In his book “Diabetes Burnout” William Polonsky states some self-care statistics from recent surveys:
Current Statistics
In a nationwide survey, 21% of patients with Type-1 reported that they never checked their blood glucose levels. Of patients with Type-2 using insulin 41% never monitored. Of those with Type-2 not using insulin 76% never monitored.
Recent surveys also found that 21-25% of patients rarely or never followed their doctor’s recommendations on monitoring, and in a nationwide survey 21% reported never checking their levels.
In recent surveys 10-24% of patients reported rarely or never following dietary recommendations.
In a recent Joslin survey 22% of patient reported knowing that they were supposed to follow a certain meal plan, but they felt that it was usually or always impossible to do so.
A study of a well-known diabetes education program showed that the program greatly helped patients to be eating better and exercising more. However, when contacted 1 year later most patients had returned to heir old, less healthy habits.
In a recent national surveys 31-38% of patients reported rarely or never following regular exercise recommendations.
In a recent Joslin survey 37-43% of patients never exercise. Only 38% managed to exercise 3 times a week or more.
A series of surveys have also found that many women with Type-1(somewhere between 10-40% depending on the study)regularly take less than the prescribed amount of insulin. One new study also suggest that some patients take less than the prescribed amount of oral medications prescribed.
Many of these people are worried about diabetes and become preoccupied with worry while at the same time doing as little as possible about the problem.
Everyone has a usual way of responding to difficult situations. These responses usually take the form of:
Thinking actions: Seeking to understand the problem, devising solutions, plans for taking action.
Feeling actions: These start with emotional responses, and ways are devised to overcome the feelings involved.
Personal Barriers
Some of these include:
Chronic depression
Poor coping styles
Eating disorders
Lack of knowledge about diabetes
Inaccurate health beliefs
Negative feeling about diabetes
Fear of hypoglycemia
Fear and frustration about weight gain
Unrealistic or unclear expectation about self-care
We talk a lot here about people who act as though they don’t seem to care about taking care of themselves, but I’m of the opinion that only the most profoundly depressed person would just not care.
Instead I think that uncovering the underlying reasons that may be responsible for their seemingly uncaring attitude will help us understand better, and perhaps be better at providing solutions for those people. People almost always have reasons, even if we don’t understand what the reasons are.
Lizzy
© EMO 6/12
Knowledge is Power
When I was diagnosed, close to 11 years ago, I was told “you are diabetic”, given a prescription for some medication, and told to wait for a nurse to come in and give me an insulin shot. When I picked up the prescription I was given a 10-page booklet telling me “All About How to Mange Diabetes”, and sent on my way. That was the extent of my “education”. 
Hi there. I keep dipping into various D sites to be inspired, but I’m confused or maybe just undermotivated. Got diagnosed in 2012 March (A1c 5.7) and after internal wrestling and lots of sad tears lost 20 lbs and got to A1c 5.3.
Then summer hit: berries, nectarines, watermelon, etc. I swim 3x a week vigorously & can pretty much stay away from all my mainstay carb favorites for my first 60 years, but fruit is very impt. to me & I feel some resolve slipping away–telling myself numbers in the 120-130 range are ok. I was doing well, but find I resent the restrictions and don’t want to motivate myself from just fear of complications. The hatred of this condition is coming back strongly, which isn’t helping. Hmmmmm….~K
Well Kathi,
As they say “attitude is half the battle”. I don’t think I’ve ever met anyone who liked being diabetic. It sucks, but if you have to have an incurable illness it’s not a bad one to have. How many chronic diseases can be managed to a great extent by the foods you do or don’t eat.
There are ways you can fit in your favorite foods (see my post about the chocolate brownie) by no, you can never again eat whatever whenever you want.
Hating the condition won’t change the facts, so why not try to make peace with it. Only you can find the motivation within yourself, and only you can choose. Perhaps more medication to help is the answer, perhaps eating smaller amounts of fruit on more frequent occasions. I’m sure you can find an answer, but first turn hatred to peaceful co- existence.
Lizzy
Ah, good advice. Most of the time I just deal with it, but when a healthy food like fruit is restricted, it’s tough. How do we make peace with D? I’d be very interested in strategies. Thanks, I’ll stay tuned….~Kathi
Kathi you have to find the motivation within yourself. As the series continues there will be more suggestions, but ultimately you have to find your own motivation by finding out what’s important to you.
