Overcoming the obstacles of managing diabetes.
with Amy Tenderich
Editor's Note: While this columnist is no longer writing for dLife.com and we have ceased to update the information contained herein, there is much to be read here that is still applicable to the lives of people with diabetes. If you wish to act on anything you learn here, be sure to consult your doctor first. Please enjoy the column!
February 2007 —A woman wrote to me recently saying, "I'd love to hear your take on why some diabetics make poor choices and choose to be in denial over consequences."
Ugh. This sounds suspiciously like another case of blaming the "non-compliant" patient for willfully choosing to ignore doctor's orders. I guess it's perfectly natural for physicians and other observers who don't live with diabetes themselves to sit on the sidelines and say, "Why aren't these patients motivated?"
Well, for your information, it's not that we don't care about ourselves. Most every human being IS MOTIVATED to live well and long. It's just that managing your diabetes day-in and day-out is a lot of hard work, and an incredibly thankless job in the short-term. It's not like we get points for all the foods we didn't eat this week, for example.
Me vs. The World
Watching everyone around you eat and do as they please while you've got about a million restrictions can be maddening, for one thing. And then you've got lots of well-meaning people (or sometimes just meddlesome strangers) who have a lot to say about your diabetes. Some classics are: "Can you eat that?" and any phrase starting with "You should…"
Sometimes it just feels like you and your diabetes versus the world at large. You want everyone to just leave you alone, for goodness sake! But then again, you want them to recognize your condition and have a little empathy now and then. See the problem? We're sending mixed messages – because emotions about having diabetes often contradict each other. No wonder it can be so hard!
Three Core Obstacles
I recently took part in a session at the Behavioral Diabetes Institute in San Diego, CA, where founder Dr. William Polonsky talked about three core things that tend to prevent people from actively caring for themselves:
* Diabetes invulnerability -- The old "I feel fine, so I must be fine" approach.
* Diabetes vulnerability -- The flipside, as in "I'm doomed anyway, so it doesn't matter what I do."
* Life gets in the way -- There's so much I'm supposed to do, "I don't have time for all this."
How true! Thinking about it, every excuse we come up with for neglecting our diabetes generally boils down to one of these three concepts.
Even though my type 1 diabetes DEMANDS my attention, I still see a little of myself in each one of these statements. They also help explain why my own father did so little for his diabetes for so many years.
What's unbelievably frustrating is that knowing the consequences is often not enough. Most of us "get" the importance of good diabetes care, and we understand that it far outweighs any supposed excuses. But we can still get caught up in the mindset of these pretexts.
What I'm saying is, sometimes you just feel like your own worst enemy. That's it. Recognition. I'm not going to tell you there's an easy fix…
But as Denise Armstrong, the secretary from Illinois who was recently profiled in Reader's Digest told me, you just have to "deal with the down days, and move on." In her case, she was inspired by a nurse's admonition that she wouldn't be able to make the lifestyle changes necessary to avoid taking oral medications (which was Denise's goal). She would show that nurse a thing or two! And she sure did.
"When someone tells you they don't think you can do something, well... I guess what my husband says about me is true: I am a little hard-headed," Denise says. A hard head certainly comes in handy for pounding against the many stumbling blocks towards good diabetes care.
* Amy Tenderich is co-author of the new book, Know Your Numbers, Outlive Your Diabetes.
Read more about Amy Tenderich.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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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...