Mind-Shifting: A Valuable Tool To Control Diabetes

Know that perfection is impossible, but that good is possible and important. And see your blood sugar numbers as information, not judgments. It may take some mind-shifting, but it’s worth it.

| Dec 22, 2008

The day I heard "Diabetes is not the leading cause of heart attack, blindness, kidney disease, and amputation," my life changed. I had believed the opposite to be true for the 32 years I'd been dealing with diabetes. Complications had always hung like a knife over my head.

The moment I heard this new message, the knife disappeared and my head cleared.

Coping with diabetes

I was attending a "Coping with Diabetes" workshop given by diabetes psychologist Dr. Bill Polonsky, founder of the Behavioral Diabetes Institute. Dr. Polonsky opened his workshop by asking the 100 people with diabetes in the room, "How many of you have heard that diabetes is one of the leading causes of blindness? Raise your hand."

Hands all over the room flew up.

"How many of you have heard that diabetes is a leading cause of stroke and heart disease?"

The hands stayed in place-up.

"How many of you have heard that diabetes is a leading cause of kidney disease and limb amputation?"

Well, now everyone's hand was still up, right? We've all heard this.

"Wrong!" he said.

We sat there, dumbfounded.

"Poorly controlled diabetes is a leading cause of these things."

I had to replay it again in my head, "Poorly controlled diabetes ..." When has any doctor, magazine article, or TV ad ever stopped to give us that fine print? Pretty much never.

Removing "inevitable"

Knowing that complications are not inevitable and that if I take good care of myself, they may never come, has created a shift in my head, not to mention my care. I'm actually more diligent in my management because now I feel like I have a chance.

Here's a second mind-shift that I took away from Dr. Polonsky's workshop that day. Actually, it's a little stickie that sits on my meter and says, "Hey, it's just a number!" It reminds me every time I test that no matter what number pops up, it's just information. All it does is tell me whether I calculated something I ate correctly or whether I need some food or insulin to keep my blood sugar in range. I no longer see my numbers as "good" or "bad": you know, those nasty judgments we make all the time. Granted, it didn't happen immediately. A 265 used to feel like a slap in the face even with that little stickie, but more and more, 265 has come to mean "I see, I didn't take enough insulin to cover that slice of gingerbread; good to know for next time."

I recommend that you stick a little label that says, "Hey it's just a number!" on your meter too. There's a ton of mind-shifting power in that little pre-digital tool called paper.

Permission to be not perfect

A year later, I sat in on another of Dr. Polonsky's workshops, this one for people with diabetes who had fallen "off track" with their diabetes management. I was there mostly as a researcher. After having interviewed more than 100 people who live with diabetes, I wanted to know why some were so much more diligent in their management than others. While there, though, I learned that I too did something that negatively impacts my diabetes management: I was wedded to the idea that I had to be perfect.

I had long heard that I would get complications unless my blood sugars were always under 140. But that day, I learned that not only is achieving perfect blood sugars impossible, but also the relative value of perfect blood sugars over good blood sugars is nearly insignificant. Wow, another mind-shift! With this one, oddly, I felt more energized to do diabetes really, really well, but the stress was gone.

These relatively simple new lessons have changed how I live with diabetes. They have allowed me to become more relaxed, to feel more hopeful, and to put my effort where it will do the most good. It makes me very aware of the power of those thoughts running around in our heads: thoughts of perfection, good and bad, right and wrong, They are an integral part of our management, even though most physicians, including endocrinologists and diabetes educators, barely acknowledge them.

So here's what I've learned:  Keep your blood sugars in good control, and you won't be the person they're talking about when they jabber, "diabetes is the leading cause of a million and one horrible things." Know that perfection is impossible, but that good is possible and important. And see your blood sugar numbers as information, not judgments. It may take some mind-shifting, but it's worth it.

