Prescription: Will Power
with Amy Tenderich
Diabetes is the only illness I know that continuously pits people against their own will power. Sure, there are other health conditions that sometimes require special diets and a measure of self-discipline. But in my opinion, diabetes trumps them all for sheer 24-hour / seven-day-a-week frustrating effort required. And since the pay-off is very long-term, it sure can sometimes feel like a futile endeavor.
Luckily, nowadays we have home glucose monitors to help us track our blood sugar levels, and a variety of medications to kick our insulin-poor metabolisms into gear. But the fact is that we live in a snack-packed, oversize-portioned, drive-through environment that is anything but conducive to managing our diabetes. We’re constantly forced to say “no” when everyone around us is saying “yes.” Who or what – I’d like to know – is helping us with that?
Do our close friends or relatives help? You wouldn’t believe the stories I’ve heard from fellow patients. For example, at Thanksgiving dinner last month: a well-meaning mother approaches her diabetic daughter with a slice of pumpkin topped with thick whipped cream. “Just this once,” she coaxes…
Isn’t it difficult enough being the odd one out with a chronic illness that can potentially kill or blind us in the long-term? To actually have to make a scene at a family gathering to get a little support really just takes the cake, so to speak. I suppose there’s no way to expect other people to understand our “diabetic agenda” without having walked a mile in our shoes.
Then you’ve got actual bona fide diabetes organizations that ought to know better. But they don’t. On the cover of the November 2007 issue of Diabetes Forecast (the American Diabetes Association’s magazine) was a mouth-watering photo of a pumpkin pecan bundt cake sprinkled with powdered sugar. The headline read, “Celebrate.” What is the message there?
Some might say it’s just meant to illustrate that “even those of us with diabetes are allowed to indulge once in a while.” But even if this cake were some special low-carb, tofu-algae health variety (which it wasn’t) I think the image is beyond wrong. People clearly do not need any additional encouragement to indulge -- certainly not from the ADA, which is supposed to be our partner in reducing temptations. How is their bundt cake helping us?
Furthermore, I attended the American Association of Diabetes Educators’ (AADE) Annual Meeting last summer, and was stunned to see carts full of candy in the hallways for “snacks.” We’re talking gum drops, red licorice, tootsie rolls, jelly beans, and chocolate-covered nuts. The official luncheon menu also included big, frosted brownies and lemon bars for dessert. The message, however unintentional, was unmistakable: it is “normal” to eat candy for between-meal snacks and include a goopy dessert with your lunch.
I’m pretty sure that 95% of the diabetes educators attending this event did not have diabetes themselves – otherwise there would have been some sort of protest, I imagine. But how are these healthcare providers supposed to give us diet advice – and expect us to be “compliant” – when they clearly aren’t tuned in to health eating themselves?
Speaking of “compliance,” I was asked in a recent online interview why diabetes patients are so “notoriously non-compliant” with their medications. You could have seen the steam coming out of my ears!
The first thing that came to mind was a reader comment submitted on my site recently: “It chaps my a$$ when clinicians (especially those who do not have diabetes) tell me what I should be doing, based on formulas, ratios, math, etc. We do not live in a vacuum. We have varied schedules, families, emotional highs and lows, travel issues, etc. My diabetes is a full-time gig, where I don’t earn vacation days. Then I have another full-time job that pays my mortgage and my bills.”
Right-O. Getting control of your health with diabetes really is a mental game every single day. It’s a game of will power that people without diabetes have trouble grasping. Because for them, a slip off the diet, an “off-weekend” or even a whole bad week is just a shrug of the shoulders. It doesn’t mean soaring blood glucose levels that leave them feeling cranky and depleted. It doesn’t mean rising A1c results that inch us toward neuropathy, kidney disease, and other ugly complications.
My response to the blog interviewer, in essence, was this:
Imagine that YOU were told you can (almost) never enjoy sweets, always have to count every gram of carbohydrate on your plate, exercise a minimum of 4 hours per week, and meticulously take oral or possibly injectable medications multiple times a day. Would you always follow these instructions perfectly? Um, no, I didn’t think so . . .
When it comes to our D-med prescriptions, I sometimes think doctors should just be more forthright, and add to the dosing instructions: “Take with a generous helping of will power.”
* Amy Tenderich is co-author of the new book, Know Your Numbers, Outlive Your Diabetes.
Read more about Amy Tenderich.
dLife's Daily Living columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team to find out what will work best for you.
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