Simple Tips for Coping With Diabetes

"How do you eat a whale? One bite at a time."

That is what a wise old Army First Sergeant told me once when we were getting hit with a hundred tasks at once, each more important than the last. In the 12,186,720 minutes that I've had Type 1 Diabetes, that advice has come to mind more than once.

We know that dealing with this is a 24/7/365 proposition. Even when we are asleep, it can still wake us up and demand our attention. Most of the time, we are on our own. If we get an hour to talk diabetes with a doctor every 3 months, that amounts to 0.046% of each year. If we are lucky, we get as much training in managing diabetes as we would if we took a CPR class. In other words, we get to mange and be held accountable (by doctors, family and friends) for mechanically managing a complex biochemical process with potentially deadly drugs using inexact tools and relying on minimal training. Oh yeah - there is no end in sight, and no reward for winning.

It's no wonder that this gets us stressed out and overwhelmed from time to time. We all have days where everything works perfectly. More likely that insulin bolus is as effective as a shot of water, the carb data we use came from a practical joker, or our blood glucose meter spits out numbers that came from a lottery number generator. In other words, we do our part right but it doesn't work. All of those failures - one after the other - can destroy our confidence (a critical thing we need when trying to stay on top of a potentially deadly disease).

I've been playing the D game for 23 years. I've had ups and downs, and more than once I've wanted to throw in the towel. But we don't have that luxury. Like another friend said, "you don't have to like it, you just have to deal with it." Here's how I try to keep things on an even keel and to keep a sense of calm in the process.

• Don't beat yourself up over the past. Learn from it if you can, but if your carb count was off, your bolus didn't work or that correction didn't budge your BG one iota - forget it. You can't change it - it's over. If you had a 12 hour run between 110 and 115, celebrate. Use that to leverage your confidence. Learn from the bad, celebrate the good and move on.

• Focus on today. You know what you need to do: do it right. Test before and after meals, before driving and when you feel off. Use the best available data for carb counts. Get the insulin going in a good location and on time. Every time you do something D related, do the best you can with the use of all the experience and judgement that you've accumulated in your D journey. I talk to myself silently as if I were explaining what I was doing and why to my endocrinologist or to somebody I was trying to teach. Today is the focus. If I give it my best effort, that is the best I can do. When my A1C results come back, I'll know that every day I gave it 100% and I'll be pleased with that, regardless of the number.

• Don't sweat tomorrow. If you think about how many carb counts, finger sticks, boluses and corrections that you will have to do in the next 5, 10 or 20 years (or until there is a cure) it will overwhelm you. When I was a little kid, I watched my mom take a thyroid pill. I asked her how long she would have to do that and when she said "for the rest of my life" I was freaked out. I couldn't imagine that. The same goes with my own diabetes. One time I counted all the shots, fingersticks, etc. that I'd done. While the numbers were impressive and I thought I was one hell of a guy for having done all of that, it also made me think of what they might be a few years from now. Not good. Instead of worrying about that, I figure if I work hard today, tomorrow will take care of itself. 

• Help each other. Somewhere, somebody is out there who has been where you are now. Reach out - you'll be surprised how many people like you are willing to help. Likewise, you have wisdom that might help others. (That is why I write some of these things.) Twitter, Facebook and some online communities are great places to find those folks. There may be groups in your community as well. Keep your eyes and ears open - help and support might be just around the corner.

In a nutshell, diabetes can play hell with you psychologically, but it doesn't have to be that way. Do your best now and don't think about yesterday or tomorrow. Easy to say, but hard to do. But just like trying your best today with managing your diabetes, handling the mental part works the same way. Do your best, forgive yourself when needed and keep working at it.

You can do this!