Finding a balance in diabetes has been compared to a three-legged stool. One leg is medication, and diet and exercise are the other two. Trying to get control of blood sugar with medication alone is like trying to stand on that stool with two legs missing. “I can give patients pills all day. But if they are still eating cookies and not moving, their diabetes is going to be hard to control,” said Rebecca Byrd, MD. “It seems so unfair that diabetics seem to crave exactly what they shouldn’t have. That’s one reason that diabetes education is so important. We have an excellent center here at Trinity that does a wonderful job teaching patients what they can do to help keep their diabetes under control.” Most hospitals in the Birmingham area have diabetes education programs. Children’s Hospital focuses on younger patients, and other hospitals in the area work primarily with patients over 18. “Most of our patients are type 2, and many of them require insulin,” said Alison Wharton, coordinator of the Diabetes Education Program at Trinity Medical Center. “Learning to take their medicines and insulin and check blood sugar is fairly straightforward. The hard part is carving out time in a busy day to exercise and cook, and learning to eat healthy even if you don’t like vegetables — all while dealing with the “food police” — well-meaning friends who have heard myths about what you can’t eat. “We may have to start with five or ten minutes of walking, or help them pick two or three vegetables they are willing to try. We also work on the ‘ABCs’ — improving their ATC, blood pressure and cholesterol. We also have group classes that are very supportive. Patients learn a lot from each other. We bring in our specialty team members to talk about exercise and the psychological side of dealing with a chronic illness.” At St. Vincent’s Diabetes Education Center on Southside, Diabetes Health Management nurse Angela Glass has also found that the more challenging aspects of diabetes education aren’t what people expect. “You’d think the hard part would be teaching patients to inject themselves and do blood sugar testing, but after a little practice, they usually do well. The hard part is nutrition and exercise, and it’s the hardest thing to keep up over time,” Glass said. “Some people are more motivated than others. Some don’t recognize the symptoms when their blood sugar is out of control, or they attribute the symptoms to something else. It isn’t easy staying motivated, or denying yourself things you’ve enjoyed your whole life when everyone around you is enjoying them. It’s hard work. But we try to make it easier for diabetics to take care of themselves by making things like exercise more accessible. We have a place to work out here on campus and a wellness center on Highway 119 to make exercise more convenient. We do cooking demonstrations there, and we also take our diabetes education program out to the center to make it more accessible.” November 2007