May 22, 2007

Keep on Keeping on

Joe Nelson

During the last session of the TCOYD (Taking Control of Your Diabetes) conference I attended yesterday, the moderator, Steve Edelman, M.D., asked those of us on a panel what messages we thought were most important to give people who live with diabetes. To summarize all five responses from the panel would be difficult, since each came from a different medical bias, but the essence of all the responses had to do with encouragement to “keep on keeping on.”

Most of us who work with people who have diabetes recognize that it can be a difficult condition to live with. It is at times difficult to remember to take prescribed medicines or insulin injections. It may be difficult to see the importance of doing certain activities (such as monitoring blood glucose levels or eating well) when it sometimes doesn't seem to make much difference. It may be difficult to keep up the effort of sticking to a meal plan if it isn't always what you prefer, even though you know it may help. It may be challenging to keep your support people in the loop on days when you don't even want to be in the loop yourself. And if you feel sad, angry, or depressed, it can be really hard to find the energy to pick yourself up and either get the help you need or take the steps you know would be best for you when something easier is more tempting (like a bowl of ice cream).

Many years ago, I had the privilege of being the psychologist with the International Diabetes Center during the Diabetes Control and Complications Trial (DCCT). This 10-year study gave us the evidence we needed to state clearly that "tight" control of blood glucose levels was essential in preventing diabetes complications. During that study, we saw that in spite of everyone's commitment and effort, there were times that all study participants lost some of their motivation and energy for focusing on diabetes. It was good timing, then, that every three months we planned educational events for the study groups. This activity would often give everyone in the study the extra boost to carry them through the next several months, and it helped us all with our motivation.

Here is the point: Motivation is a moving target! Not everyone is motivated by the same thing, but everyone is motivated by something. Know yourself well enough to know what gets you going, and then use it. It may be the energy you get from local conferences like TCOYD. Maybe it's the positive comments you get from your spouse or health-care provider. Or maybe it is seeing a 1% reduction in your HbA1c. Whatever the motivator is for you, the message I hope you are getting for yourself is "Never give up!" That was the common theme from the TCOYD panel.

What are the things that motivate you? How do you get back on track?

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