Why are you NOT taking care of yourself?

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Permalink Reply by Joe Milam on September 10, 2008 at 1:04pm

I posted this for discussion and I will have the first post as well. I have type 1.5 and ever since my diagnosis I have been working on getting in the best shape of my life, eating well, and logging my numbers to learn what not to eat or do. My A1C is 5.9 and I am shooting for 5.5 because my heart doctor wants to make the chance of me having an event as close to zero as possible. (I have a family history of heart disease) WHY are people not treating themselves??? I am pulling my hair out on this because it is stupid not to, or to believe you are exempt from the rules. I keep reading about how only 17% of type 2 diabetics even treat themselves and this is a group of diabetics that are increasing at a rate of 400% a year... I seriously can not think about it without getting angry at people. Is it that they do not care at all? Please help me understand this because I am fed up in all this research I am reading that makes it sound like America is going to eat it's self into type 2 diabetes then on to the grave and not do a damn thing about it.

Permalink Reply by Lee Ann on September 10, 2008 at 1:14pm

It's not "stupid", but it is incredibly insulting and presumptuous to call a phenomenon that you don't understand and have never experienced stupid.

Permalink Reply by Joe Milam on September 10, 2008 at 1:21pm

How is not living longer and not taking care of yourself smart? Here is one of numerous studies that have clearly said, take care of yourself = longer and healthy life...

Lee Ann, 2+2=4 in my book...

Permalink Reply by Lee Ann on September 10, 2008 at 1:27pm

Again, you are being judgemental of a behavioral phenomenon that your don't understand, and clearly haven't researched. There's plenty of research about it out there, so if you look for it, you'll find it.

Permalink Reply by Joe Milam on September 10, 2008 at 1:35pm

And what will the research tell me that is different then what I have stated... take care of yourself and you will live longer? What research will I find that says never check your blood glucose, have a high A1C and drink as much beer as you can and you will live to be 105...? Let me lead a guess to say none.

I think it comes down to education like Landileigh pointed out. Education and getting people to understand that small changes in there life can have HUGE impacts... how difficult is that to understand.

Permalink Reply by Dave on September 10, 2008 at 1:44pm

Hey there is nothing wrong with having a couple of beers!!

Permalink Reply by dino on September 10, 2008 at 2:31pm

Cheers!!

Permalink Reply by Lee Ann on September 10, 2008 at 2:22pm

I didn't say medical research about how diabetes management affects health outcomes. I said behavioral health research about how human behavior affects diabetes management, research that has been taking place for many years and continues to take place because researchers don't have a good understanding of human behavior.

Anderson, B. J., Miller, J. P., Auslander, W. F., & Santiago, J. V. (1981). Family Characteristics of Diabetic Adolescents: Relationship to Metabolic Control. Diabetes Care, 4(6), 586-594.

Cerreto, M. C., & Travis, L. B. (1984). Implications of Psychological and Family Factors in the Treatment of Diabetes. Pediatric Clinics of North America. 31(3), 689-710.

Colton, P. A., Rodin, G. M., Olmstead, M. P., & Daneman, D. (1999). Eating Disturbances in Young Women with Type 1 Diabetes Mellitus: Mechanisms and Consequences. Psychiatric Annals, 29(4), 213-218.

Delamater, A. M., Jacobson, A. M., Anderson, B., Cox, D., Fisher, L., Lustman, P., Rubin, R., & Wysocki, T. (2001). Psychosocial Therapies in Diabetes: Report of the Psychosocial Therapies Working Group. Diabetes Care, 24(7), 1286-1293.

Jacobson, A. M. (1996). The Psychological Care of Patients with Insulin Dependent Diabetes Mellitus. The New England Journal of Medicine, 334(19), 1249-1253.

Kovacs, M., Obrosky, D. S., Goldston, D., & Drash, A. (1997). Major Depressive Disorder in Youths with IDDM. Diabetes Care, 20(1), 45-51.

Miller-Johnson, S., Emory, R. E., Marvin, R. S., Clarke, W., Lovinger, R., & Martin, M. (1994). Parent-Child Relationships and the Management of Insulin Dependent Diabetes Mellitus. Journal of Consulting and Clincal Psychology, 62(3), 603-610.

Rubin, R. R. (2000). Psychotherapy and Counseling in Diabetes Mellitus. In F. J. Snoek & T. C. Skinner (Eds.), Psychology in Diabetes Care (pp. 25-59). New York: John Wiley & Sons, Ltd.

Schwartz, S. A., Weissberg-Benchell, J., & Perlmuter, L. C. (2002). Personal Control and Disordered Eating in Female Adolescents with Type 1 Diabetes. Diabetes Care, 25: 1987-1991.

Sternberg, E. M., & Gold, P. W. (1997). The Mind-Body Interaction in Disease. Scientific American, 7(1), 8-15.

I'm tired of typing these, but if you get through these, and still don't understand my point, let me know because I can direct you towards plenty of other sources in addition to these.

Permalink Reply by Megan Skelly on September 11, 2008 at 12:08am

Wow, thanks for the great reading list!

Permalink Reply by Lee Ann on September 10, 2008 at 1:07pm

Do you understand the psychological mechanism between attaining knowledge and applying it, or the countless mediating factors that affect that mechanism? If you do, you should contact the leading diabetes behavioral researchers, Richard Rubin, William Polonsky, Ann E. Goebel-Fabbri, and many others, because they've been working on it for years, and still don't have a clear understanding.

Permalink Reply by landileigh on September 10, 2008 at 1:14pm

i think that part of the answer is the fact that most doctors aren't having people test as often. I've often seen them thing that they just need to be below 8 with their A1c. Cost is another big issue, the cost of strips/insulin/medications. and the biggest is MISINFORMATION! education is key!

Permalink Reply by dino on September 10, 2008 at 1:36pm

Hey Joe...you sound a lot like my mom when I was first diagnosed.

I really am glad that you are taking good care of yourself and that you have got it all figured out and that your A1c is under 6%. I try every day to get to where you're at.

Bravo.

Now I'd like you to stop shaking your angry finger and calling people stupid and and judging other people with this horrible disease. With all due respect, you've had diabetes for about a year (honeymooner), and you were diagnosed as a grown adult.

Some of us were not so lucky. Some of us went through our teenage years pretending like diabetes didn't exist just to fit in. Some of us diabetic adults still practice these bad habits and struggle every day to balance life and diabetes.

What can I say Joe?...Does it make sense for a diabetic to NOT take care of themselves...of course not. But diabetics are just people. Not lab rats...not robots...not perfect. We have emotions, money problems, relationship problems, work problems, family problems, and insurance problems just like everyone else.

The only difference is that on top of all that we have to take shots, eat clean and exercise daily or else we go blind, lose our legs, and die. Sweet.

Hey...I'm not making excuses, and as diabetics I think we all know that we can improve our control. But I don't think your angry scare tactics are going to inspire anyone because we've heard it all before. Try a little understanding because the judging gets pretty old pretty fast.

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