Riva Greenberg is the author of the book, The ABCs Of Loving Yourself With Diabetes. Her new book, 50 Diabetes Myths That Can Ruin Your Life: And the 50 Diabetes Truths That Can Save It, will be published in July 2009.

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Categories: Amputations & Amputee, Blood Sugar, Diabetes, Diabetes, Eye Care (Retinopathy), Food, Heart Care & Heart Disease, Insulin, Kidney Care (Nephropathy), Living with Diabetes, Low Blood Sugar, Reversing Complications

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Posted by rosiolady on 22 December 2008

I was diagnosed in 1970 with type 1, got some training on injections and urine testing from a nurse, and was sent to ADA meetings. I only went to one. At the meeting we unfortunate diabetics were shown photo after photo of different stages of people's feet rotting until they had to be amputated. We were told that if we kept our blood sugar in perfect control, this "might" not happen to us, but it still could. Well it took me no time at all to learn that I couldn't keep my blood sugar in perfect control. The threat of amputations, along with blindness, kidney failure, etc. convinced me that I didn't have a chance, so for about the first two years after diagnosis, I controlled my blood sugar minimally if at all. After that I did the best I could because I had a young child to raise by myself and had to work. This was best done if my blood sugar was at least "in the ballpark." 38 years later and I do have some complications, but nothing I can't deal with and nothing that is noticeable.

Posted by Anonymous on 22 December 2008

Diagnosed with diabetes as a thin 47 year old, my biggest initial fear was a heart attack, as CV disease is big in my family and my doctor warned that diabetes greatly increased my chances of having a heart attack. After a month of pouring through on-line information, I figured out for myself that it's not the diabetes itself that causes the complications. Within 6 months of diagnosis, my endocrinologist acknowledged what I had suspected - that I have type 1 and am actually very sensitive to insulin. Being diligent (but not "perfect"), my A1C is usually 6.1 - although I do sometimes want to delete a BG reading so my doc can't see it. I am thankful for the advances (monitors, various types of insulin, sugar-free treats, etc.) that help me avoid those not-inevitable complications.

Posted by Anonymous on 23 December 2008

What a powerful article - thank you for posting! Now to get this message TO THE PHYSICIANS! I despise visiting my endo for the simple reason that nothing is ever good enough and the visits always have a negative tinge, regardless of A1cs ranging from high 4s to low 6s! This should be required reading for every endo. Thanks again.

Posted by Anonymous on 23 December 2008

I'm a Type 1, have been since 1964. I had a Dr. back then that really understood me and my Diabetes, I was 9. I grew up in a mind set that you only have one body and you better take care of it. All these years I took care of Me and it has paid off. Yes things can come like it did for me this last year but the technology is so much better now then 20 years ago. My right eye started hemorraging about 4 years ago but they sealed up on there own, then Oct. 07 they didn't seal and I woke up with floaters, I have had 6 surgeries and I can see to this day. My Retina Dr. said it wasn't anything I did but that your eye does age and I have had Diabetes for 44 years. I really agree with Dr. Polonsky statement "Poorly controlled diabetes is a leading cause of these things", Blindness, Stroke & Heart disease, Kindney disease and Limb amputation.

Posted by Rick on 23 December 2008

When you think about it, it's just commen sense. If you keep your blood sugars as close to normal as possible, why would it have a detrimental effect on you? I've had type 1 since 1966. I'll never forget the shame I felt when everyone was being drafted and sent to Vietnam. I wasn't good enough. Talk about an inferiority complex. Diabetes is a kind of funny disease. You look perfectly healthy, but you're not. People think all you have to do is not eat sweets. They didn't see me boiling my needle and syringe at five in the morning before I went to work. Anyway, long story short, I have complications. It affected my sex life long before viagra. Neuropathy. I don't drive anymore. But you know what? For some reason I've been attracted to exercise since I was twelve years old, and I get ten hours of vigorous exercise every week and my heart is in good shape. Eighteen months ago I went on an insulin pump. I urge anyone who takes injections to get on a pump. To me, it's probably as close as I'll get to a cure. It's wonderful. I feel like I finally have a say in how this damn disease progresses or doesn't. I wish I would have had one in 1966. People think diabetes isn't a serious "problem." Just don't eat sweets. They just don't know.

