Redefining "Success" In Diabetes Management


Think back to your last doctor appointment where you talked about your diabetes. What was the main topic of conversation? Your A1C levels? Or maybe your insulin dosage? There’s no questioning the importance of these metrics, but it’s also crucial to acknowledge the work it takes to achieve those numbers—namely, the ability to successfully manage your self-care each and every day. But how do you measure that type of success when it comes to diabetes management? There’s not exactly a number you can place on it, is there?

Most people would probably say that successful self-management in diabetes has to include physical activity, healthy eating habits, weight management, and, for some, medication—which, of course, are all important. But how do we actually stay motivated to maintain consistency in all of these different aspects of our health?

That’s where redefining our achievements comes into play. Here, Dr. Harpreet Nagra, PhD, VP, behavior science and advanced technologies at One Drop, helps us reimagine what it means to find success in diabetes management.

Allie Strickler: First, let’s talk about how “success” is traditionally defined and measured in diabetes management. How can these measures impact the way you feel about your relationship with your health?

Dr. Nagra: From a healthcare perspective, it is typically defined by factors such as time in range, meaning the amount of time you spend in the target blood glucose range (which, for most people, is between 70 and 180 mg/dL), A1C values (which tell you about your average blood sugar levels over the past two or three months), and the number of complications you have, if any, related to living with diabetes, such as high blood pressure, neuropathy, kidney disease, etc.

Since these values are mostly numbers-based, they’re often restrictive in terms of how you as an individual can define success for yourself, let alone for your healthcare provider. In fact, many folks experience greater diabetes distress and burnout as a result of this numbers-focused relationship with their health. (Find out how a One Drop coach can make your diabetes data seem less overwhelming.)

Plus, since healthcare teams typically work within systems that reinforce how many people they’re able to see per day, what their clinical outcomes look like, and how many hospitalizations happen on their caseload, that’s often what those providers end up discussing and reinforcing in their conversations with you.

Allie Strickler: How might these measures of “success” set us up with unrealistic expectations?

Dr. Nagra: If success metrics are only numbers-based, or focus on the quantifiable factors, oftentimes, the holistic, human-centered approach will get overlooked. We then end up devaluing our efforts and work in setting up better habits and lifestyle changes that actually help us reach the health goals we’d like to set up for ourselves.

For example, having an A1C around seven is a great goal. But think of all the process-based changes you would need to make to help you accomplish that goal: reducing your stress, more physical activity, managing carb intake differently, or even medication adjustments. Without consideration of all the effort that you’re putting into these different lifestyle changes, it’s easy to feel overwhelmed or that you’re “failing” at managing your health.

Allie Strickler: We often hear doctors use the word “control” in relation to achieving success with managing diabetes. How might redefining “control” in diabetes relate to redefining “success” in the same context?

Dr. Nagra: “Control” has a very fixed connotation to it. Either you’re “in” or “out” of control, and when you’re checking your blood sugar multiple times per day, the chances of being “out” of control are quite high. If we can shift your focus away from just the outcomes of A1C, weight, and blood sugar numbers, we can start helping you concentrate more on the process of becoming healthier—the process of establishing better habits so that more daily wins happen, like going for a 10-minute walk, or trying out a new vegetable, or staying consistent with drinking water for a week.

These mindful efforts may seem like small changes, but they can have a huge impact on our psyche and mental health. And if our mental health is in a good spot, then our stress levels are lower, and our blood sugars will readily be in a better range.

Allie Strickler: What are some realistic ways to redefine “success” in diabetes management?

Dr. Nagra: I think it’s helpful for people living with diabetes to reflect on how they’ve measured success for themselves in the past. What is your unique definition of success? From there, you can begin to identify the small steps you need to take to eventually achieve that level of success.

More often than not, it will come down to not only building new habits, but also being more mindful of how you talk to yourself about those habits and the outcomes they may (or may not) lead to. After all, we’re our own worst critics, and we hardly ever give ourselves the grace that we give others.

Some examples of different ways to measure success in diabetes management include:

  • Intuitive eating. For most of us, eating is something we tend to do mindlessly, whether we’re watching TV during dinner, checking emails while scarfing down lunch, or hastily eating a granola bar during our morning commute. Intuitive eating, on the other hand, challenges us to approach food with more intention and instinct, and less fear and judgment. In doing so, you can improve your ability to know when your body is full and satisfied, and you’ll have a better understanding of how you react to different types of foods. To measure your progress with intuitive eating, try enjoying a distraction-free meal at least once a day, and work up to the habit of eating until your body feels 80% full.

  • Self-advocacy in medical settings. Advocating for yourself at your doctor appointments not only means being able to ask the hard questions of your medical provider, but also challenging them to see you as more than a number, whether it’s your weight, A1C levels, insulin dose, or all of the above. The next time you see your doctor, try asking at least one question during the visit—even if it’s just to clarify a detail or two—and don’t be afraid to take notes if you need to. Show your doctor, and yourself, that you’re present, paying attention, and committed to your self-care. (Here are more ways to be your own advocate in a world of health disparities.)

  • Self-love. Again, we’re all our own worst critics. Loving yourself doesn’t necessarily mean avoiding all self-criticism, but rather building the habit of catching yourself when you’re being overly self-critical or engaging in self-blame—because, let’s face it, it will happen from time to time. So, when it does, give yourself grace, and remind yourself that those blood sugar levels, and any emotional experiences accompanying them, are all temporary.

  • This article has been clinically reviewed by Jamillah Hoy-Rosas, MPH, RDN, CDCES, and VP of clinical operations and program design at One Drop, and Dr. Harpreet Nagra, PhD, VP, behavior science and advanced technologies at One Drop.

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    Allie Strickler
    Nov 03, 2021

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