This is #5 of Dr. William Polonsky’s 10 things you need to know about the emotional side of diabetes.

5. Appreciating the Power of Pals

Diabetes is easier to manage when you have people in your life who are rooting for you. When you feel alone with diabetes, it is harder to handle.

Imagine the meaningful ways that loved ones could support you or help you feel less alone: for example, when family members join you in having healthier meals each night, when a good friend shares your anger or disappointment with a high blood sugar reading, when your spouse offers to help you with your next insulin injection, or when your neighbor agrees to join you for a brisk walk each morning. Just having someone in your life who cares can go a long way.

• Ask for the help you need. Many of your loved ones want to support your efforts, especially when you are trying to change your habits, but they may not know how to do so in a manner that fits your needs and respects your independence. So think of a small, specific way in which a friend or family member can be helpful, then ask for that help.
• Be a pal to your pals. Ask for support in a kind, considerate way. If you are too demanding, your loved ones may be unwilling to cooperate. Thank or acknowledge your loved ones when they offer support. Everybody appreciates positive feedback!
• Seek out new friends. Sometimes, friends and family just aren’t as supportive as you had hoped. So make some new friends who can understand the hassles of diabetes. Join a diabetes support group in your community. Your doctor or local hospital can help you find one that is right for you. Talking to other people with diabetes can help you feel less alone.

More excellent advice from Dr. P! I have certainly experienced first-hand the power of having a wonderful support network of friends and family. It makes everything from exercising to eating to empathizing much more fun.

But while support is wonderful, there’s a fine line between supporting and nagging. Everyone needs a break from their diabetes now and then. And everyone needs a little self-indulgence. Often, what’s not said to a person with diabetes, is even more important than what is.

A year or so ago I attended a free series of workshops entitled “Living a Healthy Life with Chronic Conditions.” While not limited to people with diabetes, it offers all kinds of great information for anyone living with a chronic disease. I will blog more about the course and contact information in an upcoming post.

When the fairy of culinary joy smiles down upon me, this is what she will leave in my fridge:

- homemade homous

- devilled eggs

- fresh veggies and bacon, chive, cheese dip

- freshly made Caesar dressing

- washed and dried romaine, leaf, and butter lettuce

- Belgian-chocolate-smothered-almonds (made with Splenda)

- chicken wings with peanut sauce (they’re yummy cold too)

- cooked low salt bacon

- unsalted butter

- freshly squeezed lemon juice

- aioli or fresh mayo

- hot sauces

- sour cream, full fat yogurt

- low-carb flax muffins

- natural peanut butter made with Valencia peanuts (honest, it’s better)

- edamame

- cheese!

- omega 3 eggs

- olives

- nsa soy milk (please someone make an nsa vanilla flavour)

- diet Pepsi

- decaf ice coffee with cream and Splenda

- tofu

- umeboshi (Japanese pickled plums)

- sweet with heat mustard

- nsa ketchup (a product I’ve raved about in the past)

- mugicha (Japanese barley tea)

- crushed almonds and whey protein for low-carb baking

I wonder if she does dishes too?

4. Giving Up the Guilt

You are not a bad person because you developed diabetes. It is not your fault. You are not “bad” because you didn’t exercise today or because you ate more than you intended last night. Nobody can manage diabetes perfectly. Guilt is common when you are living with diabetes, and it is hardly ever useful.

Because of guilt, people often establish tough, sometimes impossible rules about how to manage diabetes (”I must NEVER eat even a bite of junk food ever again.”) Since you can never be perfect, rules like these can make you feel like you are failing and can promote depression. Enough already!

• Remember that you didn’t give yourself diabetes. As people around the world grow heavier and heavier, it almost seems like everyone is trying hard to develop type 2 diabetes. Yet most “fail” to do so. Obesity and a sedentary lifestyle are contributors to type 2 diabetes, but if you don’t have the genes for it, you can’t develop it. For type 1 diabetes, your own actions played no role at all. It wasn’t all those sweets you ate as a child, or anything else you did.

• With your doctor’s help, make sure your diabetes expectations are achievable. Stop beating yourself up when you eat more than you planned, forget to exercise or skip a blood glucose test. You don’t have to be perfect to reach the level of control that can keep you healthy. Develop a reasonable behavioral plan that can help you achieve those goals, then relax!

• Get perspective. Instead of criticizing yourself for the occasional lapse, give yourself credit for all of your positive efforts to manage diabetes. Everyone needs a pat on the back, and you probably deserve one.

Go Dr. P! These are the words that everyone with diabetes needs to hear. We waste so much of our lives feeling guilty about so many things, and having diabetes can be a big contributor to those guilty feelings.

When I was first diagnosed with gestational diabetes I felt soooo guilty. I was sure that gestational diabetes was my “punishment” for having an unhealthy lifestyle. One of the very first things the diabetes nurse said to me was “it is not your fault.” A huge weight was lifted off of my shoulders with those 5 words. Instead of wasting energy on my guilt, I was able to move forward and put that energy into eating well and exercising often.

