By Saima Farghani, MD
While I’ve done it thousands of times, it never gets easier for me to tell a patient he or she has diabetes. For some, it comes as a complete shock; for others, the news confirms what the patient already suspected. Regardless of the response, living with diabetes is life-changing and it doesn’t just affect the patient—it also changes the relationship dynamic with family and friends.
And more and more New Jerseyans are being diagnosed–over the past 20 years, the estimated rate of new adult diabetes cases has more than doubled in New Jersey.
Stages of grief and denial for the newly diagnosed
New patients often experience the five stages of grieving: denial, anger, bargaining, depression and acceptance. According to the American Diabetes Association (ADA), studies show that people with diabetes have a greater risk of depression. Like denial and anger, depression can also derail proper diabetes care.
Patients newly diagnosed with diabetes often veer in two directions—they are in denial or they become fixated with disease management. My younger patients sometimes ignore the diagnosis initially because (early on) they don’t have any outward symptoms. Others become fixated with checking their blood sugar every few hours or are so cautious about what they eat they become nutrition-deprived.
You can’t manage this disease on your own
Susan was diagnosed at 30-years-old but felt she could self-mange the disease through weight loss. But her health deteriorated over the years and she came to see me with diabetes-related complications in her eyes that, if not controlled, can lead to blindness. Without medication and self-care, I explained that her kidneys could also fail and she’d be facing life-long dialysis.
No longer in denial and now a mother, Susan realized she could still be in control of her disease—but supported by medication, dietary changes and partnering with an endocrinologist. She decided to accept the fact that she had to be very serious about her health as she was at higher risk for going blind and being on dialysis. By taking that responsibility and diabetes medications, Susan changed her life for good. She also managed to lose 75 pounds by adopting a healthier lifestyle. She does not require multiple diabetes medications anymore and has never felt better emotionally and physically. I do have to say, truthfully, that her effort and accomplishment is not the norm, unfortunately.
The importance of family support
Family members are justifiably frightened when a loved one has diabetes. But this worry and fear can grow into a need to “police” the patient and “turn him in” for any deviation from the treatment protocol. “My husband ate a brownie last week so I haven’t spoken to him since,” one angry wife told me during an office visit. “He just doesn’t care that he’s so overweight.” While well intended, this kind of negative reinforcement doesn’t work.
Instead of attacking the loved one, focus on the positive:
- Adopt a diabetes-friendly lifestyle for the whole family that focuses on eating well, exercising and quality sleep.
- During doctor visits, focus on what the patient is doing right rather that itemizing every cookie he ate.
- Empower the patient to believe he or she is the boss—not the disease.
- Don’t make the loved one feel isolated or like a failure.
Finally, if you or a loved one has been recently diagnosed, I recommend the book “When Diabetes Hits Home” by Dr. Wendy Rapaport.
Personalized diabetes care and support
The Novo Nordisk Diabetes Center at CentraState Medical Center is recognized by the American Diabetes Association for meeting the national standard in diabetes education. This comprehensive program provides the latest type 1 and type 2 diabetes education and disease support, including a customized one-on-one management program.
The Star and Barry Tobias Health Awareness Center offers an ongoing selection of diabetes nutrition classes and support groups for individuals and family members. To learn more, call 866-CENTRA7 (866-236-8727) or visit centrastate.com/diabetes-services.
Saima Farghani, MD is a board-certified endocrinologist on staff at CentraState Medical Center in Freehold. She can be reached at MidAtlantic Diabetes & Endocrinology Associates by calling 732-409-6233.
