The Psychology of Type 2
Handling the psychology of diabetes can be so revealing.
By Ilene Raymond Rush
Before a recent family dinner, I hoisted my t-shirt, dabbed a spot on my stomach with an alcohol wipe, stabbed myself with a shot of Byetta, chased down a Glucophage and an Amaryl pill with a glass of water, and readied myself to eat.
Watching all this was my father-in-law, a vibrant and active octogenarian who was diagnosed with type 2 diabetes in his late seventies. After a rocky start in learning how to manage his fluctuating blood sugars, he has settled into a strict routine that has stabilized his glucose readings and permitted him to eat almost all of his favorite foods (give or take a few cherry pastries).
"I like how you take your drugs," he said. "Very business like - one, two, three - you're done before I start."
"I've got it down," I smiled.
He shook his head and then explained that when he's eating at home, he likes to unfasten his pants to inject his Symlin in his upper thigh, but when he's in public, modesty prevents this. So, he's learned to either inject himself in the very little fat around his stomach, or to head to the restroom, which he finds inconvenient.
As the only other relative who shares a diagnosis of type 2 diabetes, the two of us like to compare notes. He'll often announce his sugar readings to me, particularly if they're good. A chemical engineer by training, he has embraced the machinery and apparatus of modern diabetes with the determination he brings to his hobbies of bicycle riding and painting. Annoyed and aggravated at the start of his treatment, he now confidently lines up his food scale, his needles, his Symlin pen, and his trusty composition notebook where he records his food intake, and goes to work. To him, the psychology of diabetes and the personal management is a challenge, something to be managed with mathematical precision.
As I've watched my father-in-law deal with his type 2 diabetes, I've sometimes thought of my own father, who passed away two years ago. Diagnosed in his early thirties, he rarely talked about the stresses of caring for or living with a chronic condition. Although he took insulin or oral medications for much of his life, he didn't stay on any particular diet or keep a food diary. He refused to see an endocrinologist or a nutritionist for many, many years, holding that his own trusted internist was enough of an expert for him.
I never saw my father inject himself with insulin except when he was in his final years and caregivers had to do it for him. Part of this was modesty, but part of it was – I think – the idea that his condition was meant to be kept quiet, a secret kind of weakness.
In a small way, I understand this feeling. Pregnant with my first son, fearful that my parents might discover that I had gestational diabetes and not wanting to cause them undo worry, I did all of my own glucose monitoring in bathrooms of restaurants or on the front seats of parked cars, away from curious eyes. That little machine frightened me to death; I saw every high reading as a judgment on my behavior and my inability to care for my unborn child. Taking my sugars was an intensely private act, filled with the possibility of blame. The responsibility for those numbers was all mine, tied to my diet, exercise, and stress levels.
Let's be frank: Diabetes can test your patience and your character. How you deal with it – the psychology of diabetes management - can be as much of a reflection of who you are as your signature.
It's not that my father or my father-in-law handled the condition in the ‘right' or ‘wrong' way – they simply handled it in ways that best fit their personalities.
As for me, I fall somewhere in between. I keep closer control than my dad, but not quite as precisely as my father-in-law.
I handle my type 2 diabetes just like me.
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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