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.)

The Future

When I started to blog, close to 12 years ago, my life was very different. Even in the last year, things have changed a lot for me, in so many lovely ways.

  • The need to lose weight is no longer a constant companion – I lost just under 100 pounds and am happy (most days!) with the way I feel in my body
  • My diabetes is well controlled
  • I have achieved a balance that works well for me between saying yes to social activities and taking time for myself
  • I am taking classes for a certification in Digital Marketing, something I have been interested in for some time and would like to explore professionally in the future

The good news about these changes is that I am so much happier now – not every minute of every day, but more often than not – and I enjoy my life tremendously.

For this blog, the changes in my life have led me to think about whether writing here is still something I want to do. As I mentioned earlier, I weigh all of my commitments carefully to make sure that I don’t overwhelm myself – even with things that would be fun – and this blog used to be a major commitment of time for me.

In thinking through things, I’ve come to a few conclusions:

  1. I still want to write. Writing makes me happy and I enjoy it, so that’s good.
  2. I don’t want to write about my personal life anymore – it’s pretty boring at this point anyway but more than that, it just doesn’t feel like a good use of my time.
  3. The story of how I went from a morbidly obese, seriously depressed couch potato with out of control Type 2 diabetes to where I am now is interesting to a lot of people who don’t know me in real life.
  4. I don’t see a lot of people writing about how to manage Type 2 diabetes, depression, and obesity – I can bring a fresh perspective to the online discussions about these topics.

So, I’ll be writing here regularly from now on, with a focus on how to manage chronic diseases and live a healthy life. My initial goal is to post at least once a week for a month and see how that works with the rest of my life.

I am grateful beyond measure for the support many of you have shown me as I’ve struggled to make sense of my life; I hope you’ll still find something worthwhile in what I choose to write in the future. If you’re interested in more of the personal side of things, you can always follow me on Instagram, where I share lots of goofy things that happen to me during the day.

Gaining weight and self knowledge

On June 14, before starting a 10 day trip to the southeast followed by a 5 day trip to Seattle, I stepped on my scale to find that I’d officially dropped belong 150 pounds and 26% body fat, representing a loss of 95 pounds and a 50% reduction in how much of my body is composed of fat since starting this journey in February 2013.

When I weighed myself last Thursday, seven weeks later, I saw 154.1 pounds and 28% body fat on the display; I have regained 7 hard-fought pounds and that weight is pure fat (as opposed to increased muscle mass). Given the way I’ve been eating lately, this was not a surprise to me, but it was – and still is – difficult to accept. One thing I’ve realized in the last 18 months, though, is that the lessons I learn when the path becomes bumpy are those that stick with me and form the structure of a healthier, happier life if I focus on finding the lesson in the experience rather than beating myself up for not being perfectly perfect.

So what will I do differently going forward?

  • Stop mindlessly eating sweets before bed – I convinced myself that I could have hundreds of calories of dessert every night because it was all low-glycemic and wouldn’t affect my blood sugar. While that’s absolutely true, extra calories add up over time and they aren’t doing my body fat percentage any favors. I’ll focus on fruit and nuts after dinner instead and see where that gets me.
  • Stop watching television with Mick after dinner – school starts back up in a couple of weeks anyway, so I need to get into the habit of reading and/or writing before bed anyway. Mindless eating while doing something mindless doesn’t align with my goal to live a happier, healthier life, so it needs to be replaced.
  • I’ve started taking one yoga class a week – anxiety is a regular part of my life that I’ve used mindlessness to “treat” for most of my life. Yoga encourages being present in my body and observing myself without judgment; I need more of that.

I’ve also been giving a lot of thought lately to what my goals are in terms of a happy, healthy weight and when to shift from weight loss to weight maintenance. At a Fitbloggin’ session this year, I was confronted by these questions as well as this troubling (for me) thought: what needs to happen inside my body for me to feel satisfied with where I am physically? I still haven’t wrapped my head around that one yet and it feels like a great topic for a session – or several – with Dr. Jennifer, my therapist; let me make an appointment to find out what wisdom she has for me.

Look, I wrote a whole post in MS Word without getting overwhelmed – perhaps there’s hope for this blog yet!

Giving it a go

I compose blog posts in my head while I walk in the mornings. While they never seem to make it to the screen here, trust me when I tell you that they’re filled with angst and wisdom, and would probably make great reading. The process of getting them from my brain to the blog just seems like too much effort most days, in a life where every decision about what to do (and what not to do) starts with the question, “Will this thing that I am contemplating help me create a happier, healthier life?” When held to that standard, many activities that previously formed the routine of my life have fallen off my plate, blogging included.

It didn’t used to be that way, though, so what’s changed? Well, I have changed, for one. I’m not a single girl with no one at home to spend time with. Running, biking, Pilates, walking, and now yoga take up the majority of my discretionary time. Blogging has changed, too – so much focus is put on publicity and writing about things that will appeal to the larger audience. Back when I started blogging, it was about sharing your thoughts about life with whoever showed up to read them, with emphasis on the honesty and quality of what you produced, rather than how many people commented or tweeted or shared it on Google.

