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D-Care: What’s Stopping You?

Tips for overcoming barriers to type 2 diabetes care

My client, Joyce, could write a book about type 2 diabetes. She knows just how her diabetes care team advises her to manage it – which foods to choose, how to stay fit, when to schedule medical appointments and more. The title of her imaginary book would probably be: Do as I Say, Not as I Do. That’s because, with all of that wisdom, Joyce doesn’t follow most of those suggestions; she can’t seem to help herself.

According to a study in the American Diabetes Association journal Clinical Diabetes, about half of all people with type 2 diabetes find it hard to care for their diabetes. Often, they may know what to do, but struggle with their care for a variety of reasons – some people may be overwhelmed by the number of health tasks to perform; others may feel anxious, depressed or unmotivated; and some may have little family or social support. I’ve been examining these issues deeply, for my forthcoming book, Approaches to Behavior: Changing the dynamic between patient and practitioner in diabetes education. If any of these issues hold you – or someone you love – back from caring for diabetes, consider trying some of my most important suggestions:

Set reasonable goals

If you feel burdened by all you have to do to care for your health, get a new plan. Meet with your health care team and talk about how to choose small, realistic goals you can gradually build on. Celebrate each small goal as you meet it. For example, don’t struggle to walk 30 minutes each day, but start with a goal of 15 minutes, 3 times a week, and try to gradually increase your walking time. (Read more about how to get started walking here.) Treat yourself to a movie, a massage, or even coffee with a friend as a reward for meeting your goals each week. If you feel that your health care provider asks too much from you, say so. You don’t have to challenge or attack, just graciously ask if he or she will help you break up the assigned goals into smaller, more achievable steps.

Focus on strengths, not weaknesses

It seems counterintuitive, but when you focus on what you already do well, you can resolve many of your challenges. Here’s an example from my client Dave who complains that he can’t stop eating: Instead of trying new ways to stop grabbing cookies and chips while watching television, I suggested he identify the times when his “snacking monster” didn’t bother him – when he successfully pushed the urge away. After some thought, Dave realized that he never snacked while he worked on the computer; he didn’t crave food when his hands were busy and his mind was occupied. So he decided to do more things that provided that level of attention, such as woodworking and painting. Now, while at home, he busies himself with these activities and finds that many of his snack cravings are gone. He is now starting to lose some weight.

Maintain a healthy blood sugar level

The body needs glucose to focus on tasks. If your blood sugar level is low, you may be more likely to become frustrated and stop what you are doing. I advise clients that keeping their blood glucose levels in a healthy range helps maintain the energy to meet their personal goals. Speak with your healthcare team to find the balance that is best for you.

Ask for help

Don’t expect family and friends to be mind readers and know what you want them to do. Be clear when you ask for help with a task. If you don’t have family support, you may want to connect with others who are living with type 2 diabetes. I advise clients to contact their neighborhood hospitals or check their local newspaper for diabetes support groups that meet in their area. You may also want to explore The DX to find some ways to discover helpful online connections. 

If you continue to feel anxious, unmotivated and depressed about your health needs, you may want to meet with a mental health professional to learn how to perceive your diabetes in a different, more productive way.  It may be possible to overcome many of the barriers that stop you from achieving your diabetes and health goals. I hope you follow the suggestions above and take your first step toward improved health.

Janis Roszler, MSFT, RD, CDE*, FAND is the American Association of Diabetes Educators 2008-09 Diabetes Educator of the Year. She is a registered dietitian, certified diabetes educator, and marriage and family therapist. Her books include Sex and Diabetes and The Secrets of Living and Loving with Diabetes. Roszler is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.

*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.

 © 2014 The DX: The Diabetes Experience


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