In my previous blog, Managing Blood Sugar and a Relationship: 5 Rules to Live By, I addressed how to cope in a relationship when you have high and low blood sugar episodes. In that entry, I brought up a few questions that need answering. First off, what is emotional self-care? Secondly, when your blood sugar numbers are out of range, what constitutes good internal thought management?
Growing Up Bad
I didn’t want to be told I was bad. It was hard enough knowing that I had messed up and was a bad boy. While growing up, I went around blaming myself for every high and every low. This was poor emotional management. In fact, that negative thinking sent me on an emotional roller coaster.
The Impact of Thinking and Feeling With Diabetes
How we think impacts how we feel. How we feel impacts the stability of our blood sugars. Depression, for example, releases cortisol—a hormone that causes the release of glucose in the blood stream. We can only control a few of the factors that impact BG levels, out of many that can’t be controlled.
As I got older, I started to realize that no mater how hard I tried, I could not get my BG under control. I was in a cycle of “poor me” thinking. I blamed myself over and over again. I spent many countless hours trying to keep my blood sugar in range; after all, I didn’t want to be accused of being bad.
Moving in the Right Direction
After enough psychotherapy and life experience, I realized my negative self-blaming was keeping me depressed, my blood sugar high, and was a waste of my time.
Shortly after college, I came to a conclusion that I still believe in and, as a professional diabetes-focused psychotherapist, recommend to my clients. The conclusion is that there is no such thing as good and bad blood sugar, only undesirable or desirable.
I know some of you are going, “Wait! Hold on for a darn minute here! Isn’t a blood sugar reading of 250 mg/dL bad?” Well, I am glad you asked. No, it’s not—and let me explain.
The goal is to keep blood sugar in range. I think most of you will agree on that point, but there are several other truths about BG that also need to be taken into consideration.
Several Truths About Blood Glucose
From time to time a person with a healthy pancreas may work out too long and hard, causing their blood sugar to drop below 70 mg/dL. And on the other end of the spectrum a person may eat or drink lots of fast-acting carbs in a short span, causing blood sugars to rise above 180 mg/dL for a short period of time. However, there are many advantages a non-diabetic has that keeps their blood sugar in tight control, which are not present in people with type 1 or may only be partly working in type 2 diabetes.
Natural insulin has 2 peaks where man-made insulin only has 1 peak. The first of the 2 peaks reduces the initial impact of the carbohydrates and peaks in 1-2 minutes. The fastest man-made insulin peak is equivalent to the second peak and happens 1-2 hours after injection.
That makes good management an up hill battle. Type 1 diabetics are ill equipped to handle carbohydrate intake without that initial burst of insulin produced by non-diabetics.
Man-made insulin working differently than natural insulin is one of many things working against ideal BG control. How man-made insulin works is out of the control of the person with diabetes. With all the potential things that can cause fluctuating blood sugars, how could a person with diabetes take full responsibility for high or low blood sugar?
It’s hard to accept that there are things beyond our control. Unfortunately, in life there are many things outside our control like lines at the post office or a tsunami.
Things not in your control will always cause blood sugars to fluctuate out of your target range occasionally, and that’s OK. As long as you take the appropriate steps to get them back within normal range, you are doing a great job.
Diabetes is unforgiving if you are unable to see the gray. Black and white views like bad and good only cause undue stress and emotional turmoil. BG readings are just numbers to guide you on your next step in managing your diabetes.
It may be better to look at high and low numbers as “undesirable” instead of “bad.” “Bad” is a punitive word and implies that the owner of the bad number is bad for letting BG numbers go out of range. There is no gray in the word “bad,” whereas “undesirable” is more emotionally neutral.
Emotional self-care is reducing or removing negative internal thinking. Changing the word “bad” to “undesirable” is a good start. By changing negative words like “bad” to “undesirable” when your blood sugar numbers are out of range, constitutes good internal thought management.
There are many other factors aside from the release of cortisol or insulin peaks that cause BG numbers to become undesirable. I will talk more about those in future blogs, but for now give yourself a break from negative thinking and refer to out-of-range blood sugars as “undesirable,” rather than “bad.”
All the advice included in this blog is therapeutic in nature and should not be considered medical advice. Prior to making any changes to your diabetes maintenance program, please consult with your primary physician or endocrinologist.