated, you can listen to other diabetes podcasts in the UIC Center’s Podcast Library.
[Host]: Thank you for listening. You can listen to additional podcasts or download a transcript by visiting us at http://www.cmhsrp.uic.edu/health/index.asp and clicking the link for Podcast Library.
[i] 1998-2012 Mayo Foundation for Medical Education and Research (MFMER). [online] Accessed from: http://www.mayoclinic.com/health/Diabetes
[iii] American Diabetes Association. Executive summary: standards of medical care in diabetes-2010. Jan 2010. Diabetes Care 33:S4-S10.[online] Accessed from: http://labtestsonline.org/understanding/wellness/
[iv] U.S. Preventive Services Task Force (USPSTF) Screening for type 2 diabetes mellitus in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2008 Jun 3; 148:846. [Erratum in: Ann Intern Med 2008 Jul 15; 149:147.]
[v] Medicare Diabetes Screening Project [online] Accessed from http://www.screenfordiabetes.org/benefits-of-diabetes-screening/
[vi] Screening for type 2 diabetes (Technical Review). Diabetes Care 23:1563-1580, 2000. [online] assessed from http://care.diabetesjournals.org
[vii] [online] assessed from http://dagc.org/managingdia.asp