Expert Blog Series: Talking Diabetes with Carla Cox

March 22nd is American Diabetes Association (ADA) Alert Day, a day-long “wake-up call” encouraging Americans to take the Type 2 Diabetes Risk Test to find out if they’re at risk for developing type 2 diabetes, and with over 29 million Americans living with diabetes today, we think it’s a pretty big deal. To help our fans better understand the importance of this test and the benefits of being proactive about your health, we chatted with registered dietitian and certified diabetes educator Carla Cox, and here’s what we learned:

Hi Carla! Thanks for taking the time to talk with us today. We understand that you have been a certified diabetes educator for over 20 years now – can you tell us what it means to be a diabetes educator?

As a whole, diabetes educators have a wide range of patients that they work with. Some of us specialize in one particular area like myself, while others have a much broader reach. Either way, the main role of a diabetes educator is to be helpful and communicate what the evidence is to the patient in a relatable way so that they can work it into their lifestyle. We are the bridges between the physician that tells the patient what they need to do, and the patient that says ‘I don’t know how to do that’ – the diabetes educator takes all of the information and tries to find a way that will work for the patient. I think that’s what education is all about – listening to the patient, understanding what they’re willing to do, and then trying and come up with a plan that works for them.

How many people in the U.S. have diabetes?

Today, about 9% of the American population has diabetes; in people who are 65 and older, 25% have diabetes. Generally, 5-10% of these people have type 1 diabetes, and the remainder being an assortment of diabetes, but primarily type 2.

What are some misconceptions that people have about both type 1 and type 2 diabetes?

One common misconception is that people with type 1 diabetes prompted their condition through lifestyle decisions. Type 1 is an autoimmune disease, so it really has very little to do with lifestyle choices. Things like being sedentary or being overweight would make type 1 more difficult to manage, but it wouldn’t be the cause.

The other thing that people think is that if you just eat healthy and exercise, managing diabetes is easy – having diabetes is never easy. Once you’ve been diagnosed with diabetes, it requires constant vigilance. It’s checking your blood sugar 3-4 times a day, it’s making having low blood glucose treatments available when you exercise, it’s knowing how much medication to give. Diabetes is a daily challenge.

Lately, we’ve been hearing a lot about prediabetes – can you tell us what that is?

Diabetes is diagnosed when the blood sugars fasting are greater than or equal to 126. When the blood sugars fasting are 100-125, that indicates prediabetes; it’s really the difference between normal blood sugars and diabetes. About 50% of people with prediabetes will go on to develop diabetes. However, there is some good evidence that lifestyle changes at that point may actually tip the scale, meaning that you could either delay the onset of the actual diagnosis, or you may never become diabetic. 

At what point should someone see a diabetes educator?

I think that anyone who has prediabetes or diabetes should see a diabetes educator. Statistics show that only about 10% of the diabetic population is actually referred to a diabetes educator, which is awful! People really need to advocate for themselves and suggest to their primary care that they want to see a diabetes educator. It’s so important in helping them adapt their lifestyle to their diagnosis.

Speaking of lifestyle, at what point does it increase your risk?

Eating junk food is not inherently bad. It’s that when someone eats junk food, a lot of times they aren’t eating the good, healthy foods that keep us well. When we don’t eat nutritious foods in addition to the junk, we develop chronic diseases. 

What are some things that everyone can do to prevent diabetes?

Eat a fruit or vegetable with every meal. Limit your junk food, whether it’s sweets or highly processed snacks, to 150-200 calories a day. Moderation and proportion sizes are important, too! In regards to fitness, exercise is medicine, so get your daily dose. You wouldn’t take a pill just two days a week, so don’t exercise only two days a week either! 

We love that advice! When you talk about exercise, what kind do you recommend?

Anything. Getting in 3-5 days of cardio and at least 2 days of strength training is ideal.

What’s the best thing about your job?

The people – I love the people and I love what I do! The thing with type 1 diabetes is that it’s kind of like being Sherlock Holmes on a daily basis. We do problem solving every day, because every patient is different and every dose is different.

We are so grateful to Carla for sharing such valuable and interesting information with us, and we hope that you enjoyed it! If you have more questions about diabetes or the American Diabetes Association Alert Day, please feel free to post them in a comment below. Additionally, don’t forget that VIM & VIGR will be donating 50% of ALL purchases made on March 22^nd to the American Diabetes Association – help us spread the word!