Lizzy
Lizzy,
Thank you again so much for your blog. I was surprised to see those statistics. I have spent most of my life struggling with eating issues – anorexia being one of them. Oddly enough once I began to deal with the control issues and began to maintain a normal body weight I then proceeded into mild obesity. Why? I was so terrified of being 82 pounds (or less) and going through being anorexic all over again. Once I was diagnosed with type II diabetes this year I didn’t freak out, I just figured something was gonna happen sooner or later. So I approached it methodically and lost some weight and have been taking my meds, etc. My doctor is happy with my progress, BUT…then it happened – I became terrified of losing any more weight at the same time I started to feel the addiction of standing on the scale daily. Its taking a bit of time and soul searching – but I am back on track. I test more often than what the doctor asks for and I eat less than the dietician wants, but it works for me.
Hi Patricia, you absolutely have to do what works for you.
I suffered from an eating disorder most of my life too, I used to “binge” but not purge. It took many, many years of self-work to understand that situation and correct the causes. I do know that it never completely goes away but the more you overcome the temptation towards the behaviors the stronger you get.
There was a time when a box of cookies would not last an hour in my house. I started out just not keeping anything like that around. Now I actually sometimes throw them away because they go stale. I can also just eat one or two. In the old days that would never have happened!
It was a very long hard journey to this point however, but it was worth it.
Lizzy
Yep, you got a couple of my big barriers on that list:
1) unrealistic expectations about self care. (I should be able to handle anything without help)
Eating disorders (anorexia, all the information is geared to the overeaters, I cannot seem to find any help for us undereaters)
Thank you again Lizzy for a helpful post.
Also, my latest “stress relief” strategy is to watch the puppy cam….they are growing so FAST!!!!
Susan
Yep Susan, puppies are the greatest stress relief ever. Sometimes when I’m stressed out from the boards or such I look at my picture collection ( I have hundreds) and that never fails to make me feel better.
There are many people with eating disorders on the boards we read. They may not say so but after a while there are hints you can pick up on. Striving to be perfect all of the time with diet is one of them (one I’m not guilty of LOL), also people that insist that a person has to follow the diet that they do, that it’s the ONLY way!!! After 10+ years on the board I’ve learned to recognize the signs.
All you can do is the best you can do. Perfection is not a requirement.
Lizzy
Great to her from you Lizzy. I could identify with a number of the barriers. I am type II and was DX about 3 1/2 years ago. I am soon to be 67 and in so many ways I am healthier than I have ever been due to being Diabetic. The silver lining around my Diabetic Cloud is that the Mental, Emotional and Physical Pain of having High or Low BG has become so severe that I am Forced to walk the straight and the Narrow most of the time. When I do walk the (S&N) I enjoy a wonderful level of Health. However, sooner or later I screw up and INDULGE in one of my Sugar Addictions, and then I get my butt kicked. I am usually our of commission for anywhere from 6 to 18 hours. I have had to stay in bed and nurse myself back to health. It scares me a lot but this disease has taught me about myself and learning how to take accountability for my actions.
Thanks again Lizzy.
Alan
Hi Alan,
Maybe you should examine your “indulgences”. If you’re plagued with guilt when you indulge that could be a factor in your reaction. The mind has a great influence on the body. If you eat things that just don’t agree with you system that could be another factor. Also if you “binge” on a large amount of food, that could be another. For most people it’s not a black/white, either/or issue.
it’s very difficult for most people to be perfect all of the time or to think that they can never treat themselves from time to time for the rest of their life. That’s a very heavy cross to bear, and really not necessary.
There are also other ways to get around the issue, see this post: http://lizzysdlounge.com/2012/06/02/how-i-ate-a-whole-triple-chocolate-brownie-without-spiking/
Lizzy
Wow, that just reminded me of the conversation I had with the Dr who diagnosed my hypoglycemia in high school. He said if I was going to eat sugar (he recommended a low carb diet, though didn’t call it that, but the guidelines he gave me only allowed for 3 servings of bread/carbs a day), that I should eat it with protein and then be prepared to “sleep it off”. Like sleeping off a drunk or a hangover.
I think I have at least a couple of those Personal Barriers to over come. They are Poor Coping Styles and unclear expectations about self care.
Hi James,
I’ll be writing more about each individual barrier in the future. Hopefully that will help you work them out.
Lizzy
Thanks, Lizzy – more info on the “barriers” will be welcome. Actually, this article made me feel good about the care I’m giving myself since diagnosed last December. I’m taking better care of me than I thought I was…the whole diabetes self-care is a rather daunting mountain but somehow I’m still on the up path and treating myself well, physically and emotionally. P.S. And am enjoying a treat now and then – your brownie advice – cutting it into small bites and taking the day to consume one brownie. This is not an every-day happening so makes it even more special when I indulge – thanks for the delicious hint! Keep up the good work, Lizzy!
Hi JD,
I have to make a trip to Whole Foods soon, heaven help me!!!!
Maybe they’ll be out of triple fudge brownies that day and save me from myself.
Lizzy