For Preventing and Managing Diabetes, Education is Key

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Sponsored by Sentara Northern Virginia Medical Center

Whether you are concerned about your blood sugar, have been recently diagnosed or have managed diabetes for years, you know this disease should not be taken lightly. Fortunately, the professionals at Sentara Northern Virginia Medical Center are there to help with gestational diabetes, prediabetes, Type 1 and Type 2 diabetes. And it all starts with education.

“A diabetes educator can provide the individualized education and support needed to successfully manage diabetes and reach health goals,” says Kristina Metzler, a Sentara Northern Virginia Medical Center Registered Dietitian and Certified Diabetes Care and Education Specialist who has been a dietician for nine years.

Robyn Johanson, Registered Nurse and Certified Diabetes Care and Education Specialist, agrees. She has been a registered nurse for 34 years. For 23 of those, she has specialized in diabetes and knows education is the first step in combating the disease.

Knowing the Signs and When to Get Tested

Diabetes is a chronic disease in which the body does not make or does not use insulin properly. Carbohydrates are digested and become sugar in the blood. Insulin is required to carry the sugar to cells for energy. Lack of insulin results in high blood sugar, which increases risk for heart disease, stroke, vision loss, kidney disease and nerve damage. This is why knowing the signs of diabetes is important. A1C is a blood test for diabetes and prediabetes. It measures average blood glucose, or blood sugar level. There are other tests for the various types of diabetes as well.

According to Johanson, the most common symptoms of diabetes are frequent urination, thirst and dry mouth. Patients might also experience fatigue, increased hunger, blurry vision and/or numbness and tingling in the hands and feet.

But no one should wait for symptoms to be tested. “It is very important to get tested for diabetes annually, especially if you have a family history of diabetes or are overweight,” Johanson says. “But anyone can get diabetes.”

Some people don’t get symptoms at all, says Metzler. “Many people may not notice any symptoms, so it’s important to get your blood sugar checked regularly by your doctor.”

Understanding Treatment

Seeking treatment right away can make a big difference. “The sooner a person seeks treatment the better because uncontrolled diabetes can cause complications to the body over time if left untreated,” says Johanson. “You can develop problems with the eyes, kidneys, feet, and nerves and have increased risk for heart disease and stroke. Good blood sugar control is important – and achievable.”

According to Metzler, “You should seek treatment as soon as your A1C is in the prediabetic range. This is the best time to start making lifestyle changes because you can reverse prediabetes and prevent developing diabetes. If your A1C is in the diabetic range, you should seek treatment from your physician and a diabetes educator,” Metzler says.

According to Metzler, medical interventions depend on the type of diabetes and A1C level. A newly diagnosed Type 1 diabetic will be started on insulin immediately and will receive education on checking blood sugar and counting carbohydrates, among other diabetes management skills. The intervention for someone with Type 2 diabetes will depend on their A1C. They are commonly started on an oral medication and encouraged to make diet and exercise changes. Someone with prediabetes will be encouraged to make diet and lifestyle changes first before starting medication.

Johanson says, “If you are diagnosed with prediabetes, this is a warning sign and an ideal time to make lifestyle changes. Reduce your intake of carbohydrates, increase exercise, and lose some weight if you are overweight.”

Johanson and Metzler both recommend a balanced diet with a variety of vegetables, lean protein, healthy fat, and fruits and whole grains in appropriate amounts. “Following the healthy plate model can be helpful: ½ of the plate is vegetables, ¼ protein, and ¼ complex carbs like whole grains, beans, fruits, or starchy vegetables. Carbohydrates are what contribute to high blood sugars, but you do not need to eliminate them from your diet completely. Working with a diabetes educator and/or dietitian can help you understand what the right amount of carbs is for you,” says Johanson

Get Help Preventing and Controlling Diabetes

“We educate people on how to monitor their blood sugar at home and make lifestyle changes like reducing their carbohydrate intake and incorporating exercise into their daily routines,” Metzler says. “Understand that diabetes is a controllable condition it just takes a little work! Monitor your blood sugars at home and take your medications as instructed. Pay attention to your diet and reduce your intake of carbohydrates. Start a regular exercise routine if you don’t have one already. You should aim for 150 minutes of moderate-intensity exercise per week. I strongly encourage anyone who has been diagnosed with diabetes to meet with a diabetes educator to help them manage their diabetes.”

Most insurance companies cover diabetes education. New and current patients can be referred to the diabetes program at Sentara Northern Virginia Medical Center by their physician. Call the office at 703-523-0590 for questions and to schedule an appointment, Metzler advises.

Johanson says, “We also offer classes for prediabetes and gestational diabetes and a diabetes support group.”  To sign up for classes, visit

Metzler also provides nutrition counseling for weight loss, high cholesterol, food allergies, kidney disease and other conditions that can improve with dietary changes. Appointments for nutrition counseling can be made by calling 703-523-0590. A referral from a primary care physician is required.

About Sentara Northern Virginia Medical Center

Sentara Northern Virginia Medical Center is a 183-bed, not-for-profit community hospital serving Prince William County and its surrounding communities. Our medical center combines the resources of a major health system with the compassionate, personalized care of a community hospital. SNVMC offers quiet, private rooms and high quality care focused on safety and patient satisfaction. We offer a wide range of medical specialties, a highly qualified medical and clinical staff and state-of-the-art technology. Our clinical services include advanced imaging, cancer services, diabetes management, emergency care, heart and vascular care, lab services, neurosurgery, primary care, orthopedics, urology, weight loss surgery, women’s services and more.








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