Posted by Anonymous on 23 December 2008

Yes, and YES! I've had type 1 sinc 1960. I do have complications, but I "do the best I can" I remember when I had that mind shift, from I gotta" to "Its information." Isn't it wonderful? and I can't be perfect. I have managed to "shop" doctors and been graced with being a le to see first, an MD who had diabetes, and now a NP who also have type 1. Both have been wonderful...trusted my willingness to be truthful, and willing to TALK. Bless them both.

Posted by kdommer on 24 December 2008

I am living proof! I have been diabetic for 35 years and have for the most part been able to maintain good control (as someone else mentioned, we are not perfect). I have been fortunate to have good doctors and have suffered no complications to date.

Posted by Anonymous on 18 January 2009

I was diagnosed in 1979 with it at age 7. I went to a JDF meeting--the big roll out of John Denver's "I Want to Live" promotional, tied in with (of all things) McDonald's McHappy Day, an event where Big Macs dropped to 25 cents and part of that paltry amount was donated to JDF. I remember seeing in that video, I was probably 9 by that time, that a juvenile diabetic (this title alone shows the distance and strength of this disease's evolution--it's no longer limited to the kids) would have, even with good control, a 20-30% reduction in life span. I've never awakened any day that I didn't remember this. I've spent a lot of time attempting to forget it through various legal and illegal means. I appreciate the idea that "poorly controlled" diabetics get complications, but I also know that I know very few 40-year veterans, fewer 50-year veterans, and even fewer 60-year veterans. But, the idea that your BGL is just a number, while it sounds great, is rather one dimensional in its response to the reality of it, and that's the reality that while we may have made some miscalculations (or maybe just downright forgot to bolus!) in food:insulin, but that big number is still brutalizing your kidneys, et al. I suppose I could try and "think" my blood sugar really isn't that bad, but reality tells us differently.

I want to add that I just had my 30th anniversary with the Girl. 20 years of injections, 10 years of the pump--and I, too, recommend anyone with injections to get the heck off of them. I just got the Continuous Monitoring system and it's the best thing since, well, air. Only Anthem pays for it currently, but I think my and other success stories with it will change that; that's one of my goals, anyway, is to be living proof of its efficacy. I visited the eye doctor recently, and my eyesight has moved from 20/20 to 20/15, which, I think, is an improvement of sorts. My point is: just like cancer, I believe this disease has gradations of aggressiveness, and I think I happen to have a "friendly" case of it--God knows, the way I behaved in college in the early 90s, I should be dead now even without diabetes (see the part about trying to forget). I used to justify my attitude by saying "it's better than chemo." IT'S NOT. This has no end, no start/stop date, no remission, no sense of finality. Anyway, I'm having a pretty tough time these days with it, even though I'm doing extraordinarily well. I can't stop wondering when will my younger years catch up and give me a reason to really be depressed about it.

Posted by Anonymous on 24 February 2009

I am a UK reader and can't tell you how much this has cheered me up. I've been type 2 for six years and have managed to keep A1Cs to 5.2 or thereabouts but still my stern-faced doctor tells me that 'sooner or later your pancreas will start to fail'. This has filled me with despair, but I now feel that it isn't inevitable. Why would any doctor want to plant a horrible idea in a patient's mind if it were inevitable in any case? There's no point if there's nothing you can do. I am pleased to say I've lost 28lb, exercise as much as I can (I'm now asthmatic apparently!) and eat a very healthy, but far from saintly diet. Thank you again. You're an inspiration!
Hilary P

