Bartlett Regional | House Calls | Spring 2019

Pia’s story On a Friday afternoon, Pia Mateo, 46, is meeting with Cynthia Gordon-Nickerson in a quiet office tucked away in a corner of the Medical Arts building, across from the main hospital. Several of Mateo’s immediate family members have type 2 diabetes. She was diagnosed after developing gestational diabetes while pregnant with each of her three children and has been living with the disease for 20 years. Mateo had not seen Gordon- Nickerson for a few years and had not been feeling well, so she made an appointment. “This time I am serious,” Mateo says. “I want to get it under control.” Gordon-Nickerson asks Mateo about her routine. Mateo replies that she has toast and coffee after getting to work. She’s been experiencing some dizziness. Gordon-Nickerson suggests she add some protein to her first meal of the day and notes that toast is a carbohydrate that raises blood glucose. Protein helps mitigate the effect and can help keep glucose from spiking. “It could be a spoonful of peanut butter on your toast,” says Gordon- Nickerson. “It could be an egg, like a hardboiled egg or something like that. Any kind of protein.” “OK, so can I have bacon?” asks Mateo. The answer is “Not really.” Bacon is considered a fat, so it does not qualify in this case. “Fat slows down how quickly your gut digests food,” Gordon-Nickerson explains. “It keeps your blood sugars higher longer when eaten with a carbohydrate, and then it goes down after several hours. These are not good helpers, unfortunately.” “These are your best fats right here,” Gordon-Nickerson says, pointing to a handout of diet guidelines for people with diabetes. “Nuts and avocados are the good guys.” “It’s time to do that— take care of myself” This is not the first time Mateo has heard such recommendations. She has the desire to make the changes Gordon-Nickerson suggests to feel better and get healthier. But she is also honest with herself. “It’s human nature,” Mateo observes. “I knew what I’m supposed to be eating, but of course it’s just that we want what we want, you know?” Despite that, Mateo resolves to check her blood sugar as recommended. “I don’t check my blood sugar when I’m supposed to—two hours after eating,” she says. “But this year I’m trying to make that change to check my blood sugar and be aware of what’s going on within my body and how I can take care of myself.” Mateo also resolves to exercise more. “I’m getting older,” she says, tearing up. “I’ve been taking care of other people instead of myself. It’s time to do that—take care of myself.” very small needle. As a matter of fact, injecting insulin hurts less than checking blood sugar. Many people are afraid of insulin. They won’t come in because they’re afraid that we’re going to suggest they start insulin.” How many times a day a patient needs to check their blood sugar varies. “Some people need to check it more; some people need to check it less,” Gordon-Nickerson says. As for the downside of not managing your diabetes? —Continued from page 5 Diabetes Educator Cynthia Gordon- Nickerson, RN, CDE, CMC, shares a laugh with Pia Mateo, who has type 2 diabetes, during a counseling session. The answer is unequivocal. “It’s going to kill you,” says Gordon-Nickerson. Major risk factors and complications for people with diabetes include heart attack, stroke, blindness, kidney failure and amputation. The good news? Ninety-nine percent of the responsibility for managing the condition is in the patient’s hands. “Either you control diabetes, or it’s going to control you,” Gordon-Nickerson says. Most of the patients she counsels are able to manage their diabetes through diet, exercise and medication. Diabetes myth-busting 6 House Calls Spring 2019