Diabetes Self-Management: You are the Quarterback of Your Care
Ball tucked to your chest, you are ready to score a touchdown, when suddenly your shoes are untied, your helmet falls off and you are faced with a gaggle of imposing figures ready to tackle you without mercy. In this overwhelming and unfair situation, how can you possibly think about scoring when you are tempted to give up the ball and run? Who do you turn to?
Your coach and your teammates.
Diabetes management is like football. The players are the ones on the field doing all the hard work, but everything goes best when you communicate and work well together with your coach and teammates.
The team: Remember that you are the Most Valuable Player and live with the diabetes 365 days of the year. While your health care providers may only see you for a few hours out of the year, they still play an essential role as coaches. Having a cohesive team is necessary for you to get the best diabetes care. Finding a doctor and diabetes educators you can work well with is vitally important in gaining control over your diabetes.
Living with diabetes can seem overwhelming at times, but you must not feel like you're alone on the field. Group diabetes classes or support groups can help connect you with others going through similar experiences. You can learn from each other and establish important connections that will promote a lifetime of proper diabetes management.
Communication: A team won't be successful if the players and the coaches don't communicate. Sharing your ideas and concerns with your doctors will allow you to work together and choose the treatments that are most suited for you. When you're well-informed about your care options, you will be best equipped to handle your diabetes.
Anticipate the next move: In order to avoid playing major defense, keep on top of your blood sugar monitoring. It may seem like a chore at times, but checking your blood glucose levels regularly will keep you a step ahead of your diabetes. In addition, the A1C blood test, done by your doctor, shows your average blood sugar level over the past two to three months. Together, both tests signal whether you're on the right track, or if it's time to shake up the strategy with a change in lifestyle or medication.
Strategy: Healthy eating and staying active are key steps in living a healthy life with diabetes. Managing your diabetes is about finding balance, rather than cutting out everything you enjoy. It may seem challenging at first, but even a few small adjustments can make a big difference:
-- Switch to diet drinks, seltzer or water, and away from regular soda and juices, which are high in sugar. Resist sweetening your coffee or tea.
-- Choose the right fuel. Divide your plate into sections: half non-starchy vegetables (salad or greens), a quarter protein (e.g. fish, chicken) and a quarter carbohydrates (e.g. rice, potatoes). A carbohydrate portion should be around the size of your fist. Cut down on the "white" carbohydrates, and choose brown rice, whole-grain bread and pasta when you can.
-- GET MOVING! No need to over think it; just get your heart rate up. Even taking a 15-minute walk around the block every evening can get you started. If you're having trouble staying motivated, try setting a time to walk with a friend or joining a class.
-- Set yourself practical, achievable goals. Don't stress about trying to become an athlete overnight. Instead, aim to skip the elevator, do as much walking as you can and start cutting back on snacks. Try writing down your intentions and sticking them on a mirror or the refrigerator as a reminder.
Keeping your cool in the game: Diabetes can be stressful for both you and your family. Your mental well-being is just as important as your physical well-being. If you're struggling with depression or feeling down, reach out to your providers and they will direct you to the help you need. Remember that your family, friends and co-workers are part of your team. The more on board they are, the easier it will be for you to maintain changes in your lifestyle.
As the quarterback of your care, the power to win is in your hands. It may feel that you haven't won a game for a while, but you and your team have all the equipment and strategy you need to succeed. You can do it! Just make sure you keep on top of your care, and work with your team. If you can make the necessary lifestyle changes, you can better control your diabetes and have a healthy, full and happy life. Having diabetes doesn't mean the game is over. There is still time to score a touchdown against diabetes!
The authors thank their colleagues, Dr. Elizabeth Walker, Ann Levine R.N., Dietlinde Wolter-Nitta R.D., Kate Farber and Karen Gambina, for their helpful contributions.
Alethea Shepardson, FNP, CDE specializes in diabetes management at Montefiore Health System. She has worked in the Bronx for the past 19 years, including eight years at Bronx Lebanon Hospital.
