There is a recurring theme that comes up when I talk to patients in class. Guilt, shame and/or judgment surrounds some area of their diabetes self-management. Whether it is from the diagnosis itself (mostly seen in type 2 diabetes), a meal choice that is a diversion from their norm, exercise that has not been done, stress that is mounting, or a mental health component that has not been addressed. There is one thing I know about guilt, shame, and judgment—they are all heavy. They are tremendously heavy. They weigh us down and slow us down. They prevent us from being our authentic selves. They prevent us from living in the moment and allowing non-perfect moments to be a part of our day, week, month and overall story.
In Gary’s opening segment he stated, “Diabetes management isn’t about being perfect. It’s about doing a good enough job to stay healthy and still enjoy the fun things in life.” These two sentences stuck with me and I felt it was a good opportunity to spend time and elaborate on this concept.
Merriam-Webster defines the word perfect as follows, having no mistake or flaws. How could a person be perfect? How could the way we manage a disease be with no mistake? How could we have such expectations no allow no flaws? It certainly sounds like a stressful and impossible feat.
Personally, I admit to having perfectionist tendencies. As a Virgo- we are known for being perfectionists, meticulous, and single-minded in the pursuit of improvement. I am also the first-born in my family which also tends to (unofficially) make us tip more towards the perfectionist side of the scale. All of this to say, that I get it. I get what it is like to want to have your I’s dotted and your T’s crossed at all times. I get the pressure that is self-inflicted and the desire to have all things together at all times. But, what I have learned as I have gotten older, perhaps wiser, is that this is truly an unattainable target.
Whoever was quoted saying “being perfect is boring” had something going there. Have you ever seen a photo of someone that was perfectly curated, posed, staged—perfect? You tend to make up so many ideas in your head about the people in the picture- they have it all together, look how happy they are! Which in a self-judgmental way can also be followed up with I don’t have it all together. I am not happy like they are! Man, that felt awful typing it, let alone feeling it.
As a dietitian I have also struggled with the persona I feel I am supposed to portray in my profession.
That I should eat “perfect” all the time. Just as some of you may think that us doing a food challenge on candy is not ideal. Think about if we ate perfect, macro-nutrient balanced, organic, portion-controlled meals for each of the challenges. Would that perhaps be followed with “who eats like that on a daily basis? I couldn’t possibly eat what they eat. That isn’t realistic!” And you’d be right. Perfection is unattainable. Real-life- is messy and imperfect as it is- is the real deal.
In life, there are way too many things to juggle on a daily basis to be any version of perfect in any category- let alone the Rubik’s cube that is diabetes. In regards to diabetes management, we like to use terms like trends, time-in range, 80/20, majority, etc.
Here are some examples.
This past Saturday when I was leaving the hospital after teaching, I had a participant from my class yell across the parking lot as she was standing with another woman from class. She said, “Hey, we are talking about you!” I awkwardly laughed and answered with the only corny response there is to that statement. “Oh yeah- good things I hope!” (Told you- cheesy!) She went on to say, “No one ever told me that my blood glucose number is a piece of information/data and not a judgment.”
In that moment I exhaled thinking, wow- it must be a freeing feeling letting go of the guilt we associate with a number. Whether it is on the scale, a pant size, minutes of movement a day, or a blood sugar reading– numbers are pieces of information. Our brain sometimes takes those numbers and places a feeling with them. That’s the part that is zero fun. When we start practicing the act of separating facts from feelings a whole other world starts to open up.
When we are looking at CGM data or blood glucose records we know that is makes so much more sense to look at percentage of time-in-range or blood glucose trends, rather than a single number. Where we sit most of the time is so much more important than those sometimes.
When we talk about our eating habits we should be more concerned with what we do most of the time, instead of that one time we ate all the carbs for dinner to celebrate our friend’s birthday and had wine and dessert afterward to boot. If you separated the facts from the feelings in the example, it would be hard to argue against the idea that that meal was worth it and the good time with your friend is what life is all about. To take that example and spin it- what if I ate a huge salad full of veggies and lean protein, but most of my other meals were highly processed convenient foods- would that big salad put an impactful dent in my overall diet?
Earlier this year I shared a quote from a book I had just read- Fit for Success- Lessons on Achievement and Leading Your Best Life by Nick Shaw. I will reshare the quote that has stayed with me ever since I read it. Nick wrote, “Perfection may be the goal, but it shouldn’t be your expectation. Dieting provides an ideal example. Someone who follows a three-month diet plan, which allows them to have five smaller meals per day, will be faced with 450 opportunities to mess up. The people who achieve the best results when dieting, based on my observations (and also data from the RP Diet App), typically adhere to their macro[nutrient] or caloric counts 85 to 90 percent of the time. That means you can be less-than-perfect on 50 of those 450 total meals and the odds will still be in your favor to achieve great results.”
So whatever it is that you are trying to achieve- give yourself some grace. We all need some good old-fashioned grace. Don’t carry the heavy burden of judgment, shame, or guilt. Easier said than done, but a question that I always ask myself in times where I am being hard on myself is, “Is that helpful?” Is that thought helpful? Is it helping me to get to where I want to go? Is this supporting my plans/goals? Is what I am striving to do helping or hurting me?
We are all just out here trying to do the best we can. It may be an unpopular opinion, but that is more than good enough. I know I can’t be perfect and I know the cost of trying to achieve it is too high. It means other areas of my life will suffer in pursuit of trying so hard to line everything up.
In closing, a friendly reminder to give yourself a break, give yourself some grace, focus on the majority of time not the minority, and do what you can with what you have. Sound like a plan?
Kristen Garron RD, LDN, CDE
Director of Group Education.
Kristen joined IDS in 2018 after working for seven years as a clinical dietitian in a community hospital and eight years as lead instructor for a diabetes self-management education company. With a knack for making complex issues seem simple and relating to people with a strong sense of empathy, group diabetes education has become her specialty and her passion.
“I think it’s important to create a warm, welcoming atmosphere,” says Kristen. “Everyone at IDS is that way – with patients and with each other. It’s tough enough living with diabetes; the least we can do is make those around us feel like family.”
A graduate of LaSalle University (go Explorers!), Kristen majored in Nutrition while earning All- Conference honors in division-1 lacrosse. In keeping with IDS tradition, she remains very active with distance-running and weight-lifting.
Kristen lives in West Chester, PA with her husband Tim, daughters Grace & Sadie, and dog Kirby. She enjoys traveling (visited 30 of 50 states and more than a dozen foreign countries so far), scrapbooking, and being outside with the kids and Kirby.