Learning to live with diabetes is like learning to drive a car. The new driver tends to start out slow, paying attention to everything that could impact the experience. Although watchful, time behind the wheel builds confidence. Eventually, the driver reaches a level of competence that most driving decisions are easily taken in stride. While a diagnosis of diabetes doesn’t bring the excitement of a new drivers’ license, the learning process is similar. From the perspective of a Certified Diabetes Care and Education Specialist (CDCES), my goal for persons living with diabetes is not doing what they are told, rather I want them to become someone who knows what to do . . . just like the experienced driver. There may be new situations to navigate, but you forge ahead. The Association of Diabetes Care and Education Specialists has identified seven self-care behaviors to help persons living with diabetes navigate toward successful self-management. These behaviors include:
1. Healthy coping. How do you feel about a diabetes diagnosis? Psychological well-being is important when learning new things. If everything about a diagnosis is negative, then attempts to learn diabetes management are overshadowed with negativity. This is behavior number one because it really is the most important behavior. Diabetes management today is not the same way diabetes was treated ten years ago. Diabetes related stress can make glucose control more difficult. Additionally, persons living with any chronic illness are more prone to depression and anxiety. Take control of diabetes just like taking control of the car. Drive to a higher level of wellness and check out online resources here.
2. Healthy eating. Learning how to eat healthier, usually begins with a review of eating behaviors. The goal is to work toward a healthier diet that supports glycemic control and positive outcomes. Over time the person living with diabetes learns how to read food labels, make adjustments to cooking preparation techniques, adjust when and how much to eat with allowances for celebration meals. A diagnosis of diabetes doesn’t mean giving up “good” food. In fact, healthy eating can include a diet that incorporates a variety of foods and indulgences while promoting health and wellness. For more information click here.
3. Being active. Movement is considered a fundamental characteristic of life. Yet we live in a world where technology seems to work against movement. Being active is one of the most difficult behaviors to adopt. There are alot of misconceptions about activity. Here are some of the facts:
- Some physical movement or activity is better than no movement or inactivity.
- More physical movement or exercise is better than a little physical movement or activity.
- No matter where the starting point is, increasing physical activity promotes better health.
- Persons who are unaccustomed to increased activity are recommended to seek medical approval prior to initiation.
- Physical activity may include structured aerobic or resistance exercise and/or unstructured activities that includes everyday physical movement and activity.
- For more tips on increasing activity click here.
Got it? No excuses. Move!
4. Taking medication. Persons diagnosed with diabetes will have medication intervention. There are multiple classes of medication that support glucose control. Each diabetes medication class supports glucose control differently in the body. Since medications lower glucose differently, it is not uncommon to have more than one medication prescribed for glucose control. There is no one size fits all when it comes to medications. Identical twins with a diabetes diagnosis could benefit from completely different medication regimens.
Additionally, persons with diabetes are at risk for other medical conditions and long-term complications. Most persons with diabetes will be prescribed medications to prevent and/or reduce the risk for these conditions and complications. Again, it is not uncommon to have more than one medication prescribed to prevent or reduce the risk of other medical conditions or complications.
The sudden addition of multiple medications can be overwhelming. Additionally, it takes time to get the medications adjusted. Ultimately, these medications are to support good glycemic control and prevent long-term complications. For the person living with diabetes, the addition of multiple medications is another learning process and any concerns they have should be shared with the diabetes care team. For more information on medications and ways to manage medications, click here.
5. Monitoring. Healthcare monitors indicators of health and wellness. Persons living with diabetes frequently monitor blood glucose either by fingerstick glucose monitors or by a continuous glucose monitoring device. Additional health indicators monitored include: diet, activity, weight, blood pressure, feet and skin, sleep, and psychological well being. There are a number of health and activity monitoring applications to assist in successfully monitoring the changes in these health indicators. Monitoring applications can also promote participant engagement and empowerment while facilitating the sharing of results with the healthcare team.
Monitoring is not an indicator of good or bad behavior. It is important to remember that monitoring is a series of snapshots of health indicators that can be analyzed by the healthcare team. Monitoring indicates where your health is. Learning is a progressive behavior. Any behaviors discouraged or recommended are part of learning to live well — not punishment for an occasional outlier result. To learn more about monitoring, click here.
6. Problem solving. Identifying self-care behaviors that support healthy diabetes self-management includes problem solving. It is from problem solving that trend analysis is evaluated for potential improvement. Problem solving is discovering that certain foods produce an exaggerated glycemic response. Problem solving is determining how physical activity impacts blood glucose after the activity. Problem solving is the skill that defines the person who can navigate the challenges in living with diabetes — even if the results aren’t as “pretty” as one would like. Problem solving can highlight gaps in knowledge that the healthcare team can correct. Problem solving is learning. Learn more here.
7. Reducing risks. The moment a diabetes diagnosis is made, the plan of care works to reduce that person’s risks. Risk of uncontrolled glucose levels, risk of long-term complications, and risk of poor outcomes. The key to reducing risks is to act early. Reducing risks at diagnosis is a good time to begin. Immediately after a diabetes diagnosis, time with a CDCES is vital. It is through diabetes self-management and support that most adverse outcomes are prevented. Annual follow-ups to reassess the person living with diabetes’ needs support diabetes self-management as a lifelong process and develops an individual skilled in navigating the unexpected events of living with diabetes. Learn more about navigating away from undesired risks here.
It is a well-established fact that diabetes complications are lower with glycemic control. Most persons living with diabetes have been told to keep glucose levels in a target range. Knowing where the target is doesn’t necessarily make it easier to hit. Learning across the lifespan and using the ADCES7 self-care behaviors make navigating your way to the target easier.