OHSU

Educate Yourself

Educate Yourself - Harold Schnitzer Diabetes Health Center
Diabetes can affect your whole body. If you do not manage your diabetes, you can develop complications (problems). However, diabetes is not difficult to manage if you take the proper steps. These steps include:
  • Keeping track of your blood sugar (blood glucose)
  • Eating a healthy diet
  • Exercising at least 30 minutes, five days a week
  • Taking your diabetes medications as prescribed
  • Having a support person who understands diabetes.

At the Harold Schnitzer Diabetes Health Center, our team of diabetes educators can help you develop the skills and confidence you need to manage diabetes.

Take a Class

The Harold Schnitzer Diabetes Health Center offers adult education programs on a variety of topics. These include:

  • Type 2 diabetes
  • Pre-Diabetes
  • Have a Healthy Heart

Our Successful Living with Diabetes program for people with type 2 diabetes has been recognized by the American Diabetes Association for Quality Self-Management Education. A team of certified diabetes educators teaches this program.

Our Successful Living with Diabetes program is covered by most insurance plans.  We charge a nominal fee of $25.00 for our Pre-Diabetes and Have a Healthy Heart courses.  Our Pre-Diabetes course covers the specifics of a healthy lifestyle that have been shown to reduce the risk for transitioning from pre-diabetes to type 2 diabetes, while our Have a Healthy Heart Course is devoted the aspects of lifestyle that help reduce the risk of developing atherosclerosis in individuals with diabetes or pre-diabetes.

To register for a diabetes class, please call 503 494-3273.

For more details on our classes and class schedules, check out the links below:

What is Type 1 Diabetes?

Type 1 diabetes occurs when the pancreas, the organ that produces the hormone called insulin, loses its ability to make insulin. Similar to a fuel pump in a car, insulin moves fuel from the food we eat into our cells for energy. The food is moved in the form of glucose, a type of sugar.

Doctors believe type 1 diabetes is caused by an immune system reaction that destroys insulin-producing cells in the pancreas. If you develop type 1 diabetes, glucose builds up in your blood because you do not have enough insulin to move it into your cells. If you do not get insulin from a source outside your body, like an injection, the glucose in your blood will cause a coma and possibly even death. This is why people with type 1 diabetes need to take insulin.

Around 5 to 10 percent of people with diabetes have type 1 diabetes. Half of people with type 1 diabetes are diagnosed with it before age 20. Type 1 diabetes used to be called juvenile diabetes or insulin dependent diabetes.

What is Type 2 Diabetes?

In type 2 diabetes, your body still makes insulin, but the cells that need glucose from the blood do not pick up the insulin as well as they used to. At first, the body tries to make up for this by producing extra insulin. After a while, your pancreas cannot make enough extra insulin to keep your blood sugar at a normal level, and you end up with too much sugar circulating in your blood.

Doctors think type 2 diabetes is caused by a combination of genetics (runs in families) and an unhealthy lifestyle. If you have family members with diabetes, and you are overweight and do not get much exercise, you have more risk of type 2 diabetes.

The treatment for type 2 diabetes is healthy eating, regular exercise and often diabetes pills. Type 2 diabetes is progressive over time. Some people with type 2 diabetes may need treatment with diabetes pills and/or insulin.

Ninety to 95 percent of people with diabetes have type 2. Type 2 diabetes used to be called adult onset diabetes or non-insulin dependent diabetes.

What is Pre-diabetes?

Pre-diabetes is the condition of having blood sugar that is higher than normal. If you have pre-diabetes, your blood sugar (blood glucose) level is not high enough for diabetes, but not low enough to be normal.

Treatment for pre-diabetes includes:

  • Moderate weight loss if you are overweight (weight loss of about 7 percent of your current weight)
  • Eating a healthy, low-fat diet that includes lots of vegetables
  • Getting at least 30 minutes of moderate exercise, like brisk walking, five days a week.

