“Should you really be eating that?” asks your “helpful” neighbor at the church potluck dinner. “If you would lose weight, you won’t need medication,” chants the early morning talk show host. For people with diabetes, remarks like these can be frustrating. Equally disturbing is that voice inside your head that murmurs, “I’ve blown my diet for today, so what’s the use in continuing to make healthy choices?” or “Why check my blood sugar? No matter how hard I try, my readings are high.”
Managing diabetes is an ongoing challenge that requires 100-plus decisions daily. These include decisions about what and when to eat, physical activity, blood-sugar checking, medication and so much more. It is these decisions that significantly impact blood sugar, blood pressure, cholesterol and weight. Add in the struggles of navigating the medical system and insurance issues, and you come up with one major juggling act.
Dealing with diabetes management and all the external hurdles is demanding. However, it’s the internal hurdles — the demoralizing demons of diabetes management — that can make an already challenging job even more difficult. They include: fatalism, perfectionism, guilt, blame and shame. Getting a handle on these forces can facilitate effective diabetes self-management and improve quality of life.
[See: 6 Tips to Keep Diabetes Out of the Hospital.]
Your Future Is Unwritten
Fatalism is a sense that future health is not in any way within one’s control. It’s that voice inside your head that says, “All my family members suffered complications of diabetes. The same will happen to me, and there’s not much I can do to prevent that course of events.” When these thoughts creep in, it’s important to remember that the face of diabetes care is different than it was decades ago. The benefits of excellent control have been well-established. The expanding knowledge of diabetes allows for greater individualization of treatment to meet each patient’s needs. Diabetes management is no longer about waiting for and reacting to poor control and complications. Modern diabetes care encompasses a proactive approach, with the goal of promoting good control and preventing complications. Diabetes self-care efforts can make a difference, and those efforts are not about being perfect.
Perfection Is Not the Goal
Perfectionism is an all-or-nothing outlook that can sabotage an individual’s efforts to control diabetes. Perfectionism can result in the creation of an unrealistic diabetes self-care plan. It’s that voice inside your head that says, “If I can’t train for that marathon and eat salad for every meal, I’ll have failed to do my best at managing diabetes.” Remember that the reality of diabetes management takes place in the context of everyday life. Perfectionism is an impossible and undesirable goal. Effective diabetes management involves small, achievable goals that can have a big impact. Effective care is reflected in blood glucose log sheets with more of, rather than all of, the blood sugar readings in range.
[See: Got Diabetes? Why You Must Protect Your Feet.]
Overcoming Guilt and Shame
The struggle to manage diabetes can often result in feelings of guilt, blame or shame. These demons are the voice inside your head whispering, “I did this to myself by eating too much sugar” or “I could move forward on my diet if only my family would change their eating habits.” When plagued by these feelings, keep in mind that the development and course of diabetes are impacted by environmental and genetic factors. Ruminating about what “could have or should have been” can exhaust the emotional energy necessary to address the challenges of diabetes care.
Often, individuals feel the addition of diabetes medication is an indication of failure to exercise or eat properly. The truth is, medication is now recommended as a standard of care by the American Diabetes Association early in the course of diabetes. Using all diabetes treatments, including medication, provides a strategy of proactive prevention of complications and the best chance for future health. Outside cues, such as huge portion sizes and the wide availability of high-sugar, high-fat snacks, can foster feelings of guilt, blame and shame, plus a feeling of self-denial in those working hard to avoid succumbing to these temptations. Despite what you may have heard, ther’s no special “diabetes diet.” The guidelines for physical activity and eating with diabetes are similar to recommendations for unaffected individuals. The goal of eating well and including exercise is central in achieving control of blood sugar, blood pressure, cholesterol levels and weight in individuals with diabetes. However, eating more healthfully and including physical activity is no less important among people without diabetes for heart-health and weight management.
Becoming a Detective and Overcoming Triggers
Blood glucose checking can be a strong emotional trigger. The best approach is to consider blood sugar monitoring a way to gather information to evaluate when readings are in and outside of the target range. Monitoring is, in a way, detective work. Test with a purpose. If your blood sugar average (Hemoglobin A1c) is elevated, use your glucometer to find out when during the day the sugar levels are high. Levels that are out of range will let you and your health care provider know where to focus treatment changes. Use the blood glucose information to find out what aspects of your treatment are working and what aspects need adjusting.
Two factors that awaken the demoralizing demons of diabetes and interfere with our best chance at healthy control are actually preventable. They are the falsehoods spread by the media, internet and our own negative self-talk. Instead of enabling, they are disabling. Thankfully, research reveals two remedies shown to help deflect the harm produced by misinformation and by our own destructive thoughts.
The antidote to misinformation is education based on sound evidence. Education not only provides knowledge and skills but has been shown to provide individuals with the power to be proactive in their self-care. The American Diabetes Association recommends diabetes education at a nationally recognized program for every person with diabetes at diagnosis and each year thereafter. Nationally recognized programs have internal and external oversight and provide information backed by solid research. To locate a nationally recognized program in your area, contact the American Diabetes Association or The American Association of Diabetes Educators.
[See: How to Cope With Gestational Diabetes.]
Treat Yourself As You Treat Others
The antidote to negative thinking and self-criticism is self-compassion. For many, self-compassion feels uncomfortable. Won’t kindness and acceptance lead to continued bad habits? Research reveals the opposite. While self-compassion may feel unnatural, being gentle and kind to ourselves has been shown to have a beneficial effect on depression, distress and blood-sugar control. On the other hand, being harshly self-critical and beating ourselves up invites back those demoralizing demons of diabetes that sabotage our efforts. The challenges and demands of diabetes are great. With education and self-compassion, the rewards can be great as well.
More from U.S. News
Got Diabetes? Why You Must Protect Your Feet
How to Cope With Gestational Diabetes
The Best Diets to Prevent — and Manage — Diabetes
Navigating the Diabetes Emotional Obstacle Course originally appeared on usnews.com
