Living with diabetes: Guidance towards a healthier life

According to the U.S. Centers for Disease Control and Prevention (CDC), more than 38 million people in the United States are living with diabetes. To learn more about prevention and care, we chatted with Diabetes Nurse Care Manager Elizabeth D’Urbano, RN, CDCES, CCM. She’s been with Mass General Brigham Health Plan for more than eight years and specializes in diabetes management.

“Diabetes is a very manageable condition,” D’Urbano said. “For anyone newly diagnosed with type 2 diabetes, you may even be able to reverse your diabetes through significant changes in diet and physical activity.”

What is diabetes?

Diabetes is a chronic condition that impacts how your body processes glucose. When we eat, our bodies convert food into glucose, which enters the bloodstream. Insulin, a hormone produced by the pancreas, helps cells absorb this glucose for energy. With diabetes, this process is disrupted, leading to elevated blood sugar levels.

There are several types of diabetes. The three main types are:

• Type 1 diabetes: An autoimmune disease that affects insulin creation and causes high blood glucose (hyperglycemia). Type 1 diabetes is typically diagnosed at a young age but can develop at any age.
• Type 2 diabetes: More prevalent and often associated with lifestyle factors like obesity and inactivity. The body either becomes resistant to or doesn’t produce enough insulin. Type 2 diabetes can often be managed through diet, exercise, and oral medications.
• Gestational diabetes: Occurs during pregnancy and typically resolves after childbirth. Gestational diabetes increases the risk of developing type 2 diabetes later in life.

Symptoms and warning signs

Individuals with a family history of diabetes may be at a higher risk for developing the disease. Recognizing common signs and symptoms can detect diabetes early on, such as:

• Frequent urination
• Excessive thirst
• Extreme fatigue
• Blurred vision
• Increased hunger
• Slow healing for cuts and bruises
• Unexpected weight loss (type 1)
• Tingling, pain, or numbness in the hands or feet (type 2)

Talk to your primary care provider if you or someone you care for is experiencing any of these symptoms. A blood sugar test can monitor glucose levels and determine what next steps are needed.

Living with diabetes

For individuals living with or at risk for diabetes, they can manage the disease with lifestyle changes and support systems. Here are some ways to manage diabetes:

• Diet: “Eat more plants and eat less animal products,” D’Urbano said. “Focus on a balanced diet rich in whole grains, lean proteins, healthy fats, and plenty of fruits and vegetables. Monitoring carbohydrate intake is crucial for managing blood sugar levels.”

• Exercise: “Either start a physical activity program now or increase the amount of physical activity you’re already getting,” D’Urbano said. “If you need to lose weight, talk with your provider to determine what your ideal weight should be, then work toward meeting that goal.” Regular physical activity can help lower blood sugar levels and improve insulin sensitivity. Aim for at least 150 minutes of moderate aerobic activity each week.

• Monitor blood sugar: Regularly checking your blood sugar levels helps you understand how your diet and activity affect your body.

• Medication: Depending on your type of diabetes, you may need insulin or other medications to help control your blood sugar.

With lifestyle changes, medication, and blood sugar monitoring, symptoms of diabetes and diabetes-related complications can be alleviated and, in some cases, reversed.

Access support from your healthcare provider and health insurance plan

A diabetes diagnosis can be unexpected and overwhelming, but you’re not alone. D’Urbano recommends asking your primary care provider to refer you to a specialist – such as a diabetes care and education specialist and/or an endocrinologist. Your care team can work with you to create a plan of action that makes sense for your diagnosis.

Talking with a behavioral health specialist, counselor, or diabetes support group can help you navigate the stress and anxiety that can come with a new diagnosis or change in health.

Mass General Brigham Health Plan members

• If you’re seeking wellness and weight management support, join the free one-year diet and exercise program, Healthier You. To enroll, email HealthPlanHealthandWellness@mgb.org or contact Health Coach Lisa Perea by phone at 857-282-3149. Please provide your name and the best way to reach you.
• If you’re seeking telephonic support, enroll in our diabetes or nutrition care management programs. This is available to all members living with type 1 and type 2 diabetes, as well as gestational diabetes. Depending on a member’s individual plan, they may also be eligible for a glucometer, strips, and lancets at either a discounted copay or at no co-insurance through their pharmacy benefits. Based on eligibility, additional monitoring devices/services may also be available to them such as a continuous glucose monitoring system or the Livongo program for diabetes.

Mass General Brigham Health Plan members can connect with the Care Management team by calling the toll-free customer service number on the back of their member ID card or by emailing HealthPlanCareManagement@mgb.org.

During National Diabetes Awareness Month, connect with others living with diabetes, talk with your care team, and be vigilant in recognizing the signs and symptoms of the disease year-round.

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