Posted by Anonymous on 26 March 2009

In 1989 I was told that I had diabetes..high blood sugar readings indicated this...the doctor left it at that, the next blood tests were not to indicate this...it went back and forth for 10 years, no treatment, no mention of treatment even. In 1999 after selling our three story house and buying a motorhome we began to travel in May by November I felt awful, we cut our trip; around the United States short and went home. I found a new doctor, I was told I had a yeast infection, a UTI and diabetes. you see I had stopped going up and down stairs several times a day, and of course my diet was terrible on the road and visiting family and friends, so my body went into full diabetes.
After a few bouts of low blood sugar and finding out that the treadmill and water were my new friends my sugar was 120-140 fasting and I was doing great on the meds and diet and excercise. A year later we moved again, another doctor was found and I was put on metformin and did not do well on it at all, but was told I should try actos with it...well I did not do well on that either...in fact I was dizzy and had UTI and yeast infections all the time. Another doctor said I needed more metformin and needed to continue the Actos...after two doses of the increased metformin I ended up in the hospital, I stopped all meds myself, and the dizziness stopped and I found another doctor. I did end up on insulin after a bout of pancreatitis and seem to be doing fine now, but I feel that most doctors do not know what they are doing in relation to diabetes, and the patient has to research and follow their what their body is telling them. I found that excercise and diet do as much or more then the meds...I have had my BS drop 20 points with drinking a bottle of water when it is too high..no doctor ever told me water would help bring down a high BS reading...there is a lot that doctors do not know or even want to know, they want to follow some study and get you out of the office, Please people if you do nothing else to help yourself, read everything you can find and see what makes your health better.

Posted by volleyball on 26 March 2009

I've only had the big D for several years, not the decades of other posters. I too was told about the inevitabilities but from day one, I knew that that was wrong. Lucky for me, I take "wisdom" with a grain of salt.
I've been preaching from day 1 on forums that we control our destiny. While we cannot make miracles from our previous poor actions, we can do a lot from today on.

Posted by volleyball on 26 March 2009

I've only had the big D for several years, not the decades of other posters. I too was told about the inevitabilities but from day one, I knew that that was wrong. Lucky for me, I take "wisdom" with a grain of salt.
I've been preaching from day 1 on forums that we control our destiny. While we cannot make miracles from our previous poor actions, we can do a lot from today on.

Posted by Anonymous on 28 April 2009

I have been a Type 1 Diabetic since 1985 and have been fortunate to not have any complications.I was on MDI for 22 years and just recently,1 year ago,this February started on the pump.The only good thing I can say about getting Diabetes in this day and age are the improvements in healthcare and blood glucose meters that make it so much more easier to control.

Posted by kscottw on 17 May 2009

I've recently been aware of high blood sugar, Dec 08, from annual physical at 38 years old. I'm disgusted by the lack of concern from doctors and med staff. Dec o7 annual physical I was asked if I was a diabetic because of the sugar spilling over in my urine sample. I said no and nothing else was said. My fasting bs was 159. This past physical, Dec 08, the same question gets asked about being a diabetic from urine sugar. This time I'm angry and ask why do you ask this question, same insensitive response was sugar spilling over. Then my fasting bs number comes in at 207 and the excitement began; oh my, we've got to let dr. so and so know about this, your bs is very high. How could I feel anything but- Look at this excitement, they think they have a perpetual customer now. There was no excitement when my bs was 159, but now it was worse and now they have a perpetual customer.
I purchased a bs analyzer and started checking my bs. I'm over denial and am going to get my a1c checked soon; I refused to go to the appointment for my a1c after the treatment I perceived from the physical. I valued my money more than my health, but am learning that my health improving will allow me to keep my money from the doctors, God willing.
This website has been an inspiration to me and I look forward to handling this challenge God has placed before me.
Also, has anyone's views on retirement/401k participation changed since becoming diabetic like mine has? It seems that there is no reason to save, save, save, since the medical community is going to consume our savings. Thanks to all for any communications on these matters.

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