Getting Your (Diabetes) Ducks in Order

I have a ritual that I do twice a year, once in the spring and once in the fall: I go through all of my closets and drawers, clean out what I don’t wear or need anymore, and then switch over to the upcoming season’s clothes. In a perfect world, I’d have closets for each season of clothes but, alas, my house isn’t big enough.

Even if you’re not overrun with clothes like I am, chances are you prepare for the upcoming summer or winter months in certain ways, perhaps by planting bulbs, putting away patio furniture, or gassing up the lawnmower/snow blower. You may even change the types of foods you eat: apples instead of peaches, hearty soups instead of cool salads. Whatever your “rituals” are for heralding in a different season, if you stop and think about it, it’s a great time to reevaluate the old, in a sense, and focus on changes that you might need to make or new things to try.

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I got thinking about getting one’s “diabetes ducks” in order yesterday. It was 80 degrees in Boston, but people were getting ready for the autumn by buying pumpkins and mums, and stores were decked out for Halloween. What if you applied the same principles to your diabetes care? Everybody gets in a rut at times. I’ve noticed that some people with diabetes plod along, monitoring their glucose levels but not looking at the numbers, or struggling with their eating plan but not taking steps to make it more manageable.

We all get in ruts, and to break out of them, we need something to ignite a spark that will prompt a change. Making changes is hard, which is why focusing on simpler, easier, more manageable actions is way more doable than overhauling everything. So, I’m using the seasons as the agent of change here. Much like you might change your smoke detector batteries at daylight savings time twice a year, think about changing your diabetes batteries at the same time. Here’s what you might try:

If you need to, upgrade your meter. There are many meters out there. They all work pretty much the same way, and today’s meters are faster, more accurate, and require less blood than their predecessors. You may be constrained by what meter and strips your health-care plan will cover, but most likely, you can get a “newfangled” meter that best meets your needs.

Look at your numbers. I mean, really look at them. Think of your blood glucose log (you do keep one, right?) as a puzzle. What are you seeing? What patterns are there? What might explain the highs or lows? What’s working for you? These are your blood glucose readings, so learn about what makes you tick. Along those lines, talk to your provider or educator about trying continuous glucose monitoring (CGM)[1] if your numbers are truly a puzzle to you.

Get up to date with your tests. When did you last get your A1C, cholesterol, microalbumin, and/or blood pressure checked? What were the results? If they’re not in target range, why, and what might you do about them? Don’t just accept the fact that your A1C never gets below 8%, for example. There’s a lot that can be done. Talk to your provider or diabetes educator[2] if your numbers aren’t where they should be. While you’re at it, make sure you’re up to date with your eye exam, foot exam, dental check-up, and flu shot. If it helps, think of it like bringing in your car for a tune-up.

Try a new food. You might be the kind of person who eats the same foods and meals all the time. There’s nothing wrong with that, but why not branch out? Swap out your rice for quinoa, or pick up a persimmon the next time you’re in the store. Invest in a slow cooker and a cookbook to make meals easier and tastier. Don’t know how to cook? Sign up for a cooking class at your local adult education center.

Make your beverages count. Do you need your Diet Coke or Diet Pepsi to jumpstart your day? Well, OK, but if you’re guzzling diet soda all day, consider trying something a little healthier. Water is best, but if you need some more pizzazz, try a flavored seltzer water (it now comes in banana flavor!). Or, if you’re always running out to Starbucks for that mid-afternoon latte, break with tradition and try a chai tea or even a cup of hot chocolate (for the antioxidants, of course). Pack in nutrition whenever you can.

Take it up a flight. I work on the seventh floor in my building and on days when I don’t get a chance to go for a walk at lunch, I climb the stairs. Rain or shine, the stairs are always there. Climb a few flights, if you have them. Stair climbing helps to tone your lower body, drops your blood glucose, and will clear the cobwebs that appear mid-afternoon (you know, when you feel like taking a nap).

Gather your team. Everyone needs support. Diabetes isn’t a do-it-yourself condition, although it does require self-management. You can manage your diabetes yourself, but you’ll likely need help. Where does your help come from? Do you have a diabetes educator? Does your physician/endocrinologist answer your questions, let you know about treatment options, and/or discuss ways to help you meet your targets? Do you have a support system outside of your health-care team? This duck is a harder one to get lined up, but make an effort because it’s important.

Happy fall!

Endnotes:
  1. continuous glucose monitoring (CGM): https://www.diabetesselfmanagement.com/Articles/Blood-Glucose-Monitoring/continuous_glucose_monitoring_making_sense_of_your_numbers/
  2. diabetes educator: https://www.diabetesselfmanagement.com/articles/diabetes-definitions/certified_diabetes_educator

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Amy Campbell: Amy Campbell is the author of Staying Healthy with Diabetes: Nutrition and Meal Planning and a frequent contributor to Diabetes Self-Management and Diabetes & You. She has co-authored several books, including the The Joslin Guide to Diabetes and the American Diabetes Association’s 16 Myths of a “Diabetic Diet,” for which she received a Will Solimene Award of Excellence in Medical Communication and a National Health Information Award in 2000. Amy also developed menus for Fit Not Fat at Forty Plus and co-authored Eat Carbs, Lose Weight with fitness expert Denise Austin. Amy earned a bachelor’s degree in nutrition from Simmons College and a master’s degree in nutrition education from Boston University. In addition to being a Registered Dietitian, she is a Certified Diabetes Educator and a member of the American Dietetic Association, the American Diabetes Association, and the American Association of Diabetes Educators. Amy was formerly a Diabetes and Nutrition Educator at Joslin Diabetes Center, where she was responsible for the development, implementation, and evaluation of disease management programs, including clinical guideline and educational material development, and the development, testing, and implementation of disease management applications. She is currently the Director of Clinical Education Content Development and Training at Good Measures. Amy has developed and conducted training sessions for various disease and case management programs and is a frequent presenter at disease management events.

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