by Robin Fein, L.C.S.W.
I remember when I was diagnosed with Type 2 diabetes about 14 years ago. I left the doctor’s office with a bagful of samples, sheets of paper with information, referrals and prescriptions and most of all, many questions. How do you manage this condition? Does this mean you can never eat sugar again? I met with a CDE (Certified Diabetes Educator) and she showed me the basics. I really recommend doing this and it is often covered by health insurance. In the subsequent years, I have distilled self-care to three categories: monitoring blood glucose, healthy eating and increasing daily movement.
Monitoring Blood Sugar
It is essential to check your blood glucose on a daily basis. At first it can be unpleasant but I have come to realize that your meter is a great tool because it gives you an immediate glimpse into your body and what’s happening with your diabetes. It helps you make decisions about food and exercise throughout the day. Monitoring blood glucose becomes a habit like brushing your teeth or combing your hair. To learn how to check blood sugar, watch this video, and this video is helpful for understanding what you can learn from testing blood sugar.
Any time you’re measuring something, there can be what I call a “scale phenomena”– that is, we can start to believe that we’re measuring more than numbers. It can be tempting to see our numbers as “success” or “failure”, or to base our self esteem on how “good” the numbers are. It is REALLY important to look at our numbers as helpful information. If my fasting blood glucose is high in the morning I can ask myself, “What did I eat the previous evening?” or “Should I start my day with with some light exercise to bring my blood sugar down?” If you have a non-judgmental attitude, it will help you make compassionate choices that are sustainable over the long haul.
Making Healthy Food Choices
It sometimes strikes me as ironic that one of the challenges of eating healthy foods is navigating the plenty all around us. We are constantly inundated with messages and images of tempting food… it can be challenging. And unfortunately, food can become another source of low self esteem if we beat ourselves up for eating foods we know aren’t good for us. I believe re-education to develop new habits and a positive relationship with food is necessary…
So where to begin? There is a lot of different dietary advice for people with diabetes and this can get confusing. A simple place to start is with “counting carbs.” Talk to your doctor about what the right number of carbs is for you, but most healthcare professionals recommend between 45 to 60 grams of carbs per meal and 15 to 30 grams of carbs for snacks. There are many benefits to this approach as it gives you a livable guideline and helps you think about balanced nutrition which includes carbs, protein and vegetables.
Smaller planned meals all through the day help me keep a more balanced blood sugar. Also, I have found that a protein-rich breakfast can make you feel fuller and more energetic. I know I often struggle with low energy and my impulse is to go to carbs or sugary food for immediate relief. The opposite is true! When I eat too many carbs, I just want to go to sleep. One tip that has really helped me is that when I eat carbohydrates, like bread, I choose a high-quality product and eat slowly to really enjoy it.
The third cornerstone of well-being is increasing how much exercise we get each day. If being more active is difficult for you, I think starting slowly is wise. I find using a pedometer very useful because it gives me a way of measuring my natural daily movement and acts as an incentive. I used to try to go to a gym, but I have realized that doesn’t work for me. The question is, how can you increase your daily activity level in a sustainable way? What do you enjoy doing? To make it seem manageable, you can start out with a goal of 10 minutes per day with a goal of doing 30 minutes per day eventually.
Another very important benefit of exercise is the way it can improve mood. Something that matters because many people with diabetes also suffer from depression. When we are more active, we increase the serotonin levels in our brain, and this is especially true of aerobic exercise. How can you increase your movement and reframe it as a pleasurable experience?
So, those are the three suggestions for good self-care which can really help for staying positive with diabetes. I would love to hear any additional suggestions you have in the comments. The next article in this series will cover the mental aspects of staying positive.