Prevention | Support Strategies
The Emotional Side of Diabetes - Part 3: Things You Should Know: A series from the Behavioral Diabetes Institute
Part 3 of our series from the Behavioral Diabetes Institute
Living well with diabetes takes emotional strength. Why? Because this is a tough disease. Diabetes is more than just eating right and taking your medications. Staying strong emotionally is the key to keeping stress and your blood glucose levels where they belong. Unfortunately, people with diabetes as well as doctors often neglect these “real life” aspects of the disease.
How can you manage diabetes while also giving proper attention to your own thoughts and feelings? In this article, we focus on the behavioral side.
The Behavioral Side of Diabetes
1. Moving from discouraged to encouraged. Don't let diabetes get you down. Diabetes can be a lot of work and sometimes even your best efforts don't seem to pay off—like when you follow your doctor's recommendations exactly, but still your blood sugars are elevated! That is understandably frustrating. But it is not your fault. There are ways to make diabetes care encouraging rather than discouraging.
Solutions
- Measure your diabetes care success in a realistic manner. You can never be perfect, nor do you need to be. Blood sugars rise and fall, sometimes for no obvious reason. So learn about the A1C test, a blood test that measures your average blood sugar over the previous 10 –12 weeks. Your A1C result is the best way to determine how you are really doing and it can help you handle the frustration of those wacky blood sugar readings. For most people, if their A1C result is in a healthy range, then they are doing fine overall, even if their blood sugars are sometimes erratic.
- Don't let blood sugar readings determine your self-esteem. Blood sugar results are neither bad nor good; they are just information. To help you remember, place a small piece of masking tape on your meter and write on it, “It is just a number”.
- Set clear, specific, short-term goals for action. If you just have a vague sense that you should be “eating better” or “checking blood sugars more often,” you might believe you are never doing enough. With your doctor's help, determine what your most critical self-care tasks should be, and get specific. For example, exactly how much exercise each week? Or what type of dietary changes at dinnertime over the next month? By clarifying your action plan, you can tell when you are successful.
2. Keeping diabetes in its place. Diabetes is an important part of your life, but it doesn't have to run your life. For many people, diabetes seems like a prison cell— no more enjoyable foods, no spontaneity, no fun, and constant attention to the clock. Some get so angry they decide to ignore diabetes altogether. If you find yourself thinking this way, it is time for an attitude change. Diabetes care in the 21st century means almost everyone can live their lives fully and take care of their diabetes successfully. Sure, some compromises will be necessary, but diabetes shouldn't be allowed to box you in.
Solutions
- Feel like you are only allowed to eat birdseed? Eating well with diabetes doesn't mean you must limit yourself to certain foods or only eat at certain times. There are no forbidden foods. Meet with a diabetes-knowledgeable dietitian to develop a personalized meal plan that fits your needs.
- Is the clock running your life? Because of your medications or frequent problems with low blood sugars, the clock may be determining when you eat, exercise or check your blood sugars. In most cases, you don't need to live your life like this. Talk with your doctor about switching to alternative medications (or an alternative medication schedule) that can give you back control over your life.
- With your health care team, develop an overall plan so that diabetes can fit into your life, rather than your life having to fit into the constraints imposed by diabetes.
3. Taking control of your environment. Your environment, whether you notice it or not, influences your ability to manage diabetes. Having will-power isn't enough. You need to harness the power of your environment to support, rather than hinder, your diabetes care.
Think about it: how well you eat is affected by the number of tempting foods in your house and the size of the portions on your plate. How faithfully you take your medications is influenced by how many you have and whether they are located in a convenient, easy-to-remember spot each day.
When you take back control of your environment, it no longer controls you. Diabetes becomes easier to handle.
Solutions
- Select a place to exercise, like a gym or park, that is conveniently located near your home or work. If it is too far away, you probably won't go.
- If you have home exercise equipment, make sure it is always set up and ready to go. The more effort required to set it up each time you need it, the less likely you will use it.
- Make sure that tempting, unhealthy snacks are out of the house or put away in cabinets out of sight.
- At meals, start with smaller portion sizes. Don't worry, you can always go back for more later.
- Limit how often you eat out; almost everyone consumes more at restaurants than at home.
- Keep your medications, blood glucose meter and supplies in a good spot, like the dining room table, where you are most likely to see them and use them.
4. Taking a “diabetes vacation.” You need a vacation. Diabetes can be a lot of work, and it demands your attention every day. It is worth the effort, but it is a tough job. All that effort can wear you down, especially if you never get a break. And you can never take a break from diabetes… or can you?
In reality, everyone takes “vacations” from their diabetes. That's not necessarily a bad thing. A break from diabetes can be a big relief. But make sure your diabetes vacations are safe. And, like any good vacation, this takes some planning.
Solutions
- Work with your doctor to arrange for the healthy, regular breaks from diabetes you need. A safe vacation doesn't last too long and involves planning ahead so your diabetes control isn't compromised. This doesn't mean quitting your diabetes care altogether. You might, for example, decide to take a night off each week from your diabetes-friendly meal plan, while learning how to adjust your medications ahead of time. A good vacation can restore your energy for managing diabetes.
- Get help if you are taking “unsafe” vacations from diabetes. An unsafe vacation is rarely planned, can go on for a long time, and may threaten your health. Perhaps you have been ignoring everything about diabetes for years, or you take your medications faithfully but decided you didn't want to ever check your blood sugars again. Develop a more practical diabetes plan with your doctor that can help you get back on track and still provide you with occasional safe vacations from diabetes.
- Everyone needs a diabetes vacation, so don't be afraid to take one. But think ahead, and collaborate with your health care providers to build safe and healthy vacations into your life.
A Few Last Words
Diabetes can be tough, but you can live well with it. You can succeed with diabetes through knowledge, good medical care and emotional strength.
