TIRED OF YOUR DIABETES? HERE’S HOW TO KEEP GOING
By David Steen Martin
When you have diabetes, your daily to-do list can seem like a lot. You track your blood sugar, take medicine, watch your diet, and exercise.
It can make you feel overwhelmed and burned out. If you’re there:
1. Know that no one is perfect.
There are no vacations from diabetes. Even the most diligent people can’t keep their blood sugar or diet or physical activity on target all the time.
“Diabetes is unique because [you’re] actually making medical decisions, day-to-day, minute-to-minute,” says Alicia McAuliffe-Fogarty, PhD, a clinical health psychologist.
This can be stressful, says David Nathan, MD, director of the Diabetes Centre at Massachusetts General Hospital.
“If people are always stressed out about diabetes, they’re miserable,” Nathan says.
He says people need to forgive themselves if they miss their goals for a day, a week, or even more.
“Chill a little bit,” Nathan says. “We’re going to do the best we can. We need to recognize no one is perfect.”
2. Pay attention to what stresses you out.
Living with diabetes can cause fear, anger, worry, and sadness.
Lawrence Fisher, Ph.D., director of the Behavioural Diabetes Research Group at UCSF School of Medicine, has studied what doctors call “diabetes distress” in people with type 1 and those with type 2 diabetes. He learned that during any 18-month period, from a third to a half of people with diabetes will feel a good bit of it.
He cites seven common sources of diabetes distress among people with type 1 diabetes. The most common is a feeling of helplessness.
“The [blood sugar] numbers have a life of their own. They go up. They go down. You’re constantly making adjustments,” Fisher says. “There’s a feeling of powerlessness that is really hard to tolerate.”
Other common sources of diabetes distress among people with type 1 diabetes include:
· Worry about what those around them assume
· Concern about access to good healthcare
· Perceived lack of support from family or friends, or feeling like they’re the “diabetes police”
· Fear of dangerously low blood sugar
· Stress over managing blood sugar levels
· Bother over what to eat and when
Fisher says people with diabetes should pay attention to what stresses them out and try to address those things. He suggests programs or workshops that focus on what gets you down.
“There are things you can do,” he says.
He found that people with type 2 diabetes also had a feeling of helplessness. A sense of failure and negative social perceptions were other common sources of bother among type 2 folks, he says.
Paying attention to what gets to you about your diabetes is important. The less spun-out you are, the better you’ll be able to manage your disease.
3. Set realistic goals.
That’s important to avoid burnout. It can mean taking a big goal and breaking it into more manageable pieces.
“Taking small steps to achieve a larger goal often makes sense,” says McAuliffe-Fogarty, who has type 1 diabetes.
If you need to lose 50 pounds, shoot for 2 pounds a month, she says. If you drink regular soda, try switching to diet. If you normally eat a pint of ice cream, switch to a half a pint.
“You should adapt your treatment plan to your lifestyle rather than the other way around,” says McAuliffe-Fogarty, who is also vice president of the lifestyle management team at the American Diabetes Association.
4. Ask for help.
Build a support network — and use it.
In addition to your doctors, look for counsellors or family friends who can be there for you when you feel down. Sharing stories as part of a diabetes support group can be very helpful.
Ask those closest to you for specific help you need. This can be anything from asking a family member to remind you to take your medication to asking a friend to go for a walk with you a few times a week, McAuliffe-Fogarty says.
“Without that support, people often get down,” she says.
5. Know transitions can be hard.
Change can be a challenge for anyone. Going through it while you manage your diabetes can be really tough.
Heading to college, being diagnosed with a complication, and trying a new treatment are types of adjustments that can bring worry, McAuliffe-Fogarty says.
To ease stress, try to anticipate and prepare for big changes in your life. That’ll lessen the impact on how you manage your diabetes.
6. Tell your doctor all about it.
See him regularly. When you go, make sure to share your physical symptoms, and how you’re feeling about things. Your diabetes can make it more likely for you to be depressed or anxious. What’s more, how you feel plays a big role in your ability to control your diabetes.
“That’s a component that’s often forgotten or left out,” McAuliffe-Fogarty says of mental well-being. “It’s equally important as eating right and exercising.”
It’s important that you take an active role in communicating with your doctor. He’s trained in managing diabetes. But he may not be as knowledgeable about the emotional toll the disease can take, McAuliffe-Fogarty says.