Diabetes Forecast - August 2012

brittle, adj.

“Brittle” has been loosely used to describe erratic blood glucose levels that are difficult to control. The term “brittle patient” (or the double whammy, “brittle diabetic”) implies that attempts to manage diabetes are futile. Those labeled “truly brittle,” a term without any definition, may feel that health care providers have given up on them. Fortunately, if people with erratic blood glucose levels work with their providers, their diabetes can usually be managed with enhanced treatment, technology, support, and education.

Because “brittle” carries so much baggage and doesn’t help improve health, the overused label should be put to rest. The next step: encouraging scientists to define solutions for people whose conditions defy the best that medicine has to offer.

cheat, v.

We all cheat. And often. It’s human nature. But ruminating on cheating doesn’t help people with diabetes move toward better outcomes. This pejorative term is only good for one thing: promoting self-punishment and feelings of shame. It’s much more effective to focus on all the healthy choices you make each day. Praise is a much better motivator than criticism.

complications of diabetes, n. pl.

The phrase “complications of diabetes” assumes that complications are inevitable. Although uncontrolled blood glucose levels do correlate with some complications, there are genetic and unknown factors that play a role, too.

Repeatedly being hammered with the possibility that you’ll develop life-altering complications as a means to motivate health behavior (“Take better care of yourself or you’ll lose a leg”) is harmful. Terror can be paralyzing, making diabetes management difficult. Let’s blame the insidious nature of diabetes for the damage, not the people living with it and caring for it as best they can.

denial, n.

Denial is a normal reaction to many things in life, including a diabetes diagnosis, but it can be a barrier to self-care. Some people are mistakenly labeled as “in denial,” and their state of mind is blamed for their poor control. The true barrier may actually be a lack of understanding about diabetes management or other factors, such as lack of enough family support or money, or depression (treating it can help).

The closer you can get to describing the issues that are bothering you, the better you and your support teams can work together. Remind yourself that you are the expert on your life and that providers advise you based in part on what you share. When you shrug off good advice by saying, “I’m in denial and can’t make any changes,” you sell yourself short. An attitude of denial can prevent you from moving forward and managing your condition. When this is the case, mental health providers are great assets.

failure, n.

Given that there are so many things that people have to do to manage diabetes, it is not surprising most report feeling like a failure at times. Sometimes, other people’s feedback only reinforces this idea. It’s hardly empowering to hear that you’re a “diet failure” or an “oral agent failure.” The same goes for telling yourself you failed to meet A1C goals. Negative talk like that does more harm than good.

Because diabetes is a dynamic process, not achieving a goal can be redefined as a moment of opportunity, one providers and people with diabetes can use to assess the elements of treatment that aren’t working and look at other options. So, if oral medications are no longer effective, it may be time to consider taking insulin. People with diabetes experience better health and quality of life when treatment plans are individually chosen based on needs and modified through the years.