Five principles of effective diabetes self management

People sometimes stop me during the day – at work, mostly – to ask what my “secret” is. I used to get embarrassed by the question but now I realize that folks are looking for a blueprint to create their own healthy life and while there’s no secret to it, I do know what works for me in maintaining good control over my diabetes. Today I’ll introduce the basic concepts; my plan is to focus on each one in detail in future articles as I delve into creating a plan for effective diabetes self management.

effective-diabetes-self-management

The first principle is eating well. Sounds simple enough, right? If I had a dime for every self-help book, e-book, website, infomercial, etcetera offering an eating plan for weight loss or disease management, I’d be able to retire to open the organic dog biscuit bakery of my dreams! The truth is that “healthy” means something different for every body. Not everybody but every body. In other words, a food that works really well for my body’s needs might be absolutely lethal for yours. I eat two hard boiled eggs nearly every morning because my cholesterol is in the healthy range and eggs are full of protein and some fat, neither of which will cause a spike in my blood sugar. By eating them after walking or running and before work, I set myself up for a great morning without having to worry about feeling hungry before I can get to lunch. For someone with high cholesterol, though, this eating plan wouldn’t work well; they might be better with Egg Beater omelets or a poached egg white. Experiment. Try different foods and see how your body responds. It’s important to give your body good fuel in reasonable amounts according to what your body needs.

Once you have the right fuel on board, you can look for ways to exercise a little every day to help your body use the calories from what you eat. I remember how much I hated the thought of exercising every day when I started on my journey to better health – mostly because my extra weight made movement painful. If you haven’t been active on a regular basis in a while, start where you are and gradually increase your duration or intensity. For me, I could barely walk 15 minutes at a super-slow pace on the treadmill before I wanted to die. So, I started with that, every other day, for a few weeks and then I added another day of walking 15 minutes. After I’d worked myself up to 5 days a week of 15 minutes of walking, only then did I very slowly increase the duration of each session. The most amazing part to me was that, after only a month of regular walking, my blood sugar readings were already nearly back in the healthy range even while I still had at least 80 pounds to lose. Biking, swimming, skating, an elliptical trainer, circuit training with weights, Zumba, playing hockey, chair dancing – whatever exercise you enjoy that raises your heart rate will work, so pick one and start slowly!

Knowing precisely what’s going on inside your body can be a little scary. If you’re at all like me, you probably don’t see much point in testing your blood sugar since, if it’s high, you can’t really do much about it and it makes you sad (or angry, or scared) to see how high it is. I was equally bad about going to my primary care physician, ophthalmologist, and dentist: I knew the news would be bad, so what was the point? I’m going to let you in on a little secret, though: nothing in my life got better until I stopped ignoring the health team that was waiting to help me manage my disease. Testing your blood sugar allows you to know which foods your body likes and which ones will send your blood sugar soaring – that’s how you start to build a meal plan. Meeting with your primary care physician and discussing the results of your lab work will help you see whether you need to watch your sodium (high blood pressure) or cholesterol; they will also help you set goals for what your blood sugar readings should be and can send you to a dietician or diabetes educator. Seeing the ophthalmologist every year will ensure that any changes in your eyes are caught early while they can still be treated effectively. And if you’re not sure why the dentist should be a part of your diabetes treatment team, I will share that I used to think the same thing until I had 15 teeth removed in a single surgery last year due to advanced periodontal disease caused by diabetes. Keep up the twice-yearly visits to the dentist in addition to brushing 2-3 times a day and flossing at least once – don’t learn the hard way like I did.

Stress is a part of our daily lives: that won’t change no matter how well you take care of yourself. If left unmanaged, stress can negatively affect your physical and emotional well-being, sometimes leading to unhealthy coping behaviors, too. According to the Mayo Clinic, symptoms of stress may include headache, chest pain, fatigue. sleep problems, anxiety, irritability, sadness or depression, over- or under-eating, drug or alcohol abuse, and social withdrawal. Finding healthy ways to handle the stress in your life can be challenging, particularly when your previous coping mechanisms might include unhealthy behaviors such as those listed above. For me, I spent most of my life using food as my stress antidote of choice. Now that I am paying more attention to taking care of my body, I spend a lot of time exploring new ways to navigate stress without turning to food. Yoga, walking, mindfulness, and deep breathing all work well for me on a day to day basis. I still struggle with binge eating in response to stress, but it’s far less frequent now that I have other viable options to turn to instead.

