Diabetes is Tough
Making the most of a life with diabetes
Life with diabetes is tough. Not only do you have to deal with a chronic, long-term condition that has no cure – but you have to do this largely on your own, every day for the rest of your life, all the while under the cloud of the possibility of developing long-term complications.
Some people can reach out to the support of family members and health care professionals. However at times this support can feel more like well meaning but ‘scolding' health care professionals and loving but ‘nagging' family members.
Dealing with diabetes can therefore feel like a very lonely place. Life with diabetes has been likened to a job; in which you work 24 hours a day, 7 days a week, 365 days a year with no break, no holiday, no reward, and no praise. You wouldn't stay in a job like that for very long! However the person with diabetes has to do this every day, perhaps all the while being told, "It's only diabetes. What's the big deal?"
A further complexity with diabetes is that it is a medical problem so it is therefore dealt with in a medical setting – with a focus on the medical regime of insulin dosage, weight management, blood glucose control, and so on. However, in the busy setting of a medical clinic, there is often limited opportunity to discuss the daily challenges, frustrations, and stresses of life with diabetes. Sometimes it feels like our well-meaning medical team is repeating the same good advice every time we visit – test your blood glucose more, eat less, exercise more, smoke less, check your feet more, drink less.
The problem is, you are usually aware of what you should be doing – the struggle is in implementing it consistently. You may leave the diabetes clinic full of motivation, adamant that this time will be different. But weeks, days, or even hours later, you lose track and struggle to get back on target.
The reason for this is a simple one – knowledge about what you should be doing just isn't enough. A research trial conducted in the 1980s, ‘The Diabetes Control and Complications Trial', conclusively demonstrated that achieving tight blood glucose control improves health and wellbeing. Yet this knowledge alone was shown to have little impact on the day-to-day behaviour of people with diabetes. This is similar to the warnings provided on cigarette packets, which have been demonstrated to actually only make a small impact on the desire for smokers to give up.
There is a range of reasons why people struggle to implement the health advice they know they should be following. This is because health does not exist in isolation from the person. It is affected by a complex interaction of meanings, emotions, thoughts, memories, behaviours, relationships with others, and much more. Diabetes doesn't just affect your body, it affects your emotions and mind too. These can have an extremely profound affect and interact with your ability to care for your diabetes.
This column will address the specific emotional and psychological barriers that get in the way of managing your diabetes. The next article will examine the issue of how to improve your relationship with your healthcare team. It will help you to understand why and in what ways your emotions might lead to a struggle in this area and the practical strategies you can take to improve it.
Dr. Jen Nash is a clinical psychologist who has lived with diabetes for more than 20 years. She runs www.PositiveDiabetes.com, an education, therapy and coaching service that supports people with type 1 and 2 to manage the emotional and psychological impact of day to day life with diabetes.
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...