Diabetes Management: Saving up for a rainy day, could leave you out in the storm.

Alicia: UnLeashed!

Saving up for a rainy day, could leave you out in the storm.

I’m a big fan of budgeting. I like to see an expense coming and save up for it. I like to budget my time too, I get rest when I need it and plan for family and friends so no one area of my life dominates and pushes the rest to the fringes.  Budgeting is important, whether it’s calories for a little splurge, time for life, money for growth, or energy for life’s struggles. But, there are two places where budgeting is rarely, if ever effective. Your health, and more specifically your diabetes management, and the weather. You can’t bank enough sunshine to make winter warmer, and you can’t bank your health either.

There are two mentalities that fall into this trap most, “I’ll do good now to let it go in the future” and “I’ll do good now to fix what I did in the past”

We often get fooled into thinking that keeping a tight A1C for no will somehow “balance out” having poor blood sugar management in the future. Parents most often fall into this way of thinking. It drives us to sacrifice a great deal in order to get to a lower A1C or to maintain perfect time in range in fear of a time in the future where diabetes will run rampant and blood sugars will be minimally controlled. However, that is not how diabetes complication risk works. It’s not like if you have an A1C of 5 for ten years, and an A1C of 10 for the following 10 years, that on the other side you average out to a lifetime A1C of 7.5. It’s not like you “banked” those years of tight control to spend later. What you actually got was 10 years of incredibly tight control and a reduced risk profile that came with it, then 10 years of reduced control and the heightened risk that came with it. All the previous years of super tight control did was give a space of time with reduced risk. But the minute management goes away and A1C rises, so do the risks, it’s not like you get “time off for good behavior”, your body has not gained some kind of shielding gained form years of ultra tight management. In fact, we typically see a sling shot effect. When we maintain super tight control the stress caused by management (or in the case of kids and teens, the stress of watching stressed out caregivers keeping tight management) pulls that slingshot back tighter and tenser, then when let free to fly we tend to see hard and fast reductions in management practices and much higher A1C values than before.

Our diabetes management, and our wellness is not something we can bank for later, it is being built day by day, in the now. Just ask any new parent. You can not sleep enough before a baby is born to somehow balance out the lost sleep a new baby brings. Nor can you save up and bank good health practices to get you through a time in the future when you will be without them. Just ask extreme endurance athletes. They can spend weeks and even months preparing their body to withstand harsh trials. Even the most intense preparation is only enough to get one through a few days of extreme deprivation at the most! And on the other side their bodies are depleted, injured, and unwell, months of preparation may have bought them hours, but not weeks, and to continue this kind of cycle for a prolonged time would have serious long term consequences to one’s health.

The second trap we fall into is “I have to be perfect now to repair all the damage I did back then”.  We most often fall into this thinking when we are newly diagnosed and become aware of the trial that our bodies made it through and damage possibly done without our ever realizing it. Or, we fall into this thinking after a time of poor diabetes management, perhaps in our young adult and teen years, or during a time of “burnout” when we lived in denial of our diabetes and made it out by the skin of our teeth. We become like someone who has gotten deep in debt and is now budgeting every penny hoping to repair their credit, pay their debts and avoid foreclosure! But again, this is not how our bodies work. Yes, maintaining good health practices will help our bodies repair from past injuries, it will help us reduce the rate  of on going damage or complication onset, and may even halt these in their paths. But again, having an A1C of 11 for a decade, is not somehow undone by keeping and A1C of 5 now. The risk of complications you had then was what it was then. Getting healthy now will help you repair and possibly regain what was lost, but being somehow “Ultra healthy” will not somehow push your body’s ability to recover as if those rough years never happened. In fact what is far more likely is that the push for “perfection” (see also: penance) is more likely to set up exactly the kind of burnout and sling shot effect that lead to the time of poor management to begin with.

The reality of wellness is that we can not go back in time to change damage done (No matter what skin cream commercials keep telling us). Nor can we save up today for a rainy day tomorrow. Diabetes management, and good physical wellness is about living our lives in the best way we can one day at a time, practicing balance and moderation. (Sacrificing your emotional, spiritual or social self for diabetes management will always have a breaking point)

What we can do is build skills before we need them.

We can learn how to bob and weave when life is easier and simpler so that we have those skills honed for when diabetes management gets tough. This is where it’s a great idea for caregivers to have their transition aged young people work with educators so kids can build their own diabetes management skills, relationships and habits while still under their care givers guidance for years before they leave home and supervision. This helps ensure that rather than going from tight control to none, young people are set up for moderation. It is also why, when planning a pregnancy working closely with an educator to sharpen diabetes management skills can really pay off by giving a strong foundation to land on when hormones and rapid changes in management are needed. SO rather than spiraling into lost management we can flex and move with the needed changes.

Budgeting is important, but your wellness is not an account ledger.

Our wellness is a living breathing resource that must be nurtured along the way. Diabetes can feel like a collection agency at the door, it can feel like winter is coming. But today, and living our best today is really the best investment we can make.