By: Laurie Block, MS, RDN, CDE. Edited by: Suvarna Sheth.
When it comes to making New Year’s resolutions it’s important to realize that change is different to achieve when you have diabetes or have recently been diagnosed with diabetes.
Diabetes often gets diagnosed without much warning, or for many with Type 1, the diagnosis comes about completely unexpected. Often there is a minimal amount of time to create a plan, develop a new way of changing routines or thinking about resolutions.
The diagnosis itself demands change that may not have been on your personal bucket list.
Yes, true if you have “prediabetes” or Type 2 diabetes maybe there is time to think about how to improve upon lifestyle habits and or routines, but for the majority of individuals diagnosed with Type 1 or Type 2, recommendations for change are placed on individuals by health care providers and support systems in attempt to get blood sugars into a healthy range.
For example, you may have been told medications coordinate with food, the importance of when to self-blood glucose monitor or the best time to exercise. — Changes that you may have or may not have been thinking about changing before the diagnosis.
Here are a few approaches to help you emotionally, and mentally prepare you for your new goals and resolutions.
1. Understand the Stages of Change
While starting your New Year’s resolutions think about where you may be in the Stages of Change Model. Also known as the “Transtheoretical Model,” it was devised by James Prochaska, a well-known psychologist and it may be the key to understanding change. The model could also be helpful to those with diabetes to achieve their resolutions.
According to the model, there are six stages of change include Pre-contemplation, contemplation, preparation, action, maintenance, and termination.
And here’s what they mean:
Precontemplation – You do not intend to take action in the foreseeable future, you are often unaware that your behavior is problematic. You may not even know you have diabetes.
- Contemplation – When you intend to start the healthy behavior in the foreseeable future. You recognize a behavior may be problematic. You may still feel ambivalent about changing. You may have been told that your A1 C was slightly elevated and thought about some lifestyle changes.
- Preparation (Determination) – You are ready to take action within the next 30 days and you start to take small steps to behavior change. You may have joined the gym or made an appointment with your diabetes health care team.
- Action – You have changed your behavior and intend to keep moving forward. You have started self-blood glucose monitoring or taking your medication.
- Maintenance – You have sustained the behavior change for more than 6 months and plan to maintain the behavior. You have a routine for diabetes self-management and are aware of changing routines necessary for blood sugar management.
- Termination – When you have no desire to return to unhealthy behaviors. You are finding it easier to manage the everyday obstacles that come along with management.
Now that you have a clear roadmap for the steps required to undergo a change, it may be easier for you to see how your own actions carry out when making a New Year’s resolution.
What stage are you in? And how can you make changes to get to the next step?
2. Take Steps Towards Acceptance
A diabetes diagnosis takes time to accept and is not always easy. Diabetes management therefore also takes time.
Anyone who has been diagnosed knows initially there is a learning curve to understand concepts of diet, exercise, monitoring, and medications.
Some are able to incorporate new ideas and can easily accept the diagnosis. More commonly, individuals struggle with change and need to come to terms with emotions that are related to a diagnosis.
Kubler Ross Stages are an important model to understand, according to Maggie Forys, RDN CDE, who has more than 25 years of experience working with diabetes.
“It is not uncommon, especially for adults to feel a sense of loss about their health,” she says. “In practice, it often looks like denying the illness, depression, not showing up for appointments, forgetting to take insulin, following strict exercise regimens or exploring alternative therapies.”
Often these actions are to prevent the start of insulin or medication or face some of the demands of self-management.
As an educator, I help patients through the common Kubler Ross Stages which include denial, anger, bargaining, and depression.
After an individual accepts the diagnosis, we create a plan of action and management becomes easier.
Accepting the diagnosis or living with diabetes for a period of time is really helpful when creating a plan of action.
3. Come Up with a Plan and Set Goals
Setting a resolution may still be an important step to achieve your goals, however, to be successful, you need a plan and you need to set goals.
To help patients achieve their goals, health professionals often use the SMART method of goal setting to assure that the goals are manageable.
Experts agree that goals should be S – specific, M- measurable- A action-oriented – R relevant or realistic, and T time-limited.
Goals do not follow a linear path. Keep the goals specific, measurable, and relevant. Whether it is a short term or long-term goal remember to expect setbacks when incorporating change.
4. Understand Emotions
Acceptance of a diagnosis, developing a plan, and taking action are important. However, it is equally important to understand how you may feel while making changes.
Well, known author, Peter Bregman shares some very insightful concepts about learning and change in his book, Leading with Emotional Courage.
Bregman notes, “Learning new things is primarily intellectual, but the experience of learning is emotional.”
This concept is very true in diabetes. For example, learning how to monitor your blood glucose in front of your peers versus in private are two very different experiences.
There are many feelings such as embarrassment, fear, and shame, that often come along with performing new tasks.
For many, it is often not about the lack of knowledge that prevents learning.
Individuals often need to be able to feel comfortable with the emotions that occur while learning and incorporating change.
Bregman’s book is very helpful in understanding the role of emotions individuals feel when making changes.
Even though keeping a New Year’s resolution is different if you have diabetes, it will most likely challenge you both emotionally and intellectually. Try dissecting your New Year’s Resolution this year with the steps outlined above and see if you have more luck sticking to your goal and achieving success this year.
To a very happy, healthy, and successful 2020!
Laurie Block RDN, CDE is a Registered Dietitian/Nutritionist who practices in New York City and La Jolla, Calif. She specializes in medical nutrition therapy with a special interest in diabetes, obesity, and cardiovascular risk factors. She is the author of the Type 1 Diabetes Cookbook published by Rockbridge Press and enjoys writing about nutrition-related topics. Block is passionate about helping kids, teens and adults reach their health care goals. She is involved in Marjorie’s Fund, a global initiative to empower adults living with Type 1 diabetes. She is also the co-founder of the Kids and Healthy Weight Program at New York-Presbyterian/Weill Cornell Medicine.