One easy way to handle stress is by consciously bringing as much joy into your life as possible. I was stunned to realize, at the beginning of this journey, that I couldn’t think of anything that I had truly enjoyed for years and years. Two years later, a list of my greatest sources of joy come easily to me: spending time with my husband, our pets, and the rest of my family; walking in our neighborhood; chatting with a friend; reading a book; taking a yoga or Pilates class; traveling. I have consciously chosen to explore new activities to help me figure out what energizes me and what doesn’t, so that I can pull more of the former and less of the latter into my life. The flip side of this equation is not allowing shame – a painful feeling that you (or something you have done) are foolish or wrong – to dominate your life. When my diabetes was out of control and I was 100 pounds overweight and I couldn’t even walk on a treadmill for 15 minutes without dreadful pain, I was ashamed, and that shame nearly kept me right there in that same state forever. Shame robs your life of joy if you let it, and I agree with Dr. Brene Brown who has said that the antidote to shame is empathy – from others and from yourself. Talk to trusted friends about how you feel but also start treating yourself the way you would a friend who was struggling with her own imperfections. As I say to myself at the start of each yoga class, “Inhale joy, exhale shame.”

I hope you’ll find something here of value no matter where you are on the journey to a happy, healthy life. As I said earlier, I’ll be exploring each of these principles more fully through future articles, so let me know if you have questions or additional thoughts to offer.

(Note that these principles apply equally well to effectively managing any chronic illness or, really, to living a healthy, disease-free life.)

Effectively managing stress

Do you know someone who never seems to react to the craziness around them but rather stays calm and serene at all times? While I want to be more like that, my more common response is to let the energy of my surroundings – whether calm or chaotic – dictate my mood and feelings. In the past, this led to my using food to soothe or distract myself, but after losing nearly 100 pounds and getting my Type 2 diabetes under good control, emotional eating in response to stress no longer serves me well, so I spend a fair amount of time seeking out and practicing new stress management behaviors.

Serenity

Serenity, by Ken Douglas, via Flickr

What works for me is:

  • taking a deep, cleansing breath – it sounds simple, and it is, but this is one of the most effective tools I’ve found for managing stress without turning to food. Not only does it keep me anchored to the present moment (instead of obsessing over every possible bad outcome) but filling your belly, chest, and throat with air before emptying them out with an enormous sigh feels simply decadent.
  • getting away from the situation – even slipping away for a brief moment provides a reminder that there is far more going on in the world than whatever is preoccupying me. I particularly like to walk laps around the inside of our building at work: I “get away” while still being close by in case someone needs me urgently.
  • walking meditation – my morning walks are my favorite 20, 30, 45, or 60 minutes of the day. Some days I listen to podcasts but others I simply walk and breathe and enjoy the people, animals, and scenery I encounter. The key is to focus on being really present where you are and holding those feelings of freedom and joy inside to help with perspective when things get rough later on in the day.
  • yoga – in the last six months, I have fallen in love with my yoga classes and have gained so much inner peace (not to mention flexibility and agility) from my practice. For the 60 minutes I’m in class, I focus on my breath and finding ways to bring more relaxation and joy into my body. (Note that I used to spend a lot of time in class worrying about how I looked in the various poses and what other students were thinking when I couldn’t do everything exactly as described. Now I know that no one cares even a little bit what you are doing or not doing because they are taking care of themselves, their bodies.)
  • communicating how I’m feeling – it can be verbally or in writing, but sharing what I’m worrying about  with another person nearly almost reduces the associated stress.

Do you have any favorite stress management techniques? Are you one of the unflappable folks who don’t seem bothered by anything, and, if so, what are your secrets???

 

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