By: Diane Herbert, MSW, LSW
T3 Mom & Diabetes Coach
Whether you’re new to life with Diabetes or an old pro, no doubt you’ve been educated, informed and otherwise drilled on the importance of achieving a healthy or target A1c in order to ward off a host of serious health complications.
We have been given the formula that involves a tight balancing act between the management of food, insulin, activity and a host of other factors that can impact our ability to keep our blood sugar in range. But how about all the emotional or “life” factors that influence our ability to do the things that we’ve been told we need to do in order to achieve the elusive target A1c? What education and training have you received for that?
“E1c” is a pun I use to capture the emotional factors we face that impact our ability and willingness to reach diabetes management goals.
Whether you have diabetes, care for someone with diabetes or are a health care professional treating people with diabetes, it is important to realize that things go badly when we assume or expect that the medical consequences of poor diabetes management will and should over-ride who we are as individuals and humans.
Our emotions, personalities and where we are, from a developmental and life stage perspective, have a dramatic effect on what our diabetes management abilities look like. By recognizing and anticipating that our level and flavor of diabetes management will naturally fluctuate throughout the course of life, there is an opportunity to identify and implement appropriate, targeted supports to offset the inevitable decline in diabetes management during those periods.
All too often the current response when a person hits a diabetes management trough is to cast a disapproving eye with the general theme being “don’t you know what will happen to you if you don’t do what you’re suppose to do?”
Sadly, this message is the message people with diabetes receive from multiple sources within their psychosocial eco-system, including well-intended family members, medical professionals and random strangers — ultimately driving the loudest message of inadequacy, shame and guilt from themselves. And given that diabetes management is something that comes up throughout the day, everyday, there are literally thousands of messages and judgments which create a very strong, defining self-picture. 
The development of this picture of ourselves with diabetes carries significant weight with respect to our relationship with diabetes management for many well-studied psychological reasons. But to boil it down to its most basic factor, it is because we’re humans. As humans, and yes people with diabetes fall into this classification, we avoid things that we perceive we are not good at as well as things that bring us shame and guilt.
These human tendencies are so powerful that they have the ability to override the fear and understanding of the serious consequences that uncontrolled blood sugar levels can bring about.
As a T3 mom, I’m a staunch cheerleader who has the greatest interest in and gratitude for the medical advances that are occurring in the field of diabetes treatment and the search for a cure. Period, Amen!
But in the meantime, we can make significant improvements to the health of people with diabetes if we work on identifying and building supports that reflect the emotional and developmental context of people with diabetes – believing firmly that if we are able to adequately take care of a person’s E1c, then their Alc will naturally follow.
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