I also find that guilt is often a mask for underlying emotions. Try changing the word “guilty” to a feeling word instead, like angry, sad, scared, or anxious. I once wrote a list of all the things I felt guilty about (it was a pretty long list!) I then forced myself to change the word guilty in every sentence to another feeling word. It was a real eye-opener as to what my true feelings were - and how I was trying to hide them under the guise of guilt. Peeling away the layers helped me to learn a lot more about myself.

It’s hard to believe, but Wednesday June 20, 2007 marks my first anniversary of blogging.

To celebrate the 90 some-odd posts on my life (in general and specific), my family, my friends, my diabetes, my obsession with food and all things tasty, and my overall conviction to have some laughs while still upright, I’d like to invite you all, dear readers, to post some comments.

I know, I know, you don’t really want to post anything because you’re enjoying your anonymity while being a voyeur into my life. But what about if I promise you a chance for some nifty prizes? Or at least an opportunity to be read by tens of people (who can resist that?) Or you could see it as a chance to use up that vast resource of puns you have at your ready disposal. Or just an avenue for congratulating me on sticking to something for a whole year (did I mention I get bored easily?)

The reasons are countless and my gratitude would be fathomless. So please, take a moment to post a nifty little comment. I so want to hear from you.

More words of wisdom from Dr. P. - here is number 3 of the emotional side of diabetes.

3. Defeating Denial

Denial can be a valuable tool. It can be a good way to cope with negative feelings about diabetes, especially when you are first diagnosed or when the disease is feeling out of control.

But denial becomes a problem when it is your only way of coping. Instead of a temporary tool, it becomes a permanent way of life. The response to all diabetes aggravations becomes “I will not think about diabetes anymore.” This means trouble. When you tun your back on diabetes, your long-term health will be endangered.

• Learn the important facts about diabetes. Attend a diabetes educational class or support group in your area. You need to know that: a) diabetes is a serious disease that can harm you when it is not adequately controlled, even if you feel fine; b) ignoring diabetes is likely to cause more serious health problems; c) paying attention to diabetes can help you to live a longer, healthier life.
• Stay informed about your own health status. See your doctor regularly and complete all of the recommended medical tests (such as A1C, blood pressure and cholesterol). Know the results of these tests and what the results mean. When you are well informed, you feel more able to manage diabetes and keep it under control.
• Don’t do diabetes alone. Share your thoughts and feelings about diabetes with a friend. Confiding in someone you trust can help you to gain the support and perspective necessary for making sense out of your own emotions and attitudes.

For me, the regimen of gestational diabetes self-care was exhausting and overwhelming. Meeting a friend in pre-natal class who also had gestational diabetes was such a comfort. We helped each other through all the testing, eating restrictions, and exercising, and ultimately gave birth to healthy babies.

I don’t find it easy to reach out to others for help, but the rewards make it all worth while.

Also see polonsky #2 and polonsky #1.

As promised, more of the “10 things you need to know about the emotional side of diabetes” from Dr. William Polonsky of the Behavioral Diabetes Institute.

2. Overcoming Depression

Depression is a serious problem, and it can be even more serious when you have diabetes. People with diabetes are almost twice as likely to develop depression as other people. If you are depressed, diabetes can become a lot harder to handle and your blood sugars are likely to rise. When your diabetes is out of control, this can make it even harder to escape depression. It becomes a vicious circle. The good news is that there are effective treatments that can help you recover your emotional health. These treatments can also help you improve your blood sugars and feel more in control of diabetes.

• Watch for the warning signs. If you are feeling down or helpless about life, have lost your “get up and go,” or are feeling reduced interest or pleasure from the things you used to enjoy, then talk to your doctor as soon as possible.

• Take action to avoid depression. Make sure to get a good night’s sleep as often as possible, stay active, and spend time with friends each day. Include activities in your daily life that are personally rewarding and meaningful, like taking an interesting class or volunteering at a local museum. All of these can be powerful antidepressants.

• If you are depressed, don’t just wait around and hope it will go away. There are several good medications and different forms of counselling that have been proven to help people recover from depression. Speak with your doctor about getting the help you need.

While I’ve been fortunate to escape depression myself, I have met many people battling this serious problem. Having diabetes (or any illness) coupled with depression, makes life even more challenging. Please take the opportunity to put yourself first, and get the help you need. It’s not easy to ask for help, but you’ll be a stronger person for it.

My hubby and I went to the Canadian Diabetes Association’s expo this weekend in Vancouver. My usual frustration with these expos are the depressing booths and the feeling of imminent demise from the complications of diabetes. We are battered with talk of kidney problems, eye problems, heart problems, mobility issues, foot problems, neuropathy, and on and on. We are told how to eat better, eat less, exercise more, check our blood sugars more often, ad nauseum. Sometimes I just want to run screaming from the building. I long for a bit of levity amidst all the doom and gloom.