For a long time, I’ve allowed myself to be distracted by the shiny blogging objects that surround me when I sign into WordPress to write: SEO, categories, tags, keywords, featured image, publicity options. I get so overwhelmed with all of this that I tell myself “it’s too much work to blog, let’s do something fun instead”.

But then the thought occurs to me that if I pretended that I was back in 2003, ignoring all of the distractions, and just wrote things down without worrying about who is reading or what they think of me? I used to compose my posts in MS Word then cut and paste into Blogger (my original blog lives on that [much simpler] platform) – I could do that again to see how it feels.

Until next time, then.

Dear Comrades: It’s been a little while since last we spoke

Way, way back, so long ago that it hardly seems real now when I think about it, I used to write blog posts as naturally as if I were casually checking in with a friend every day. Heck, I sometimes posted more than once a day if I had a particularly interesting – at least to me! – day. I didn’t worry about what anyone wanted to read, or about how it all came out, I just let words tumble onto the keyboard and the blog page. Somewhere along the way I lost that mindset and writing here became something I had to do and it had to be done properly, with tags and pictures and search engine optimization and all of that rigamarole.

I have a couple of lovely friends with whom I am supposed to check in every day to report how I’ve done on my Healthy/Happy Me routines, so I wondered if I could use the blog to do that since there can’t be anyone left reading here who isn’t a friend at this point. (Who but a friend would indulge me my long, unexplained absences?) So, with that, I give you my check-in for today:

Dear Comrades,

Where to start? It’s been a tough week, with lots of changes at work and odd pain with swelling in my shin, but I think I’ve done pretty well in staying focused on taking care of myself. The scale at Weight Watchers said that I lost 0.8 pounds this week but more importantly to me, my blood glucose testing results show no rise in my sugar levels even though I haven’t been able to walk or get any sort of real exercise since last Monday’s walking 5K – huzzah!

So, what have I done to keep my sanity – and maintain healthy blood sugar levels – without physical activity?

  • I’ve cut out nearly all carbohydrates other than fruit and vegetables from my eating. It’s not that I eat a lot to begin with but they’re completely gone until I can exercise enough to burn them off.
  • Keep close watch on the sugar content of the packaged foods I do eat. For instance, I have Greek yogurt every morning and used to scarf down 17-20 grams of sugar with the brand I was eating. Since I’ve been paying more attention, I’ve reduced that to 10-15 grams instead. Small changes add up, particularly with sugar and simple carbohydrates.
  • Hydrate, hydrate, hydrate! Water, tea (iced and hot), non-fat/skim milk (at least 8 ounces a day), and decaffeinated iced coffee are all keeping my body humming along nicely without the false hunger cues that can sometimes pop up when I’m actually just thirsty.

TCB and I are off to watch The Book of Mormon this afternoon and I still need to take a shower, so I’ll close here. Hope all is well with you and that you’ll share how you’re doing – any challenges coming up or recently faced? – in the comments.

xoxo Denise

Creating a new habit

  • I never used to walk anywhere if I could drive.
  • I never used to bring my own food – healthy or otherwise – to work with me.
  • I never used to walk a 5K every morning before work so that I could start my day off with 8,000 steps on the pedometer (that I didn’t own).
  • I never used to do anything about it when I had worrisome medical symptoms.

…but I do now.

For each item on the list above, I’ve created a new habit over the last 14 months that makes me a happier, healthier person. None of those things were easy to change – believe me! – but I knew I needed to change my old way of doing things in order for Project: Happy/Healthy Me to succeed. I started out small, increased what I was doing slowly and steadily, and eventually it became easier to do the new habit than revert to the old way of doing things. Writing here needs to be the same way.

I am struggling to reach a healthy Body Mass Index (BMI). The number on the scale doesn’t always go down and certainly it does not do so easily when it does. The 15 pounds between where I am now and a healthy BMI feel simultaneously impossible and yet so tantalizingly close that it sometimes feels as though I’m already there. It’s like the feeling I have when we’re nearing the end of a long road trip: aren’t we there yet? How much longer? This was fun four hours ago but now my back aches and we’re out of snacks, so let’s just get this done. But, like a seemingly never-ending road trip, there are no short cuts in weight loss, either, so I’ll keep plodding along because there is no other option. (Thanks, Kay Lynn, for reminding me of that fundamental truth at our recent lunch chat!)

In the meantime, I ponder these moments in time and remember how far I’ve come:

post-5K 9/3/2011

post-5K 9/3/2011

post 4 miles, 4/26/14

post 4 miles, 4/26/14

Just Write

“I need to include at least one picture with every blog post, for SEO, Google+, and Pinterest.” If you don’t write anything, there’s nothing for a search engine to fine and nothing to be shared on Google+ or pinned.

“I need to finish that major project on the blog before I write any new posts.” The project isn’t as massive as you’re making it out to be in your head and you did the most urgent portion of it in 10 minutes just now.

