Although the diagnosis was surprising, looking back, Merkerson says there were clear signs. “I could remember being really, really thirsty. I was dealing with frequent urination, feeling fatigued even though I was getting enough sleep, and hungry when I knew I had eaten recently,” she explains. Then there was her deep family history of the disease, including her father who died at age 57 from complications of type 2 diabetes. Still, she didn’t know to watch out for it in herself. “We didn’t discuss diabetes in my family,” she says. RELATED: What to Know About Your Disease Risk if a Family Member Has Diabetes Merkerson, now 65, is working with Merck and the American Diabetes Association on America’s Diabetes Challenge, a program that challenges participants to collaborate with their doctor to reach their A1C goal, which is your average blood glucose level from the past three months. She’s not only a face of the campaign but is an example of how lifestyle changes coupled with medication, if necessary, can help patients get their diabetes under control. Initially the shock of hearing she had type 2 diabetes left her dragging her heels in putting healthy habits in play, but talking to her family and discovering that other relatives had suffered blindness or amputations because of the disease gave her a reality check. “Those are the things that can happen when you don’t take care of the issue. You can’t run away from it, you have to make changes. I knew it was time to take this seriously,” Merkerson says. RELATED: Type 2 Diabetes Complications You Can Avoid One challenge when you’re diagnosed with a disease as an adult, she points out: You already have ingrained habits that can be difficult to break. But it can be done. Here’s how she’s taken action to address the common challenges patients face: Learn the lingo. While she remembers discussing her A1C at previous doctor’s visits before her diagnosis, “I never asked what A1C was,” she says. Knowing your levels and why they’re important can help you be proactive about your health. Find exercise you love. Merkerson admits that getting into a workout routine was difficult at first. “I have a friend who’s a major spin person and I went to a class but realized it was not for me. That workout is not for the faint of heart,” she says. She got a trainer and tried boot camp, but what really made a difference was walking. “I put on my sneakers one day, and I started with one block, then two, then three, until I realized I was walking for an hour,” she says. Finding what you love is what leads to lifelong exercise habits. “Research says that there isn’t a specific activity that’s better than others. The best exercise in the world is the one that you can stick to for the rest of your life,” says Sean Hashmi, MD, a Kaiser Permanente adult weight management leader and a nephrologist who is based in Woodland Hills, California. He notes that as little as a 30-minute morning walk not only lifts your mood but can set your entire day up for success. “With a small victory like getting exercise in, you can better tackle temptations for the rest of the day,” he says. RELATED: Is It Better to Eat Before or After Working Out if You Have Type 2 Diabetes? Analyze your diet. “I know that if you give up foods and deprive yourself, that’s not healthy, so I had to learn how to do things in moderation,” Merkerson says. That might mean she’s sharing a few bites of dessert with the table when out with friends rather than having one all to herself. While it may be difficult to cut back on sugary foods at first, doing so will recalibrate your taste buds to appreciate the natural sweetness in foods like fruits, says Dr. Hashmi. Another change Merkerson made: eating breakfast. A hearty breakfast is another winning strategy, especially if you have type 2 diabetes, says Hashmi. He cites a study published in July 2013 in the journal Obesity that looked at two groups. One ate a 700-calorie breakfast, a 500-calorie lunch, and a 200-calorie dinner. The other ate a 200-calorie breakfast, a 500-calorie lunch, and a 700-calorie dinner. Those in the big-breakfast group lost more weight than the small-breakfast groups, and they trimmed their waist circumference, and lowered their triglyceride levels by 33 percent. They also decreased their glucose and insulin better than the big-dinner group. Oatmeal topped with berries is a healthy option, he says. RELATED: 7 Easy Breakfast Ideas for Type 2 Diabetes Change up the plan. Your treatment plan may need tweaking or there may be phases in life where your A1C climbs again and you need to take a step back. Merkerson’s goal is to keep her A1C at 7 or below, so she goes to her doctor every two to three months to have her numbers checked. While she’s at her goal right now, three months ago, she wasn’t. “I was eating things I shouldn’t have been, so I made a change. My doctor tells me not to get discouraged,” she explains. It’s something Hashmi echoes in his patients, too. “There are so many variables you’re fighting against on a daily basis when it comes to your blood sugar. Small infections or stress can make your levels go out of control,” he says. That’s why you don’t want to come down hard on yourself for missteps. “Be forgiving and mindful. Today is what you can control,” he says. Talk to others. Type 2 diabetes is a disease that can be difficult to cope with. “My brother, who’s two years older than me, has type 2. Our conversations used to be about music. Now we also talk about our A1C,” says Merkerson. Knowing that there are others dealing with the disease, and talking through the challenges you’re facing can be helpful. You can find community support resources through the ADA website. RELATED: 4 Ways Diabetes Support Groups Can Change Your Life Work with your doc. One important factor in controlling diabetes is sticking with the treatment plan you’ve worked out with your doctor. “Making sure I take the medication prescribed to me daily is important,” says Merkerson. “Everyone wants to know what I’m taking, but the key is that you stick to the treatment program,” she says.
