Working with patients with diabetes through the years, I hear a common theme. “Is this bad?” “Bad” is often used to describe a particular food, blood glucose reading, habit, or behavior. Or similarly I sometimes hear, “this is good, right?” Labeling habits and behaviors as good or bad, black or white may not be the best strategy to managing diabetes over time. It can lead to frustration and diminish our efforts to take care of ourselves.
November is National Diabetes Awareness month, highlighting the condition that can be challenging because of the daily attention to meal planning, physical activity, medications and stress levels. These factors are managed and individualized by a person’s diabetes care team. One size doesn’t always fit all, and being perfect with a treatment plan is a tall order.
For example, reducing food portions at meal times is beneficial when managing diabetes. This guideline is “better” than overeating and taking large portions. But when we do overeat, we aren’t suddenly “bad.” Consider redirecting these types of all or nothing thoughts and ask what can improve next time. Maybe that is not going back for a second helping or swapping out a starchy food for a non-starchy vegetable.
Some people with diabetes check their blood glucose levels at home. It can be hard not to think of these readings as judgment. Some people even believe they are “bad” if the numbers are not in the range their diabetes care team has recommended. A better approach would be to reframe those glucose checks as information or data to help with decisions about meals, activity and medication. Look to see what is happening to readings over the week and see if there is a pattern. Is there a higher reading after the work potluck? How about when you skip exercise? Use that information to guide lifestyle adjustments and discuss concerns with your care team.
Diabetes is not always predictable. The condition changes with age, life stages, and stressful events. Even changes in the seasons can affect diabetes. What works best now may not later. Being flexible and staying positive are helpful mindsets for managing diabetes.
Pam Noonan is a registered nurse and certified diabetes educator at Sutter Gould Medical Foundation.