“I’m too busy training for the Tour de Cure, working, and doing homework for my class – I don’t have time to write a post.” Stop making up rules about what a blog post “should” be – you can write a sentence and be done, if that’s all you have time for.

“What would I write about?” Are you joking? How about any one of the hundreds of posts you compose in your head while you’re walking but never take the time to write down when you get home???

“It’s been so long since I’ve written anything, how will I explain my absence?” How about not bothering with all of that and just writing something? (And also, do you really think anyone’s noticed that you haven’t written since end of March? My, my, what an inflated sense of your own importance you have.)

Three things I’m grateful for this week: March 27

Making lemonade from lemons!

Making lemonade from lemons!

  • Our vacation to Phoenix for Spring Training. Oh my gosh, it was so good to get away and relax for a few days – I’m so grateful to my husband for organizing everything (and doing all of the driving) so that I could focus on the enjoyment of it all.
  • Gentle rain. Last month’s gully-washing rain in San Diego were awful because so much moisture came down so quickly that it couldn’t be absorbed to do any good for our plants and streams. This week we’ve had a couple of days of slow, gentle rain and you can see it all soaking into our poor, parched dirt. With any luck at all, we’ll have some wildflowers in May to show for this.
  • A recovering Pug. Poor Alouysius, he swallowed a large piece of landscaping bark not last weekend but the weekend before and had to have emergency surgery to remove the obstruction. Between eating the bark and the veterinarian discovering what was going on, fluid and partially digested food built up in his abdomen and even post-surgery it was still draining from his (very short) nose, leading to concerns that he could aspirate some of the fluid and develop pneumonia. You can’t imagine how little sleep any of us got until it was clear he was out of the woods! He’s got to wear the Cone of Shame for another day, until his stitches come out tomorrow, so he’s doing Doggy Day Care at the vet’s office for the week, but it’s a small price to pay to get his sweet, squishy face back and healthy.
Poor, sad Cone-of-Shame Pug!

Poor, sad Cone-of-Shame Pug!

Your turn: What are you grateful for this week?

Surround yourself with inspiration

This is a sponsored post; it does not contain affiliate links.

For as long as I can remember, having bright, pretty things to look at has inspired me. From the colorful posters I plastered on the walls of my on-campus apartment freshman year in college to the bright red, patent leather heels that make me smile whenever I wear them, I am happiest – and do my best work – when I have pretty things to look at.

When I moved into our new home – now just over six years ago! – I wanted to wait to hang things on the walls until I could figure out exactly the perfect piece for each spot. As a consequence, most of the walls in our bedroom and office are bare. A rare exception is the wall next to my side of the bed where I wake up every morning to see this:

More Than Coffee, a limited edition print by Lehan Veenker on minted.com

Several years ago now, I stumbled upon minted, where I found this print for sale, and fell in love. There are so many gorgeous pieces on the site, created by independent artists who submit their work for consideration and are chosen by visitors to the minted site; this one spoke to me because I am obsessed with coffee. Once I’d chosen the design I wanted, I was able to easily view my options then choose the size and frame for my finished piece – saving me a trip to the framing shop plus the time to wade through all of the framing options to choose just the right one for my piece. A short time later, my limited edition print, framed and ready, arrived in the mail and went straight onto the wall in our bedroom, where it still lives today.

When I was recently approached by a representative from minted to write a review of my experience with their site, I remembered the great end-to-end experience I had with my purchase and agreed without reservation. There’s a quote on their site, in the About Us area, that I absolutely love –

“Our purpose in life is to uncover exceptional design from all over the world and bring this to savvy consumers who won’t accept anything else.”

By giving visitors the power to choose what will be offered for sale on the site, minted allows artists from anywhere in the world to put their work in front of buyers who might not otherwise ever see it; what a neat business model.

What inspires you? And is anyone else still looking at (mostly) bare walls in their home and/or office?

Disclosure: I received compensation in exchange for writing this review. Although this post is sponsored, all opinions are my own.

Three things I’m grateful for this week: March 6

  • San Diego finally got some desperately-needed rain. Yes, we did get about a quarter of what we ought to get for a whole year in one very soggy weekend and yes, lots of areas flooded badly, but I was beginning to despair of ever seeing rain without going on vacation again. Also, it restores my hope that further precipitation could still happen here before the end of our rainy – ha, what a misnomer! – season.
  • Work is getting slightly less hectic. Yes, it’s still tax season and things get crazed several times a week right up until the filing deadlines but our number of weekly releases will finally start decreasing drastically with this week’s schedule and it can’t come soon enough for everyone on the team. (Working without a complete weekend off from Halloween until well into March every year is tiring.)
  • I attended the Women Get Social conference this weekend in San Diego. While I was there, I learned a few cool things from the scheduled content but even more from the three smart women I was privileged to spend most of my time with for two days – thank you, ladies!
Three fabulous bloggers (and one very fortunate one)!

Three fabulous bloggers (and one very fortunate one)!

Your turn: what are YOU grateful for this week?