What is Gestational Diabetes?

Gestational diabetes is high blood sugar in pregnancy. This is caused by some of the hormones in the body during pregnancy. If it is not diagnosed or treated, it can cause birth defects.

The treatment for gestational diabetes is a healthy diet and physical activity. If diet and exercise do not work to control your blood sugar, your doctor may have you take diabetes pills or insulin. A woman who has gestational diabetes has more risk for type 2 diabetes later in life.

Diabetes Detective Animations

Diabetes Detective: Examining the Evidence (Animation)

Diabetes Detective: Uncovering the Complications (Animation)

Preventing Diabetes

A research study called the Diabetes Prevention Program was published in 2002. In this study, about 3000 overweight people with pre-diabetes were put in three groups. They had three different treatments:

  • A placebo medication (no treatment)
  • A diabetes medication called metformin
  • A healthy, low-fat diet and 30 minutes of exercise, five days a week to achieve a weight loss of about 7% of current body weight

People in the placebo group had no change in their risk of getting diabetes. People who took metformin had a 31% lower risk of diabetes. The people who ate a healthy diet and exercised lowered their risk of diabetes the most, by 58%. Researchers stopped the study early because the people in the diet and exercise group did so much better.

This tells us that you can lower your risk of type 2 diabetes by losing about 7 percent of your body weight if you are overweight, eating a lower-calorie, low-fat diet and getting 30 minutes of exercise, five days a week.

Take a Diabetes Risk Assessment

What's Your Risk?

These guidelines will help you get started with a healthy diet. However, all people with diabetes should talk with a registered dietitian once or twice a year.
Healthy Recipes

Eating With Diabetes

If you have diabetes, you need to eat balanced meals at least three times a day. A balanced meal contains carbohydrate (starch, fruit, milk or yogurt), protein (meat, poultry, fish or eggs) and some fat (olive oil, avocado, soft or liquid margarine or mayonnaise).

The key to controlling blood sugar (blood glucose) is moderate carbohydrate intake. For most adults, a moderate amount is three to five servings per meal. Although vegetables (broccoli, spinach, green beans, cauliflower and other vegetables) are in the carbohydrate family, vegetables do not really increase blood sugar. People with diabetes should eat lots of vegetables.

At each meal, one-half of your plate should be vegetables, one-quarter should be cooked protein and one-quarter should be starch or a combination of starch and fruit.

These guidelines will help you get started with a healthy diet. However, all people with diabetes should talk with a registered dietitian once or twice a year.

To make an appointment with a dietitian at the Harold Schnitzer Diabetes Health Center, please call 503 494-3273.

Blood Sugar Testing and Blood Sugar Goals

Keeping track of your blood sugar (glucose) at home is done by placing a small drop of blood on a test strip in a blood glucose meter. The meter will show your blood glucose (blood sugar) level. Testing your blood sugar regularly will give you important information about your blood sugar control.

Other reasons to test your blood sugar include:

  • To learn how certain foods, activities, stress and other situations affect your blood sugar. Knowing this will help you find ways to control glucose levels and adjust your diet, medication and exercise if you need to.
  • To learn whether your blood sugar is too low (hypoglycemia) or too high (hyperglycemia). You might need additional treatment if this happens.
  • To see how changes in your diet, medication or exercise routine affect your blood glucose.

Research shows that people who monitor their blood glucose levels regularly have lower blood sugar most of the time. This can lower your risk of having complications (problems) with diabetes.

Some people with diabetes test their blood sugar (blood glucose) up to seven times a day. Other people only test their blood sugar two or three times a week. Your doctor or diabetes educator will tell you how often to test your blood sugar.

American Diabetes Association goals for blood glucose*

  • Fasting or before meals: 70-130 mg/dL
  • 2 hours after start of meal: less than 180 mg/dL

*Your doctor may give you blood glucose (blood sugar) goals that are different from these.