Fortunately, this time I was surprised and inspired by listening to Dr. William Polonsky give an informative and entertaining lecture on “diabetes burnout.” Dr. Bill is a clinical psychologist who is an expert in the field of behavioral diabetes (I didn’t even know the field existed!). He talked about the emotional side of diabetes which includes the personal, social, and behavioral sides of the disease. I would love to have a DVD of his presentation. (I settled for buying his book, “Diabetes Burnout: What to Do When You Can’t Take it Anymore”).

I also picked up his pamphlet called “the emotional side of diabetes: 10 things you need to know.” I think it’s an invaluable resource and I thought I’d share some of the information here. Dr. Bill also has a website: www.behavioraldiabetes.org where you can learn more.

Anyway, here is #1 of the 10 things you need to know about the emotional side of diabetes:

1. Harnessing Your Fears

With good care, you can live a long, healthy life with diabetes. Many people think they are doomed to suffer terrible complications, but this is simply not true! Diabetes is a serious disease and some people do develop severe long-term complications, but most of these problems are preventable if you have good medical care and take good care of yourself. Feeling a little frightened is not necessarily a bad thing, but when your fears get so big that you feel helpless and hopeless, it’s time to take action. You need to harness fear to help you manage diabetes.

• Fight fear with knowledge. Learn about the powerful benefits of good diabetes care by talking to your doctor or enrolling in a diabetes education program.
• Know the real odds. Ask your doctor about what your real odds for developing complications might be, and what you can do to improve those odds.
• Stay informed. Subscribe to any of the popular diabetes magazines to keep informed about how to avoid or slow complications.
• Don’t put up with frequent lows. If you are anxious about hypoglycemia, talk to your doctor about medication changes that can help. Fear of hypoglycemia is about losing confidence in your body, worrying a serious reaction could happen at any moment. It can lead to chronically high blood sugars, eating problems and an overly restrictive lifestyle. With treatment, these problems can be resolved.
• Stay in charge. Remember that your own self-care can make a big difference to your health. You are not helpless! After all, it’s not diabetes itself that typically causes serious problems, it’s poorly-controlled diabetes. With good care, you can live a long and healthy life.

Hope you can find something relevant here. I’ll do my best to keep posting Dr. Bill’s words of wisdom!

I love chocolate, especially dark chocolate. Because my chocolate consumption is limited due to the carb factor, I often resort to eating the no sugar added (nsa) chocolate. Unfortunately, the nsa chocolate is sweetened with maltitol. Maltitol is a sugar alcohol (polyol) and it doesn’t like me, nor does it like my guts.

Maltitol-sweetened foods (usually nsa candies and chocolate) do come with a warning that they make cause a laxative effect (or gastric distress, bloating, etc.) if consumed in large quantities. For me, the quantity does not have to be large and in fact, I can suffer after eating quite a small amount of maltitol on an empty stomach.

Without going into the gory details, let’s just say it’s not pretty (definitely not something to share on a first date).

I’ve tried all the major chocolate retailers and producers including Purdy’s, Charlie’s Chocolate Factory, Roger’s, Rocky Mountain Chocolate, Hershey’s, Cadbury, Daniel, and Bernard Callebaut. Every one of them uses maltitol as their sweetener of choice. Apparently, this is due to the fact that maltitol is fairly cheap, it acts similarly to sugar (except for the browning effect), and has been used as the “diabetic” sweetener of choice for years.

I’m sure I’m not the only one who is adversely affected by maltitol and would appreciate having some choices of sweetener in my nsa chocolates and candies. I would love to see one of the major chocolate producers take the lead here and produce and market an alternatively-sweetened chocolate. I’ll be first in line to buy it.

I got some disturbing news the other day.

I’m an inch shorter than I thought I am. I won’t tell you what that magic number is, but let’s just say I don’t have a lot of excess height to play with.

That makes my BMI today 25.3 (officially overweight) as opposed to yesterday (when I thought I was taller) and my BMI was 24.5 (officially a normal weight).

Makes me want to go eat a donut.

I take supplements. All kinds. Right now my stash includes a multi, ferrous gluconate (a fancy name for iron), vitamin C, ASA, and chromium. In the past I’ve also taken ALA. Many diabetes books recommend even more supplements - like vanadium, CLA, omega 3s, and mushrooms (the non-hallucinogenic kind).

I used to pooh-pooh extra vitamins and minerals, oils and fungi as unnecessary. I eat well, so why do I need to supplement my diet?

I am also confused by all the information out there. Which vitamins go together, what facilitates what, which ones can be harmful and how do I finance all this pill popping?

I decided to start taking a few supplements after researching, talking with my dietitian, and trying to slow down the effects of my diabetes. I truly don’t know if they help or not. Do I feel healthier? No. Do I feel more energetic? No. Do I get sick less often? No. Am I slowing down my diabetes? I don’t know.

What I do know - I have very expensive urine.