I realized, while walking my dog today, that training a dog and managing diabetes have some things in common. Up until about a week ago, I thought my dog really got the whole process. He went out in the morning, did his thing, then went out again around mid-day and once more at night. He was eating two meals a day with a few treats scattered in there.

Then about a week ago, for no apparent reason, he stopped eating breakfast and started going out at random times with or without success. Maybe he just got smart and realized he could live on treats so why bother with the real food. Maybe he's sick (although he acts just fine). Or maybe he's going through a phase.

This reminded me of managing diabetes, because just when you think you've got it down, something changes and it feels like starting over. Some of these management-upsetting changes can include puberty, pregnancy, medications, menopause, a new job/different schedule, major stress, going on or off an insulin pump, and many others.

Although the details of how you would deal with one or another of these situations would vary, here are some general suggestions for staying sane and managing your way through them:

• check blood glucose levels more often, if possible
• keep a record of your blood glucose readings
• make regular appointments to see your health care providers (preferably ones who specialize in diabetes)
• use whatever stress management techniques work best for you - don't beat yourself up for unexpected blood glucose levels
• be informed about whatever situation is happening (puberty, pregnancy, stress, etc.) and discuss it openly with your health care provider
• if possible, find a friend who will support you through the process (most, if not all of these situations do not last forever)
• be willing to make adjustments and find a new "normal" for your diabetes management
• keep an open mind and be ready for the next phase that comes along.

Time to go walk the dog!