Managing Diabetes with Another Life-Changing Condition

You've been told you have diabetes. At that moment, you know your whole life has changed. Your family meals. Your activity. Your routines. Your social experiences. Your time spent at a doctors office. They will all be a bit different. But you adjust. And you stay strong.

Then, months later, your doctor sits you down to explain that you also have heart disease, even further adding to your lifestyle changes and medical management workload. And while you can live a very fulfilling life with the right medical and self-care, its just not easy.

In fact, studies have confirmed that patients with multiple chronic conditions have on average:

• Increased illnesses
• Reduced physical functioning and quality of life
• Greater likelihood of persistent depression
• Less reported social well-being

Diabetes and other chronic conditions often go hand-in-hand.

And this is a very real struggle for so many because diabetes is a risk factor for comorbid chronic conditions such as cardiovascular diseases, musculoskeletal diseases and mental diseases, in addition to diabetes-related complications such as neuropathy, kidney disease and eye disease, affirms Jennifer Hein, clinical project manager for AdventHealth's corporate diabetes care program.

In fact, according to the 2017 National Diabetes Statistics Report of 7.2 million hospital discharges that were reported with diabetes as any listed diagnosis among U.S. adults aged 18 years or older in 2014, 1.5 million also had the diagnosis of cardiovascular disease.

In another study, it was found that among patients over 64 years of age, common potentially diabetes- and nondiabetes-related illnesses, including heart diseases, rheumatologic conditions and hyperlipidemia (high cholesterol).

Whether this hits home to you personally, or as someone who cares for or about a person with diabetes and other life-changing chronic conditions, Hein has some tips on how to improve quality of life and health in body, mind and spirit.

Develop healthy coping strategies

No doubt, chronic conditions will bring challenges. But developing coping strategies is one way to take them in stride by learning ways to better cope with stress. And reducing and minimizing stress is incredibly important for someone with diabetes, emotionally and physically.

Hein explains, Stress can cause blood sugar to go up and make it more difficult to reach your glucose target range.

She adds that blood pressure can also be affected by chronic stress, which can also influence blood sugar control and risks of complications associated with diabetes, including heart disease.

Coping strategies is one of the aspects of care that we focus on at the AdventHealth Diabetes Institute; we help our patients learn how to identify their stressors and build their own skills and confidence to overcome them, Hein advises.

It could be identifying a support person to come with you to doctor appointments, engaging family members in your meal planning and prep or doing some mindfulness training.

Bringing a family member or support person with you during doctor appointments can help because the support person can play the role of note taker and gather information that can be forgotten or not heard when a lot is discussed by medical professionals at once, says Hein. She adds, Having support also helps people stay connected and positive.

And staying positive with an optimistic attitude has been linked to better health outcomes and better decision making with health and lifestyle behaviors.

Focus on problem-solving

In addition to coping with stress, its crucial to collaborate with your medical team to problem solve. We encourage our patients to work with their providers to understand and collaborate on their treatment plan and with their coaches or case managers to keep ahead and organized of medical appointments, and also work through any challenges that come up, says Hein.

A case manager can assess your entire care plan and look for any gaps in care to help you get what you need quickly and efficiently. People with diabetes and other chronic conditions are often taking several medications, seeing several medical specialists and managing many daily medical management tasks at home. This can be hard for one person to manage on a day-to-day basis.

When you build problem-solving skills and your team of support behind you, you can focus on taking control of the challenge to find solutions.

Maintain normalcy of life

Diabetes is life-changing, but it doesn't have to change you. We encourage all of our patients to keep active in the things they love to do; be with family, travel, be active, engage in hobbies whatever it is that makes them feel fulfilled, notes Hein.

While some activities might have to be modified, it's important to try to maintain as normal of a life as possible to boost the spirit and keep a positive outlook on life.

Develop a self-care routine

Routines help all of us. And for people that have a lot to manage in one day, routines are critical. Diabetes in addition to other chronic conditions likely requires multiple medications taken at very specific times multiple times per day.

We recommend that patients use tools such as a seven-day pill box so that they stay organized and don't miss their medications, advises Hein.

She adds, We also recommend that patients tie their medication and monitoring routines into something that they do every day, such as putting their meter out where they are eating at mealtime to check blood sugar, placing the glucose tablets or medication for low blood sugar in several convenient spots that can be grabbed right away, and using technology to set audible reminders.

Exercise and meals are also an important part of a self-care routine. The more you build routines, the more you take ownership of managing your conditions and health.

Be proactive with health and learning

Diabetes can seem like a part-time job, adding another chronic illness can intensify the complexity, so its helpful to think about how to simplify managing the illness, which is critical to your outcomes, says Hein.

One of the ways you can be proactive about managing your health is using online portals to look at your labs and jot down any questions to ask your doctor at your next appointment.

And because diabetes and chronic conditions are often evolving, staying up-to-date with continuing education about your conditions is vital for your well-being.

The AdventHealth Diabetes Institute has many educational programs to help patients learn how to manage their diabetes- wherever they are in their health journey, says Hein. If a patients condition has changed and they need more education on managing their disease at home, or if they have a heart condition and need education on heart disease, we can connect them to those resources, she continues.

Hein stresses that its very helpful people with multiple chronic conditions, including diabetes, to be proactive and seek out information and services that can help them continuously learn about their illnesses.

At the AdventHealth Diabetes Institute, there is a multi-disciplinary team and a widely connected network throughout the AdventHealth system that can help you find the resources to overcome many of the challenges that come your way. Often, we can help, so it's important to ask; we're just a phone call away, remarks Hein.

Click here to learn more about the AdventHealth Diabetes Institute.