Living with diabetes is not easy at all. No matter how much attention and effort you give to your diabetes care, you can be sure that something can or will eventually go wrong.
There will be crazy days when blood glucose levels rise or fall dramatically for no apparent reason. There will be frustrating days when you can’t stop eating, and there may be scary days when minor or major complications suddenly appear. If only the results were predictable, a great deal of personal effort and many daily personal decisions in diabetes care would be tolerable.
One of the many reasons contributing to burnout is the frustration of following instructions, doing everything right, and failing to get diabetes into control or desired numbers. Given all of the work responsibilities, decisions, and at least occasional disappointments, how can you manage diabetes successfully year after year?
Research shows that blood glucose management and other healthy actions can dramatically lower your risk of long-term complications. However, many people are not taking advantage of this opportunity to ensure a longer and healthier life for themselves. This is not because they lack willpower or are stupid. Instead, the primary culprit is diabetes burnout. Sadly, many people who, because of diabetes burnout, have chosen to ignore their diabetes for years have been struck by long-term complications i.e disease kidney disease, heart disease, painful nerve damage, amputations, and more, the arrival of serious complications.
To manage your diabetes successfully, you need to be aware that, as human beings, we are strongly influenced by short-term results than by thoughts about long-term consequences. There are many long-term benefits to taking care of diabetes but not many immediate ones. Short-term outcomes are so powerful that they can cause us to change our behavior and attitudes without even realizing we are doing so.
Unfortunately, in a condition like diabetes, the most important benefits are not immediately seen, particularly the prevention of long-term complications. In contrast, there can be immediate positive consequences for ignoring diabetes concerns i.e, when you choose to sit in and watch a movie for entertainment (immediate gratification) instead of taking a 40-minute walk or eating certain foods i.e, cakes to satisfy your sweet tooth/taste buds instead of taking time to boil say sweet potatoes or yams and eat them as snacks. Diabetes burnout is more likely to occur when you believe the costs of taking good care of diabetes outweigh any possible benefits.
With this understanding, here are the three areas we challenge you to revisit and work on religiously with some sacrifice, discipline, and willpower. We will also suggest ideas to help you overcome barriers to good self-management. There are three possible barriers to good diabetes management. Let us divide them into three categories;
1. Personal
2. Interpersonal
3. Environmental
Personal barriers.
Your thoughts, feelings, and attitudes can make diabetes management easy or difficult. When feeling very blue, it can be hard to summon any energy to care about your diabetes. Even the simple tasks of daily life seem too challenging to accomplish, which can result from poor management. If you are stressed or depressed, please resolve the root cause of what’s depressing you. Speak to a counselor or friends if need be as a way of coping.
Another personal barrier is a lack of knowledge about managing diabetes. I recommend resources like dmrc support groups or blogs (https://blog.dmrckenya.co.ke/) as a go-to place to learn more about diabetes.
Health beliefs can be barriers to good care. Many people believe that diabetes is not a serious disease or that they will not develop diabetes complications. If they think that good diabetes management will not affect their health, they are unlikely to make much effort. On the other hand, other people believe that diabetes is so severe and terrifying that there is no hope. Often these people have seen their neighbors, parents or grandparents, or other loved ones suffer diabetes complications, and they feel that they are also doomed to suffer the most terrible complications, and there is nothing they can do about it. From this perspective, good diabetes management is, again, meaningless. It is essential to realize that both of these extreme beliefs are wrong.
Other people have developed a terrible relationship with their condition. They feel at war with diabetes, and they think that they are in an ongoing battle to determine whether diabetes will control them more whether they will control diabetes. Feelings of hatred, anger, sadness, and guilt are common, and they lie at the heart of diabetes burnout. To deal with negative emotions:
- Acknowledge and accept feelings.
- Talk to someone.
- Learn more about diabetes.
- Take care of mental health.
- Connect with others who have diabetes.
Fear of hypoglycemia (low blood glucose)
Because good diabetes management usually brings high blood glucose levels closer to the normal range, there may be some risk of your blood glucose dropping too low. This is especially true if you take insulin or certain oral hypoglycemia blood glucose-lowering medications.
If you are already nervous about low blood glucose, perhaps you have had a scary, embarrassing, or unpleasant experience with hypoglycemia in the past, then you may be uncomfortable with the idea of improving your diabetes care; such fears are common and reasonable, and they can influence your quality of self-care. To manage the fear of hypoglycemia despite good sugar control, talk to your doctor about it, monitor blood sugar regularly, plan meals and snacks ahead of time, carry glucose tablets or other fast-acting carbs, stay active, and practice relaxation techniques.
Eating disorders and the fear/frustration of weight gain.
There are many ways in which people battle with food and with their body image; these include clinical disorders such as bulimia nervosa and anorexia nervosa as well as problems such as binge eating and emotional eating. Eating disorders can interfere with your ability to follow a healthy meal plan and can make good diabetes management all but impossible.
You may gain weight when you achieve better control of your blood glucose. Weight gain can be a disheartening consequence of good self-care if you are concerned about your shape, and this can make you question your effort and wonder why bother working so hard when relaxing your self-care efforts may help you. Check and ensure your weight is within healthy BMI and adopt healthy meals, fewer in carbs.
Finally, do not set unrealistic or unclear expectations about self-care. Some people have become convinced that they must manage their condition perfectly. They believe that they must follow a healthy and balanced meal plan without ever straying from it, rigidly adhere to an exercise plan, check their blood glucose, and take medications on a tight and unbending schedule and that their blood glucose must always be in the normal range. This is not only overwhelming and exhausting, it is also impossible. If you feel that you must be perfect with your diabetes care, you will end up feeling like a failure, which can make you feel like quitting diabetes care altogether. Work with your doctor, nutritionist, and physical activities instructor to ensure your goals and targets are reasonable and fit into your lifestyle.
Next…..
2. Interpersonal barriers…