A1C Blood Test

The A1C blood test shows your blood glucose (blood sugar) level over three to four months. As red blood cells circulate in your body, glucose molecules stick to them. Since red blood cells circulate for about three months, the A1C test can tell how much glucose has been in your blood during that time.

Research shows that people with an A1C level of 7.0 percent or lower have less risk of having complications (problems) caused by diabetes.

Physical Activity and Diabetes

Physical activity is a tool to help control your blood sugar. If you get regular physical activity, three positive things happen:

  • Exercise burns blood sugar. Just like driving a car burns gasoline, moving your body and exercising your muscles burns blood sugar.
  • Exercise makes your cells more sensitive to insulin. As your physical fitness gets better, your body needs less insulin to move blood sugar into your cells.
  • Exercise helps you lose weight loss. Regular exercise often helps you lose weight. If you have diabetes and are overweight, losing around 7 percent of your body weight can help lower blood sugar. Losing weight seems to clear a path for sugar to move from your blood to your cells. If you are already at your ideal weight, losing more weight will not help you control blood sugar.

People with diabetes should try to do 30 minutes of moderate exercise, like brisk walking, at least five days a week.

Adjusting to Having Diabetes

Learning that you have diabetes can cause many emotions. Some people feel concerned and anxious at first. Other people, especially if they have relatives with diabetes, are not as upset. Research has shown that people may feel mildly depressed when they learn they have diabetes, but also that most people feel better as they adjust.

Think of three ways you felt when you found out you have diabetes. Some people feel overwhelmed, and shut down (stop doing anything) to avoid dealing with having diabetes. Other people feel very anxious, get angry or feel sad and depressed. These reactions can also keep you from coping with diabetes, because you focus on your feelings, not on staying healthy. Although learning you have diabetes can be stressful, your feelings can be barriers, or blocks, to taking care of yourself.

To cope with your diabetes, you also need to cope with your feelings about the disease. Talking with a psychologist or a social worker can help. The Harold Schnitzer Diabetes Health Center has a child psychologist and a pediatric social worker to talk with patients and families.

You can also talk about your reactions with your diabetes doctor (endocrinologist) or family doctor. Your family and friends can listen to you, and encourage you to start taking care of your diabetes.

If you are overwhelmed or depressed about having diabetes, you may act in ways that don't help you stay healthy. For example, some people withdraw from others when they feel overwhelmed and depressed.

However, you need support when you first learn you have diabetes. Think carefully about how you could use help and then ask for that kind of support. For example, if you need someone to drive you to the Harold Schnitzer Diabetes Health Center for appointments, ask a friend or family member to drive you or arrange a ride.

It may also help to have other people arrange support for you. If you feel withdrawn several weeks or months after finding out you have diabetes, it may be time to get professional help from a trained mental health provider.

To talk with a pediatric social worker or child psychologist at the Harold Schnitzer Diabetes Health Center, call 503 494-3273.

Social Support and Diabetes

Diabetes is a family affair. A person with diabetes will do better each day and in the long run if they manage their diabetes properly. If you or someone in your family has diabetes, try to learn as much as you can about it. This will help you understand the daily routine and avoid surprises. You can also teach other family members about diabetes, and get their help to support the person with diabetes.

You can also form a partnership with your doctor and the members of your health care team. Join organizations like the American Diabetes Association (ADA) or the Juvenile Diabetes Research Foundation (JDRF) to learn more about diabetes, including new research and treatments.

If your child has diabetes, find out what the local chapters of ADA or JDRF offer in your community. See if they have a mentor program, where your child can get to know another child with diabetes. Connect your child with other children who have diabetes through community activities, online support and programs for diabetes support and education.

Books on Diabetes

We hope you find this list helpful. However, the Harold Schnitzer Diabetes Health Center is not responsible for the content in these books. Any advice in these books should not replace the advice of your doctor.

