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    A Doctor’s Perspective on Managing Type II Diabetes—for Herself and Her Patients

    Dr. Leslie Strouse 11/13/2015
    Type II diabetes is an increasingly-common condition here in the Tri-State, with as many as 1 in 9 older adults having the disease. I have been managing my own diabetes for more than a decade now. So as both a physician and patient with the condition, I have a unique perspective on what it means to manage diabetes.

    Dr. Strouse’s Personal Experience Managing Diabetes
    To me, managing diabetes means getting excess sugar out of the bloodstream and sending it where it needs to go. That’s the goal in a nutshell. I know there are a lot of philosophies about managing diabetes. Mine is that I want to help the patient take care of themselves uniquely, to understand that not every patient can manage certain aspects perfectly.  What a person can’t manage, I will help them treat.
    For instance, weight loss is probably the number one piece of advice we give to diabetics.  Many times, just losing weight will “cure” their diabetes—brings their blood sugar back to normal levels. However, in reality, the majority of people don’t achieve their ideal weight. I don’t want to “beat people up” about things they struggle with, such as their weight. My job as their doctor is to use other tools to help them manage their sugars.
    In my experience in treating diabetic patients, they’re embarrassed or afraid of judgment based upon what they’re eating and how they’re checking their sugars. And they beat themselves up for not having lost weight or followed some other instruction they’d received. My job as their doctor isn’t to judge—it’s to teach and treat. I’ll teach some simple tips that I think can help them, but I’m not going to try to overhaul their entire lifestyle in a week—or ever. We have to leave room for diabetics to be human, and to understand that there will be birthday parties with cake, and ice cream cones on Sunday afternoon drives, and beer and pizza at football games, and our treatment protocols need to be able to allow this kind of “cheating.”

    Checking blood sugar levels
    When I work with a patient, the first thing I want to do is establish “where we are,” because from there is how we figure out “where we need to go.” The most important tool for me for working with a diabetic patient is a log of their blood sugar readings.
    Many times, patients are reluctant to check their sugars because they know they’re going to be high and they don’t want to actually know how high it is. They don’t enjoy the process of the finger prick and testing. There are lots of reasons, but ultimately, regular checking (which is also an individual schedule) is a critical tool for me to use to help someone manage their sugars. In this instance (as with almost others) honesty really is the best policy. So I need that blood sugar journal as well as a food journal to start with. I need to know what a patient’s blood sugars are, and how they relate to what the patient ate, and when.

    Controlling blood sugar
    There are some well-established guidelines for helping diabetics control their blood sugar. Here are some of the most significant ones, explained simply:
    • Lose weight. Reduce calorie intake below what is expended each day.
    • Exercise. Get your heart rate up with some cardio activity, and also do some strength training. Activity and muscle burn sugar.
    • Diabetes can be inherited. Some of this is almost beyond your control.

    Dr. Strouse’s advice for managing diabetes
    Get a primary care doctor you like and trust. He or she is going to be your partner in managing your diabetes. Sometimes he or she will have a health coach nurse or dietitian or similar person who will work with you, but overall, your doctor is the #1 ally in your diabetes battle.
    • Realize that you have to take control of the disease so that the disease doesn’t take control of you. Don’t be frightened of the disease—just respect that it’s there.
    • Be honest with yourself and with your physician(s) because the bottom line is….. we (you and the doctor) have got to get the blood sugar out of the blood vessels to prevent the very serious complications that may occur if we don’t.
    • Check your sugars and keep the blood sugar level and food intake journal. Don’t be embarrassed. Just be honest, keep the log, and show it to your doctor. (At that point, I remind you…. I see no point in beating you up about it. I just want to know what I’m dealing with so that I can figure out a way to help you reach your goal of lower blood sugar.)  If you’re going to eat it, we’ve got to show you how to treat it.
    • Work with your doctor to learn how to take medication appropriately, and how to test your sugar on a schedule that’s right for you. It varies from person to person.
    • Respect the disease, be honest with yourself and your doctor, check your sugars, and get on with living and enjoying your life.
    I hope that my diabetes management practice philosophy is encouraging to you.
    I’m currently accepting new patients here in my office at Deaconess Clinic Boonville. I’m right in front of Walmart on State Road 62, next to Los Bravos - yes, I do sometimes go there for lunch.
    For more information about me, including my self-introductory video, please visit my bio page.

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