Disclosing to family and friends

[binnieman]

If I am seem overwhelmed, I really am although I am consistently on the border line of normal with my FBG according to my meter. One nagging problem for me has been how to deal with family and friends in terms of sharing foods. My sister is staying with me now while in school; she prepares most of our meals and she is a minimal-fat dieter which to some extent forces her to cook on the high carb side. I am not ready to tell her my issue yet because she will blow it out of proportion. She has been wondering why I have been eating out a bit more recently. At work this morning, my co-worker brought a fruit pizza, crust was sugar cookie with cream cheese and some sugar and a little bit fruits on top. I took just a bite and he was somewhat unimpressed with my reluctance. I have declined eating out with my buddies at our usual hang out spots although I have always ordered on the healthier side. The list goes on. How did you guys deal with this issue upon receiving the first wake up call?

[fgummett]

It can be a tough call but you are not alone out here!

There may be other considerations for why to keep it private but I am unashamed about looking out for my health and have made it clear to family and work colleagues.

One approach is to lead by example... show them the kind of things that you choose to eat.. because truth to tell, they probably should be eating the way you are instead of making you feel that it is the other way around :)

[foxl]

Full disclosure, all the way, even at work. Open book.

You get more sympathy that way than if you try to conceal it and people think you are up to something else!:)

[princesslinda]

If you don't want to tell them about diabetes, just tell them you're on a "low-carb diet," and you won't be eating "white" foods or sugar. Everyone understands a diet......and you won't be "policed" that way....mention diabetes, and you'll hear "my ------ is diabetic, and she eats this.." or "can you eat ----" at any holiday, celebration, etc that you go to.

[Granny Shanny]

My reason for immediate disclosure to family is simply that my medical history is THEIR history too, with disorders such as this.

As for friends, I've mentioned it in passing, so if they took the hint fine - if not, fine too.

[jer.lawrence]

I told everyone as well -- was very up-front about it. I guess I just feel like it's not something to be ashamed of. Not only that, I feel that by telling everyone, they are half as concerned about what I eat as I am, and that adds a little extra motivation for me.

Everyone that I spend a lot of time with now (wife, my mother, wife's mother, even some folks I work with) are all now watching what THEY eat a little more closely than they did before as well, and seem to be pleased with my knowing nutritional information on most foods (that I had no idea about before).

So, that was the way that I went. I actually never even considered not telling anyone -- I don't know why. I guess it's not for everyone, though. Hehe.

[Mich]

In my opinion, sis needs to get a little more salad into your diet. Just because you like it. Show her how--cooking together is fun. Anything else she makes, you can just eat a little of the carbs and go heavier on the meat. She'll get the idea soon enough.

Fruit pizza is not pizza, it's a dessert made to look like pizza. Treat it as you would a plate of brownies. A taste and rave reviews, then move on.

Eating with the guys: Keep doing what you're doing. If you really want to drive them crazy order a protein appetizer (like shhrimp cocktail) and wolf it down yourself with a little salad. Tell them you just like to eat that way.

As for disclosure, only folks who might need to cover for you when you are crabby and eating glucose tabs need to know. All others are strictly optional. My rule of thumb: If someone complains excessively about their relatively minor health problems, you can always bring up diabetes and trump them. :-

Mich

[jer.lawrence]

My rule of thumb: If someone complains excessively about their relatively minor health problems, you can always bring up diabetes and trump them.

Now I do wish I'd thought of that one. :D

Although I suppose there are plenty of things that trump my D too.. at least I don't have cancer or something. :P

[binnieman]

I can't be thankful enough to everyone in this forum. Anyone would learn a great deal more in a few hours of reading here than any other way about the impacts of diabetes and how to manage it, IMHO. But fortunately for me, I am quite a ways off from being diabetic. My FBG hovers right around 100 and my post meal numbers are just about the same before the meal so I think I am doing fairly well but I chose to treat this as if I am diabetic. I feel better with this lifestyle anyway. I actually now weigh less than any other time I can remember in the last decade even though I have never been outside the normal BMI range. It has only been less than two months. In any case, I agree that I should not indulge at the expense of my health just to fit in social groups. What helps a little bit is the fact that I was always more conscious so it will only seem to most of my close friends that I am going even more crazy about being healthy. If I were to guess, a number of them are probably in worse situations than I am with respect to BG except that they don't know. I will find the right time to educate some of them. Right now, I am just trying to let this higher risk for diabetes situation I am in to sink in. I will deal with the social aspect of it a little later. Hopefully, I will have it controlled well by staying with this forum and doing all the right things.

[davef]

Full disclosure, all the way, even at work. Open book.

You get more sympathy that way than if you try to conceal it and people think you are up to something else!:)
Ditto

That's what I did. I didn't make a big song and dance about it or go out of my way to tell people. But I told all my close friends (people I would hang out/eat with), family & work colleagues.

I can relate to the problem with your sister potentially blowing it out of proportion - I faced that with my mother. It's really down to how you approach it. I told my mother and went on to explain that it wasn't the end of the world, that I had done extensive reading and that they is I can eat anything but choose not to eat somethings. That as part of my new healthier lifestyle I was choosing to cut back on carbs as they would have the greatest impact. Tell her you know what you will or won't (I avoid the use of the words can/can't) and that you are dealing with this. If she is doing the cooking for you, and willing to help, meat and veg are things you will eat and that you will be avoiding or eating small amounts of rice, pasta, bread and potatoes (if you have decided to avoid those).