America's Best Cookbook for Kids with Diabetes by Colleen Bartley

101 Tips on Nutrition for People with Diabetes, Second Edition, by Patti B. Geil and Lea Ann Holzmeister

The Complete Quick & Hearty Diabetic Cookbook: More Than 250 Fast, Low-fat Recipes with Old-fashioned Good Taste by American Diabetes Association

Diabetic Athlete's Handbook. Your Guide to Peak Performance by Sheri R. Colberg.

Diabetes Burnout: What To Do When You Can't Take it Anymore by William Polonsky

Diabetes Meals On $7 A Day--Or Less!: How to Plan Healthy Menus without Breaking the Bank by Patricia Geil, Tami Ross

Diabetes: The New Type 2: Your Complete Handbook to Living Healthfully with Diabetes Type 2 by June Biermann, Virginia Valentine and Barbara Toohey

The First Year Type 2 Diabetes: An Essential Guide for the Newly Diagnosed by Gretchen Becker

Insulin Pump Therapy Demystified: An Essential Guide for Everyone Pumping Insulin by Gabrielle Kaplan-Mayer and M.S. Gary Scheiner M.S.

Pumping Insulin, 4th Edition, Everything You Need For Success With An Insulin Pump by John Walsh, PA, CDE and Ruth Roberts, MA

The Ultimate Guide to Accurate Carb Counting: Featuring the Tools and Techniques Used by the Experts by M.S. Gary Scheiner M.S.

The Uncomplicated Guide to Diabetes Complications, 3rd Ed. by Marvin E. Levin & Michael A. Pfeifer

Using Insulin, Everything You Need for Success With Insulin by John Walsh, Ruth Roberts, Timothy Bailey, and Chandra B. Varma

Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin by M.S. Gary Scheiner M.S. and Ph.D. Barry Goldstein M.D.

Type 1 Diabetes: A Guide for Children, Adolescents, Young Adults--and Their Caregivers, Third Edition by M.D. Ragnar Hanas M.D., Ph.D. Stuart Brink Ph.D., Jeff Hitchcock

When You're a Parent With Diabetes: A Real Life Guide to Staying Healthy While Raising a Family (Paperback) by Kathryn Gregorio Palmer

Your First Year With Diabetes: What to Do, Month by Month by Theresa Garnero

Diabetes Links

We hope you find this list helpful. However, the Harold Schnitzer Diabetes Health Center is not responsible for the content in these websites. Any advice in these websites should not replace the advice of your doctor.

American Diabetes Association
http://www.diabetes.org/

American Dietetic Association
http://www.eatright.org/

Children With diabetes
http://www.childrenwithdiabetes.com/

Daily Strength Online Diabetes Support Group
http://www.dailystrength.org/c/Diabetes-Type-2/support-group

Defeat Diabetes Foundation
http://www.defeatdiabetes.org/

National Diabetes Information Clearinghouse
http://diabetes.niddk.nih.gov/

Diabetes Exercise and Sports Association
http://www.diabetes-exercise.org/

Diabetes Forecast
http://forecast.diabetes.org/

Diabetes Health
http://www.diabeteshealth.com/

Diabetes Mine
http://www.diabetesmine.com/

Diabetes Monitor
http://www.diabetesmonitor.com/index.htm

Diabetes Self Management
http://www.diabetesselfmanagement.com/

Diabetes Training Camp
http://www.diabetestrainingcamp.com/

dLife
http://www.dlife.com/

Fit4D.com
http://www.fit4d.com/

Insulin Independence
http://www.insulindependence.org/

Juvenile Diabetes Research Foundation
http://www.jdf.org/

Medosa.com
http://www.mendosa.com/diabetes.htm

National Center for Chronic Disease Prevention and Health Promotion- Diabetes
http://www.cdc.gov/diabetes/

National Diabetes Education Program
http://www.ndep.nih.gov/

Tu Diabetes
http://tudiabetes.com/