Canary in the Coal Mine

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I recently read a very interesting research article on mindfulness training and diabetes management among U.S. veterans with both Type 1 and Type 2 diabetes. In the study, 28 veterans were asked to engage in focused, relaxed breathing, meditation, and awareness exercises for just 15 minutes each day. A1C levels (a measure of glucose control over the previous 2–3 months) were taken before the start of the study, and again at the conclusion, three months later. Additionally, at the start of the study and at one month and three months after its completion, the participants were given questionnaires to monitor their levels of diabetes-related distress and self-care habits.

What the study found was pretty remarkable: The participants saw a one-point drop in A1C, from an average of 8.3% to an average of 7.3%. The levels of reported distress decreased by 41%, and self-care habits improved. All of this came about from 15 minutes a day of mindfulness training.

But correlation isn’t always cause
So I found this study to be pretty amazing, and I’ve always been an advocate of mindfulness training to help with diabetes management. But there IS a caveat here: The drop in A1C, the improvement in self-care, and the decrease in stress can’t be definitively traced to those 15 minutes a day. After all, these individuals were all involved in a research study, and that means diabetes management was probably more central in their daily lives simply because they knew they were part of a study. In other words, maybe the drop was simply because they knew they were being more closely monitored.

Furthermore, we can’t really say for sure whether the mindfulness and relaxation had a direct physiological effect on blood sugar profound enough to cause any significant change. Maybe the mindfulness training merely helped the participants be more organized about their self-care, and the resulting increased self-care was solely responsible for the change.

But here’s my “caveat to my caveat”: It doesn’t matter. Whether the relaxation directly altered the physiological responses of the body to better manage blood sugar levels or just helped participants take better care of themselves, the results were the same. The A1C levels dropped. And while the fact they were in a study undoubtedly helped to an extent, the effect of a daily practice is certainly more potent than the psychological knowledge that one is part of a study.

Canary in the coal mine
Diabetes is a “canary in the coal mine” when it comes to stress management. Because we have such an easily monitored condition that relies on quantifiable, daily measurements, we can catch stress before it takes over. I have no doubt that every human being on the planet struggles similarly with stress, and I have no doubt that stress impacts the physical well-being of all of us. But that impact is patently obvious and quantifiable for those of us with diabetes. For the rest of the world, it’s not.

That’s both an advantage and a disadvantage for us. It’s a disadvantage because it means we simply ARE more fragile when it comes to high stress levels. We can’t get away with the levels of stress that some other people (who have no obvious health issues) can get away with. We need to take more time for our own self-care, and sometimes that can be a real pain.

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The advantage of being so quantifiably sensitive to stress is that having this direct feedback can help us sustain the kind of practices this study was talking about. When stress’s effects aren’t being reflected back to someone, it’s easy to ignore it, even if that stress is causing misery. Because even if someone can “get away” with a high-stress daily life, that doesn’t mean stress isn’t affecting them. Chronic stress does NOT lead to feelings of happiness, contentment, and calm. It leads to agitation, depression, and bitterness.

Our blood sugar is a canary in the coal mine of stress. It can tell us we’re slipping into a pattern of chronic stress BEFORE that pattern starts to erode our emotional life (and before it starts to really mess up our physical health). And that’s a great tool if we use it correctly. Yes, it demands more attention and some focus from us, but it’s demanding the kind of focus we should ALL be devoting to our inner lives, anyway. It’s a great tool, and we should all use it wisely.

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