Diabetes Self-Management Blog

Hope you have or had a good Thanksgiving. I thought this would be a good time to remember the people on the other side of Thanksgiving. But this blog entry isn’t an angry listing of the wrongs and abuses Native Americans have suffered (though you can read some examples here). It’s about self-esteem, self-love, and diabetes.

You’ve probably heard of the Pima Indians of Arizona. They have among the highest rates of Type 2 diabetes in the world. They are also among the most studied people in the world. In my opinion, most of these studies are wasted effort. Others disagree.

But one Pima study I did find valuable enough to include in my book, Diabetes: Sugar-coated Crisis. In this study, published in the journal Diabetes Medicine, 95 obese adults were split into two groups. “Pima Action” consisted of physical activity and nutrition interventions, typical diabetes stuff. “Pima Pride” met with tribal elders for activities emphasizing Pima history and culture.

The experimenters thought of Pride as a control group to the real intervention, Pima Action. They were shocked when, two years later, the members of the Pride group had better results in weight, waist size, diet, two-hour glucose tolerance, and systolic and diastolic blood pressure.

What does it mean?
How could these results have happened? Probably not by chance— the “p-values” of some results were as low as 0.007, meaning that the odds of that outcome happening randomly were less than 1 in 142. Pride clearly had an effect on people that Action did not.

Like most Native Americans, Pima have been victimized for generations, and years of powerlessness can make it very difficult for people to value themselves. The Pima have sky-high rates of suicide, drug and alcohol use, and domestic violence, but they also have high levels of cancer, heart disease, mental illness, and many other problems.

In the face of these conditions, an activity and nutrition program didn’t have much of a chance. People have to value themselves and believe in themselves to live a healthy life, especially in unhealthy environments. Feeling helpless, hopeless and worthless makes self-management seem too difficult and too much trouble.

It seems that learning about their tribe’s history and accomplishments raised the Pride group members’ self-esteem and self-confidence (or “self-efficacy”). They learned that they did have value, and they learned some of the reasons why things are so hard for them. They may have realized that it’s not their fault. They have to do the best they can with their situation, but they should not blame themselves for it.

These feelings translated into better behaviors and probably mind-body healing as well.

Applies to all of us
I think that this is an important finding for everyone to know. Few of us are living through an ongoing genocide. But all of us struggle with believing in and loving ourselves. Society has many ways of tearing down our self-confidence and self-esteem. And we need those qualities to live good lives.

The great Jewish philosopher Hannah Arendt wrote, “If we do not know our history, we believe it is our fate.” In other words, we blame ourselves for the way we are and the way our lives go, when most of it comes from our history, whether it’s social, genetic, or personal.

If we can learn to forgive ourselves and accept ourselves the way we are, we will have a much better chance of changing behaviors and much better quality of life.

What about you? Can you see ways that you blame yourself for things that were not your doing? Ways that your history has affected you in healthy or unhealthy ways? What have you done to improve your self-concept or love yourself more? Let us know with a comment.

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Type 2 Diabetes
New Metformin Combination Medicine Approved for Type 2 Diabetes (10/30/14)
Discovering I Had Type 2 Diabetes (10/17/14)
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Living With Diabetes
It's Hard Work, But We Can Manage (11/06/14)
Diabetes Dilemmas (11/03/14)
The Anatomy of Transformation (10/30/14)
Share Your Thoughts With the FDA (10/21/14)

Emotional Health
Diabetes Holiday Blues (11/25/14)
Fear and Diabetes… (11/20/14)
Diabetes: The Good and Bad Go Hand in Hand (11/10/14)
What Has Diabetes Taught You? (10/29/14)

 

 

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