Diabetes Self-Management Blog

Since I write books and articles and speak about healthy ways to live, I am ashamed to report that real health depends on… not worrying about your health! That’s what a new book says, and I tend to agree. But does this message apply to people with diabetes?

In the January 5 edition of The New York Times, Tara Parker-Pope reports on Dr. Susan Love’s new book Live a Little! Breaking the Rules Won’t Break Your Health. Dr. Love has written several books on women’s health, menopause, and breast cancer, on which she is a leading expert. In her new book, she says that all the various self-care prescriptions we learn — about sleep, food, exercise, attitude, stress, regular checkups, etc. — are making some of us crazy.

“Is the goal to live forever?” she says. “I would contend it’s not. It’s really to live as long as you can with the best quality of life you can.” The book was cowritten with Alice Domar, PhD, a psychologist and professor at Harvard. The basic message is to “just relax; you’re probably living healthy enough already.”

In general, I think this is good advice. Worrying about our health can be a never-ending source of stress, and we know that stress is bad for diabetes and bad for happiness. I spend hours each day in self-care, and I’m not sure how much benefit I receive from it. Maybe the effort would be better used on other things. But is it safe for people with diabetes to take a more relaxed attitude toward their health?

After all, the trend in diabetes care, at least for Type 1, has been toward more “intensive therapy.” Some articles define “intensive therapy” as meaning at least three injections of insulin a day. How relaxed is that?

Even leaving insulin injections out of it, some people check their glucose four to six times a day. Some with Type 2 might exercise for hours or put themselves on very strict diets (low-carb or otherwise.) Is this really necessary? Do the benefits outweigh the costs in worry, time, effort, or money? I think each person must find his own answers to these questions.

What I’m really wondering is how much self-management feels right to you? Do you feel like you are constantly stressed by glucose numbers and carb counts, or can you relax and, as Dr. Love says, “have some fun and live a little”? Do you find yourself worrying over all the things that can go wrong and all the things you “should” do for yourself? How much do these demands interfere with your enjoyment of life?

And how much does diabetes affect your sense of yourself? Do you feel like you are constantly being judged, if not by others, then by yourself and your glucose meter? Do you interpret glucose numbers as value judgments?

Society likes to blame people for being sick, because it makes healthy people feel like it couldn’t happen to them. So you see people trying to make us feel bad all the time. Referring to Dr. Love’s book, The New York Times quotes one professor, Elizabeth Barrett-Connor, MD, who worries that people “may feel they’ve been forgiven… They shouldn’t feel like this is a license not to try to do better.”

Thanks, Doc. I’d hate to be forgiven after all these years. Perhaps I can be allowed to enjoy my life and still take care of myself, if it’s all right with you.

So what do you think? Could you relax more about your health? Do you want to? How could you do it safely? Are there maybe some things you obsess about a bit too much? Or are you afraid that maybe you’re too relaxed now? Help us find a balance here.

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Living With Diabetes
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