How harmful can a little white lie be when it comes to answering questions from your doc? Actually, if you have diabetes, little white lies can come back to haunt you.
“Sometimes, people don’t tell their doctor the truth,” says endocrinologist Alan L. Rubin, MD, author of Diabetes for Dummies, Type 1 Diabetes for Dummies and other health books in the “Dummies” series. “You may want your doctor to like you. Or you may be afraid he or she will scold you. You may be afraid of being judged. But if you don’t tell the truth, your diabetes care could suffer.”
Here’s how eight common fibs could mess with your blood sugar and your health:
Blood glucose monitoring is a powerful tool for keeping your diabetes in control. But 2 out of 3 people with type 1 diabetes don’t check their blood sugar as often as recommended by the American Diabetes Association, according to a study of 44,181 people by researchers from California’s Kaiser Permanente Medical Care Program.1 In a National Institutes of Health study of 1,480 people with type 2 diabetes, 24% of those who used insulin, 65% who used oral medications for diabetes, and 80% who controlled their blood sugar with diet and exercise said they tested their blood sugar less than once a month.2
If you have type 1, you may have to test 4 times a day – and up to 7 if you use an insulin pump, or give yourself three or more insulin shots daily or are pregnant.3 And type 2s should check as recommended by the doctor—you’ll likely have to check more often if you use insulin, if your blood sugar isn’t well-controlled or if you’re pregnant, according to the American Diabetes Association.
The honest approach: Explain why you don’t test as often as recommended. Confusion about using your glucose meter, the price of testing supplies, painful skin pricks and just being tired of all that testing can get in the way. Your doc may have a solution.
Blame it on side effects, the price tag, inconvenience or a ‘what, me worry?’ attitude. In any case, about 20 to 40% of people with diabetes don’t take blood sugar-controlling pills or injections the way their doctor prescribed them, according to experts from Johns Hopkins University School of Medicine.4
The problem with that: “There’s no way you’ll improve your diabetes if you don’t take your medications,” Dr. Rubin notes. Taking lots of daily medications can become confusing, especially if you’re among 3 out of 5 people with diabetes who also have high cholesterol, high blood pressure or both—and you're taking medicines for those conditions. In one study, older adults with diabetes took an average of 15 medications daily to control blood sugar, as well as health problems like high blood pressure, high cholesterol, heartburn, depression, brittle bones, allergies, insomnia and asthma.5 Skipping your medications makes all of these conditions worse—even if you don’t feel a difference right away.
The honest approach: Tell your doc about side effects, financial barriers and difficulty remembering what to take, when. A low-cost generic drug may be right for your wallet. “And pharmaceutical companies have programs that provide medications at a reduced price or even for free for some people,” Dr. Rubin says. “It’s vital to tell your doctor what you’re taking.”
Just 19% of people with diabetes get the physical activity they need;6 in nationwide phone surveys, one in three told the Centers for Disease Control and Prevention researchers they hadn’t exercised at all in the past month.7
The problem with that: Exercise enhances insulin sensitivity and prompts your muscle cells to pull more glucose from your bloodstream. The result: lowered blood sugar now and better A1c levels. If your blood sugar’s high and you’re secretly not exercising, your doctor may increase your drug dosage or change medications because she thinks you’re doing all you can. “You could end up on more medications or higher doses, when you really just need a workable activity plan,” Dr. Rubin says.
The honest approach: Admit you’ve been sedentary and tell your doctor what you really can do, even if it’s just a few minutes a day. Every little bit helps.
In a recent, international survey of 652 people with diabetes from the U.S., Europe, India, Japan and Brazil, 50% admitted that they hadn’t really changed their diet much since their diagnosis.8 When researchers from the University of Washington in Seattle checked up on the eating habits of 1,480 people with diabetes, they found that 62% ate fewer than 5 servings of fruit and vegetables a day. Just 17% got enough fiber and just 19% kept their salt intake down to healthy levels in an Israeli study of more than 1,000 Americans with diabetes.9
The problem with that: A plate packed with lean protein, veggies and right-for-you portions of whole grains, low-fat dairy, good fats and fruit can help your body process blood su
gar more efficiently. Healthy eating also keeps a lid on high blood pressure, high cholesterol and weight gain, too.
The honest approach: Don’t go it alone. Ask your doc for a referral to a registered dietitian or certified diabetes education (usually covered by insurance) or to a diabetes education class where you’ll get support, guidance and smart tips that make eating right easy.
“Up to 50% of men with diabetes have erectile dysfunction problems. After age 75, it’s 90% of men,” Dr. Rubin says. “And about half of all women with diabetes have sexual-function problems as well. These may be less obvious, but include vaginal dryness and loss of sensation.”
The problem with that: “Too many people with diabetes settle for an unsatisfying sex life or none at all,” Dr. Rubin says. “But don’t give up on intimacy. “It’s so important for your relationship and your well-being. There’s plenty your doctor can do to help.”
The honest approach: Take a deep breath and explain what’s going on. “With my patients, I start by making sure their diabetes is really in control,” he says. “Beyond that there are medications for men and for women that can help, including erectile dysfunction drugs, creams for women and even devices that can help men.”
About 1 in 5 people with diabetes are smokers – and it’s likely that even more are ‘social smokers’ who light up occasionally when out with friends.10
The honest approach: This is your chance to quit, so tell your doc you’re ready. The most effective quit strategies include nicotine replacement products, crave-soothing medications and counseling or other support. Big bonus: Your blood sugar will become easier to control soon after you stop, according to the CDC.11
Is it? Over half of all people with diabetes take dietary supplements; people with type 2 diabetes are twice as likely to try out herbal remedies and other non-vitamin types, according to a 2011 University of Washington study.12 Like them, you may be popping supplements that promise to help control blood sugar such as cinnamon, fenugreek or bitter melon – or taking one of the thousands of other remedies that crowd health food store shelves.
The problem with that: Supplements you’re taking could raise your risk for low blood sugar if you also use insulin or oral medications that increase insulin levels. Allergic reactions, drug interactions and even liver damage may also happen.
The honest approach: Tell your doc what you’re really taking. He or she can evaluate the risk for interactions and side effects. She can also help you save money if what you’re taking really isn’t helping.
People with diabetes are twice as likely to experience depression as folks who don't have diabetes.13 The reasons why are still mysterious – the stress of living with a chronic condition is just one possible cause. But just 1 in 3 people with diabetes get help for depression, according to a University of Washington review in the American Journal of Medicine.
The problem with that: Depression can make sticking with a healthy lifestyle, taking medications as prescribed and checking your blood sugar as recommended more difficult, according to the World Federation on Mental Health.14 As a result, depression boosts your odds for complications like heart disease, stroke, vision loss, kidney problems, sexual problems and amputation.
The honest approach: Speak up. Tell your doc if you’ve been feeling down, have a loss of pleasure, a change in sleep or appetite or unusual fatigue.