Diabetes ABCs

Diabetes ABCs: T



Managing diabetes can be difficult, but you don’t have to go it alone; your care  team is there to help.  Members of your team can include:  your primary care physician/endocrinologist, a Certified Diabetes Educator and a nutritionist.  Other teammates include a podiatrist to help care for your feet and an eye care provider (an optometrist or ophthalmologist) to help care for your eyes.  And don’t forget your support network of friends, family, and peers.  Everyone has an important role in helping you to live well with diabetes.

(Content reviewed by MGH Diabetes Center)

Goal Setting

Rock climbing.

As the New Year approaches, many people start making New Year’s Resolutions around what they’re hoping to accomplish in the coming year.  While early January is a popular time for setting goals (a new year means new beginnings and fresh starts), you can make healthy lifestyle changes at any time.  Just remember, whenever you set goals for yourself, make sure they’re SMART goals. 

SMART is an acronym that stands for Specific, Measurable, Action-oriented, Realistic and Timely.  Specific means your goal isn’t too broad or vague.  Measurable means there is some way to track your progress.  Action-oriented means you have to actively work towards achieving your goal.  Realistic means the goal is do-able and Timely means there is a timeframe or deadline for what you hope to accomplish.  So let’s say your goal is to improve your Diabetes management.  This is a great start, but how can we make it into a SMART goal?  How about:  I will take control of my Diabetes management by testing my blood sugar before eating and two hours after every meal for the next month.  Stating your goal this way gives you a clear picture of what you’re working toward, which will help you stay on track and hopefully develop momentum to stick with it after your goal has been reached

Once you’ve decided on a goal, don’t feel you have to go it alone.  Talk to your friends and family about your plans—they can help keep you on track and offer emotional and moral support during the tough moments.  If you do hit a rough patch—maybe your A1C came back a bit higher than expected or you missed an entire week’s worth of gym workouts—don’t get discouraged.  Give yourself permission to slip up; no one is perfect (and no one expects you to be perfect either).  Instead, see if there is anything you can learn from your experience and make a plan to work around whatever obstacles have popped up.  For example, if you’ve found it’s difficult getting to the gym first thing in the morning, see if it’s easier to on your way home from work.  Then, pick up where you left off and keep going.  

Finally, don’t forget to reward yourself.  You’re putting a lot of time and effort into making some positive changes and you should celebrate your accomplishments!  For each milestone you reach, give yourself something that will help you stay motivated to stick with it. 

What are your goals for 2012?

(Content reviewed by MGH Diabetes Center. Photo Credit: Bryan Wintersteen)


Diabetes Burnout

By Eileen B. Wyner, NP
Bulfinch Medical GroupStress

“I give up”. “I’m tired of doing this every day.” How many times have any of us uttered these words? This seemingly never ending winter has certainly made me feel this way, especially on the many days that the Needham commuter rail line came late, or more often, not at all. The choices facing me at that point included going home, (not really an option) or trudging to the Orange Line (along with all my other train friends). Whichever option I chose would cause an inconvenience, either to my co-workers and patients or to me, but not a potentially life threatening consequence.

When you have Diabetes and feel like giving up, the potential repercussions are much more serious and can include new or worsening complications like heart disease, stroke, blindness and kidney disease. People who feel this way about their Diabetes are frequently experiencing something called Diabetes burnout (DB). This means that you are just overwhelmed or exhausted with taking care of yourself. This feeling may last days or weeks or be intermittent. However, the longer it goes on without any intervention, the greater the possibility of a worsening in your Diabetes control.

I want to make it really clear: it is totally understandable that you may feel like giving up on your Diabetes self care sometimes. Almost everyone who has Diabetes feels frustrated and distressed from time to time, and some more than others. Taking care of yourself and your Diabetes is a fulltime plus job, and that is on top of everything else going on in your life. Your daily self care includes things like checking your blood sugar, taking your medications, watching your carbohydrate intake, and exercising. Sometimes you just don’t have the energy or motivation to do all of these things all of the time.

Helping hands

Here’s the key: the most important thing to realize when you are feeling this way is to acknowledge the feelings and know that there are people and strategies available to help you deal with them. It’s also important to be aware of some cues that may mean you’re experiencing DB. You may not be aware of anything different, but the people in your life may notice things have changed. It may be you aren’t checking your blood sugar as often as usual, you’re more careless with your diet choices, or you may even be less precise with the timing and taking of your pills or your insulin injections. In the most serious instances you may even neglect to do these things all together.

Now that you are aware of these behaviors, you can work on improving the situation. Here are a few strategies to implement when you feel worn out:

1. Admit to yourself how you feel. Don’t be ashamed of these feelings. Keep a journal to help you gain perspective.

2. Talk to your health care provider. They will help you to manage these feelings.

3. Get support. Let your family and friends know that you are struggling and let them help you—they care about you and want to be there for you. You may want to join and work with a Diabetes support group, too.

4. Identify roadblocks. Realize that sometimes things happen that you can’t control. You may have blood sugar fluctuations or not be able to eat exactly as you would prefer. You just need to do the best that you can and keep going forward

5. Make a schedule of all that you have to do to self manage your Diabetes to help you to stay focused.

Once you are diagnosed with Diabetes, it doesn’t go away. You can close your eyes and click your heels 3 times, but when you open your eyes you will still have Diabetes. It’s the job that you can’t resign from. My hope for you is that you always reach out to those in your life to help you through the rough patches.