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.
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.