It was slightly different for me as I was DX'ed full blown D T2 and not pre-D.

I understand that some people are private about these things and that of course is their right, but for me I'm an open book. It's surprising how many people tell you that their father/mother/brother etc. have D when you disclose and if you are well controlled these same people look to you for advice ;)

My 2c worth.

[Handybear]

Told everyone, friends and family, as soon as I found out.

[ShottleBop]

Had it tattooed on my forehead.

[slipperyelm]

Had it tattooed on my forehead.

:D :D :D You silly goose, you!

[Ronin]

Hi Binnieman!

This is a common problem to all of us with the Pre-D diagnosis. Generally people only hear the "D-word" and don't get the concept of making lifestyle changes to avoid the onset of full-blown diabetes. That is not unusual - just think about your first reaction to the diagnosis. Chances are you heard the "Diabetic" really clear, but the "Pre" didn't catch on till later.

What do we tell the family? There are two approaches -- the "lifestyle adjustment" and the "diabetes avoidance" routes.

The lifestlye adjustment gets a lot less anxiety response. The downside is that family and friends will advise you to "cheat" on birthdays, anniversaries, or simply because it's Thursday.

The diabetes avoidance will get everyone's attention. They will be more than willing to work with you and you will get a lot of sympathy. However, you will be subject to their own misconceptions about diabetes. They will over-react and over-protect.

Personally, the lifestlye adjustment approach works best. As a tandemist/bicyclist I will make reference to managing my weight to handle hills and this gets me past the "go ahead and cheat -- nobody's looking" temptations. It also allows me to have some carbs (particularly when I need them) and not have someone thinking that I'm going to die or go into diabetic shock if I eat a cookie after a long bicycle ride.

[binnieman]

Ronin and all, as usual thank you for the great advice. I like the life style adjustment approach as well which I have begun already and I am feeling very well. One thing that I am not clear with though is that how is Pre-D diagnosed. My doctor never said I was pre-diabetic, she did not even run any further tests aside the initial 106 FBG, a test I requested in passing. After that, my FBG invariably hovers between 94 and 105 (when I fast for longer hours) and my post meal values are close to where they were before meals no matter what I eat, so far. My HbA1c is 5.6%. I take no medication for anything. Where does all these put me? I am really not trying to let myself off the hook because I like this new look at foods anyway but I would like to know how high my risk is for the onset of full-blown T2 so that I would approach this reasonably rather than over-react and miss some dietary opportunities.

[ShottleBop]

From the Center for Disease Control (http://www.cdc.gov/diabetes/faq/prediabetes.htm): What is the risk of a person’s prediabetes converting into type 2 diabetes?

The risk of progressing to diabetes depends on the type of prediabetes that a person has (IFG only, IGT only, or both), as well as other diabetes risk factors. Individuals with prediabetes who are older, overweight, and have a family history of diabetes and gestational diabetes are more likely to progre–ss to diabetes.5 Individuals with prediabetes are 5-15 times more likely to develop type 2 diabetes than are people with normal glucose values.4 Individuals with both IFG and IGT develop diabetes approximately twice as often as individuals with just one of the two conditions.5

Annual progression to diabetes

Studies in the United States and abroad show that, for persons with IGT, between 2% and 34% will develop type 2 diabetes annually; for persons with IFG, between 1.5% and 23% will develop diabetes annually.4 Two randomized controlled trials of diabetes prevention, the Diabetes Prevention Program (DPP) and the Finish Diabetes Prevention Study, demonstrated that 3–5% of individuals with IGT who lost weight and engaged in moderate physical activity progressed to diabetes annually. For persons with prediabetes who did not lose weight and engage in moderate physical activity, 11% progressed to diabetes annually.10-11

Prolonged progression to diabetes

The natural history of prediabetes (both IGT and IFG) indicates that about 25% of persons with prediabetes progress to diabetes within three to five years. With longer observation, the majority of individuals with IFG or IGT go on to develop diabetes5 within about 10 years, unless they lose weight through moderate changes in diet and physical activity.12 Over the course of a lifetime, as many as 83% of persons with prediabetes (IGT) who neither lose weight nor engage in moderate physical activity will develop diabetes.13 Over the course of a lifetime, approximately 65% of persons with prediabetes who lose weight and engage in moderate physical activity will go on to develop diabetes13- 14

As for diagnosis (from the same source): How is prediabetes detected?

At present, the fasting plasma glucose (FPG) and the 2-h oral glucose tolerance test (OGTT) are the tests of choice to identify all states of hyperglycemia. Either test is suitable, and each has advantages and disadvantages, such as convenience, cost, and reproducibility. Identification of individuals with IGT can be made only with a 2-hour OGTT; the fasting plasma glucose (FPG) alone will miss approximately 30% of patients with isolated IGT. A recent consensus statement issued by the American Diabetes Association has recommended that if pharmacotherapy is used, both IFG and IGT should be documented. If only lifestyle modification is planned, a confirmatory test is not required.5,4


IGT is detected when blood glucose levels are elevated (140–199 mg/dL) two hours after an Oral Glucose Tolerance Test is administered.

IFG is detected when blood glucose levels are elevated (100–125 mg/dL) after a fast of at least eight hours.

[binnieman]

Thank you ShottleBop. That piece of information was quite resourceful.