Random thoughts on diabetes.

How is it that we expect people with diabetes to be able to leave the hospital, manage their insulin shots, completely change their diet, change their lifestyle, increase their physical activity almost overnight?

And judge them when they fail?

All too often, there is a sense that it is their fault anyway. They 'ate' themselves into diabetes and the fact that they can't control their blood sugar is further proof of their gluttony and lack of self-control.

You can't help people with diabetes if this is what you think.

Firstly, when you first get diagnosed with diabetes, you have no idea what you can or cannot eat. Yes, everyone will tell you that you shouldn't take anything sweet and you should avoid carbohydrates.

That advice is quite simply useless.

The reason why that advice doesn't work is because it doesn't help people make changes in their daily diet in a practical sense.

Avoid sweet stuff? Do you mean no sugar at all? What about fruits? My usual cup of tea? Wait, so SOME fruits are fine? Which ones? How much?

Avoid carbohydrates? So, no rice, no bread? Wait, some rice but not white rice? Bread but not white bread but not so much bread? What about noodles, vermicelli, ramen? Potatoes?

Without proper useful advice it is easy to feel like you're lost in a sea of confusing messages.

The same for physical activity. What should I do? Will this be enough? Is it too much? What if I feel faint? Should I skip my insulin, should I take some sweets? Will it be dangerous?

Without proper useful advice, it is easy to give up and go back to what you've always done.

All too often, advice for diabetics is given as a one-off during a consultation. That advice is also given as a medical intervention, based solely on lab results and medical parameters.

The question is: How is the person supposed to live out the advice?

The person spends 99.99% of their time away from a healthcare professional. In that 99.99% of the time, they are faced with various competing priorities, as well as obstacles in their life that make it difficult to stick to advice that is given in the 0.01% of their time.

My ask is that we acknowledge how difficult it is for someone to overhaul their life.

My ask is that we work with people who have diabetes instead of working on them.

My ask is that we understand that what is for us a moment at work, is to them their life.