Diabetes Self-Management Blog

This is it, folks! The last in a three-part series reflecting on a severe low blood glucose episode I went through four years ago. Last week, I talked about how the experience highlighted some of the remarkable gifts I have developed through my years of living with diabetes. It was, if I do say so myself, an interesting little piece of philosophical prose.

Today, however, I’m going for practical. I want to share some of the straightforward, how-to-get-through-your-day-with-diabetes lessons I learned. Since we’re going for practical here, I’m going to break it down lesson-by-lesson. I’ve even included a few “homework” assignments for those of you who feel so inclined. So everyone take a seat, spit out your gum, stop talking to your neighbor, and let’s begin.

Lesson Number 1: Take back your lunch (and other things)!

If you recall, at the time of the incident I was working as a therapist at a residential treatment center. Days were almost always 10-plus hours, and there was still never enough time to get everything done that needed to get done. It’s the kind of situation many of us find ourselves in at work — too much work, not enough time. And what’s the first thing to go when time gets tight? Lunch.

For me, it started by moving from a half-hour lunch break to a 20-minute “working lunch.” Soon, it became a 10-minute working lunch, then 5. On the day I passed out, there simply was no lunch. Little by little, I had allowed the hectic pace of the work environment to completely take over. Most of my coworkers did the same. And to be sure, it wasn’t exactly healthy for any of us. But diabetes takes that choice from kind of unhealthy to extremely dangerous.

After I came home from the hospital, I simply decided that I would never give up my half-hour lunch. With each new job since (and I’ve had a few, being a part-time social worker, teacher, musician, and writer), I have been explicitly clear that lunch is nonnegotiable. Ten-hour days? Sure, those happen. Come in on a Saturday sometimes? All right, I can do that. Skip lunch? Never. I have made it a condition of my employment.

If you are living with diabetes, you have a right to take the time you need to care for your condition. You have a right to ask for the things you need, to set the limits you need to set, and to say “no” when those limits are not respected.

Homework: Write down the basic things you need in your daily routine to take care of your condition the way you feel you should. Once you have that list, take a look at your work schedule and see if those needs have been “trimmed back a little,” severely limited, or dropped altogether. Then, talk to your boss. Tell him about any reasonable accommodations you need in order to effectively manage your diabetes. If he refuses to hear you, remember that diabetes is protected under the Americans with Disabilities Act, and no employer can legally deny you reasonable accommodations.

Lesson Number 2: HAVE SUGAR ON YOU AT ALL TIMES!

There’s nothing else to say about this one, really. Have sugar on you. Do it! Now!! There’s no reason not to. If I had bothered to take that incredibly simple step that day, none of this would have happened.

Homework: Got sugar? If yes, great. If not…. GO GET SOME GLUCOSE TABLETS!!

Lesson Number 3: Breathe…

The final (and central) lesson here is time. We need to take the time to care for ourselves without compromising; without letting our health management needs be over-run by our environment. If you had asked me then why I had given up my lunch altogether, or why I didn’t ask my client to wait for three minutes while I ran back to my office for more glucose tablets or some M&M’s from the vending machine, I would have said it was because I “didn’t have the time.” I would have told you that I simply had “too much to do,” and that it couldn’t wait. The truth is that I had given away that time without thinking about it, simply because it seemed to be what “everyone else was doing”.

But in recounting the events and lessons of that day, I’ve come to realize something more fundamental about living with diabetes, and perhaps about life altogether: time is something created, not something absolute. Humans are unique in dividing the natural world into segmented measurements like time. And while our habit of measuring the world has led to some truly inspiring discoveries (the discovery of insulin among them!), it is not without its drawbacks.

Measuring time the way we do leads us away from the present moment. We spend our lives focused on tomorrow’s errands, this deadline or that deadline, or creating next week’s schedule down to the minute. But while it is important to plan for the future, it is equally important to do our best to live in the moment, especially living with diabetes. As I wrote last week, diabetes requires us to be always attuned, and that requires us to be in the present moment.

Homework: Find your way to be present. Meditation, yoga, exercise, art, writing — all of these are great ways to return to the present moment. Once you find what works, stick to it. Living mindfully is one of the most invaluable tools available for those of us living with diabetes.

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