Tag Archives: diabetes control

Diabetes and Clinical Language Problem: We Have the Power

Recently and over the years, there have been very intelligent and thoughtful written reactions to the way that people with diabetes are clinically labeled as uncontrolled, non compliant and non adherent.

I wanted to share my thoughts today.

First, I think we need to define what “control” means in regards to diabetes and blood sugars.
Clinically speaking, my doctor would label me “in control” or “compliant”. Does this mean I always manage my blood sugars, can always predict them or often have swings that are outside of my ability to manage? No, but it means that my daily readings and A1c are generally considered the best possible for someone without the ability to make their own insulin.
 
Whenever an additional factor is present like gastroparesis, poverty or depression then we ourselves should keep those in mind so that if we do somehow come across the label “non compliant” we remind ourselves that we have our own legitimate reasons for blood sugar instability. While it is nice if others support us, especially for those without the self-confidence to prop themselves up emotionally, I think we should strive to be responsible for our own feelings of guilt. I understand this is difficult depending on who you are, what you have been through, how you were raised to think and so on.
I no longer feel guilty about my blood sugar management when it is poor. I know diabetes is hard and I work to improve it while patting myself on the back for attempting the impossible. This helps me tremendously because instead of sinking at the sound and judgment of a word, I focus more on the meaning of it and what I need to do. I’m not always very good at this but I try to focus on solutions instead of my feelings. I get that this can be very hard. I for one, always initially react emotionally to something and those feelings often overwhelm me when trying to think clearly. Still, I find that it helps to stay rational and try to keep emotions out of the troubleshooting process. 
Better results regarding my diabetes are going to help me feel better so they are my lighthouse.
I can certainly empathize with wanting clinical terms to go away. I’ve always advocated that doctors keep their technical in-house terms to themselves because they do not translate to people and their feelings. The truth is that outcomes are negatively influenced when people are emotionally upset. Doctors should recognize that there are many good reasons why someone isn’t managing their blood sugars as well as they’d like and help a person make improvements wherever possible without using a phrase that doesn’t take their serious effort into account. In-house, fine, I’m “controlled” or “uncontrolled”, whatever. Sitting with my doctor in an office, I’m “doing my best” and then we proceed to improve what needs improving.
 
If a healthcare provider or institution doesn’t want to change their ways of describing me on paper, I’m not going under for it, not going to cry, be hurt, feel inadequate. Not in the least bit. And I hope you don’t either. You are doing the job of an organ! If you are alive you already have my genuine congratulations. Maybe in this context we can all think of control as a clinical term to describe best outcome treatment goals being met? After all, our doctors and clinicians need a way to describe us for data compilation and such.
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In the meantime I suggest not tying any of your value, self worth or personal efforts to language. We have the power to start solving this problem for ourselves and our children by not being victims of words if we don’t want to be. 

 

Learning to Put Diabetes First

I feel like I say this in every post now, but I’m so busy ALL the time. At least that’s what it seems like because I always have things to get done. Balancing so many responsibilities is tough and definitely stressful and my diabetes control is suffering a little because of it. I admit that recently I’ve been letting my diabetes take the back seat. I may need to give insulin, but if I need to catch the bus, I’ll wait until I get to class to give my injection. I eat at random times and my meals are not always wholesome–a consequence of working around classes and meetings (and weather sometimes…). During nights when I have to stay up doing homework, I tend to get hungry and I snack. Only in the morning do I regret doing so, once I see the 250 on my meter. Sometimes I skip lunch and then eat too much for dinner. The list goes on a little further, but I’ll stop before I make myself look worse…

So what I’m trying to say is that we need to learn to put diabetes first. If you think about it, it makes sense to. The way we feel determines whether our day will be productive or not. If you don’t monitor your bloodsugar levels and give your insulin on time and eat nutritious foods at consistent times, it’s going to make you not feel so good later on. And let’s face it, when you don’t feel good, you don’t feel like doing much. At least I don’t. I would rather lay in my bed and watch movies or sleep. Especially if it’s raining, too.

I’m finally getting into more of a routine here at school and learning better time management so now my goal is to get back on track with my diabetes control. The picture above is of a meal I made for myself a few days ago. I was having frequent stomach aches and thought that plainer foods such as a salad and some pita bread and hummus would be good to eat. I made my own vinaigrette as well. That meal was delicious and I felt really good afterwards. The only problem is that it took a fair amount of time to prepare. Time that I don’t always have!  I feel like I rarely have time to make food for myself so I resort to microwaveable food. But again, it’s a matter of prioritizing. I can make time if I really try. If I need to, I’ll wake up a few minutes earlier so I have enough time to give insulin and eat breakfast in the morning. I will pack lunch when I know that I’m going to paint in the studio in between classes. I will finish homework earlier if I can, so I won’t have to stay up late and be tempted to late-night snack. As you can see, the common theme here is planning ahead. Unstable control can be a hugely stressful part of your life. By planning ahead, you can make your life much less stressful. I’m up for anything that will do that!

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