I firmly believe that one of the main things that makes people with diabetes give up the struggle toward better health is having to monitor blood glucose regularly. It often feels like a thankless task, one of those chores everybody always tries to get out of.
I talked about losing interest in self-care in a past column when I reviewed the book Diabetes Burnout by William Polonsky, a clinical psychologist and certified diabetes educator. Burnout's been on my mind ever since. While digging around on the Internet I found an article at DiabetesSelfManagement.com that really spoke to me. It was titled "Ten Good Reasons to Hate Blood Glucose Monitoring."
It turns out that the article was an adaptation of a chapter from Diabetes Burnout.
Some of the reasons Polonsky lists are:
Your meter makes you feel bad about yourself.
To me, having to prick my finger every day and test how much glucose is in that little drop of blood is like being on a "diet" and judging myself by what the scale says. Depending on the number I see on the scale, I've either "passed" or "failed."
I may have had a great day, but one bad number can ruin it.
It's a constant reminder that we have diabetes.
Monitoring can be expensive.
Monitoring can hurt.
We're just too busy, and it's inconvenient.
You get the picture. And for some reason it seems like I can spend more time avoiding the task than it would take if I just went ahead and did it.
I think that most of us know how important it is to monitor our blood glucose levels. But knowing something is good for us doesn't always mean we'll use it to our advantage.
By tracking our numbers regularly it's possible to see just how beneficial exercise can be in lowering them, and we can see how different foods or our medicines affect the levels, too.
Often we have unrealistic expectations about what we can accomplish. Maybe we should get with our doctor or diabetes educator to see what reasonable goals really are.
And we need to be reminded that despite our best intentions, erratic blood glucose readings will occur. Sometimes there's just no logical explanation for wacky numbers.
I have finally gotten back into the habit of monitoring at least once a day, usually first thing in the morning, before I've eaten. My glucose reading is often too high, even if I haven't had a bite since dinner.
I found a little reassurance in information from the American Diabetes Association about the "Dawn Phenomenon," a normal surge in hormones the body produces daily between 4 and 5 a.m. -- just about the time I check my glucose level every morning. Most people have it whether or not they are diabetic. The problem is that people with diabetes don't have normal insulin responses to adjust for the phenomenon, so they see their fasting glucose level go up.
The rise in glucose is mostly because our body is making less insulin and more glucagon, a hormone that increases blood glucose. That messes with the liver and usually results in higher glucose levels, especially for Type 2 diabetics.
Steps that may help are eating dinner earlier in the evening and doing something active after dinner, like taking a walk.
Blood glucose monitoring is the main tool we have for maintaining diabetes control. Keeping a log of our results is vital, and our health-care provider can use it to get a picture of our body's response to our diabetes plan.
The association also mentions the fact that blood glucose levels can often trigger strong feelings. We get upset, frustrated, angry or depressed. At those times we need to remind ourselves that it's not a judgment of us as a person, we may just need to adjust our attitudes and make a new plan.
POSITIVE STEPS
So what are some strategies for overcoming the barriers and getting into the habit of regular blood glucose monitoring? Polonsky has some good ideas.
Have a serious talk with your blood glucose meter. It may seem silly, he says, but the antagonism has to stop. The meter is not our enemy. We have to remember that there are no good or bad readings, and we cannot "fail." It's just a number.
People who are successful with monitoring tend to view the readings as simple pieces of information that present opportunities for taking action.
Look at it like the gas gauge in your car. When it nears empty, do we just avoid looking at it? Do we yell at ourselves for being so stupid as to allow it to get low? We don't tend to think of the amount of gas in our tank as good or bad, the gauge is just providing information that allows us to make the best decisions. The same goes for our blood glucose meters.
And we should stop referring to the process as "testing." Instead, think of it as monitoring or checking. And instead of seeing our readings as "good" or "bad," how about "high" or"low"? Our readings should never determine our self-esteem.
We also need to try and make our environment work for us. There are ways to make monitoring fit your schedule more easily. Anchor your reading to already established habits, or take your monitor to work and test there. Just don't leave it in the car. Extremes in temperature can affect accuracy.
And last but not least, make sure everyone knows you are in charge. The "diabetes police" -- friends who know we have diabetes -- are well-intentioned, and they are just trying to be helpful. And they are a little afraid of what might happen if they don't keep a close watch on us. It might help to explain our diabetes plan and ongoing efforts, and let them know what kind of support we prefer.
The good news is that barriers can be overcome once we take the time to identify which of them may be keeping us from regular monitoring.
In my next column I plan to write about blood glucose meters, the process of checking our levels and what numbers we should be shooting for. I welcome tips and feedback from anyone who wants to share.
Email me at:
rboggs@arkansasonline.com
ActiveStyle on 07/14/2014