advice on exercise.) The problem is that making a long-term change to a more physically active lifestyle is difficult; most people become more active for a time but eventually fall back into inactive routines.
Another study demonstrated the tendency for people with diabetes (and for people in general) to abandon exercise programs after a certain period of time. This information was reported in the New England Journal of Medicine in July 1991. In this study, a group of people with diabetes received professional support for two years to encourage them to increase physical activity. For the first six months, the study participants responded well and exercised regularly, resulting in improved blood glucose, weight management, and overall health. After that, participants began to drop out and not come to training sessions. At the end of the two-year study, most participants had regained their weight and slipped back into poor glucose control. However, the few people who didn’t stop their exercise maintained the benefits and continued to report an improved quality of life.
If you’re in the small group of diabetics who require intensified insulin treatment, perhaps you’re afraid that intensified insulin treatment, which involves three or four daily shots of insulin and frequent testing of blood glucose, will keep you from doing the things that you want to do and will diminish your daily quality of life. (See Chapter 11 for more information about intensified insulin treatment.) Your fears are not justified by the facts.
A study published in Diabetes Care in 1998 explored whether the extra effort and time consumed by such diabetes treatments had an adverse effect on people’s quality of life. The study compared people with diabetes to people with other chronic diseases, such as gastrointestinal disease and hepatitis (liver infection). The diabetic group reported a higher quality of life than the other chronic illness groups. Interestingly, the people in the diabetic group were not so much concerned with the physical problems of diabetes, such as intense and time-consuming tests and treatments, as they were concerned with the social and psychological difficulties.
Another report in Diabetes Care in 1998 stated that insulin injections don’t reduce the quality of life; the person’s sense of physical and emotional well-being remains the same after beginning insulin injections as it was before injections were necessary.
Teenagers who require insulin injections don’t always accept the treatment as well as adults do, so teenagers more often experience a diminished quality of life. However, a study of more than 2,000 such teenagers, published in Diabetes Care in 2001, showed that as their diabetic control improved, teens felt like they were in better health, experienced greater satisfaction with their lives, and therefore believed themselves to be less of a burden to their families.
A study described in Diabetes Care in January 2002 showed that lowering stress lowers blood glucose. Patients were divided into two groups, one of which received diabetes education alone and the other of which received diabetes education plus five sessions of stress management. The latter group showed significant improvement in diabetic control versus the former group.
✔ Identify the source of the stress. Are you adding to stress yourself by accepting it as an unchanging part of your life or blaming others or outside events that you can’t control?
✔ Examine the way that you cope with stress now. Do you smoke, drink too much, overeat, spend too much time in front of screens, sleep too much, or overschedule yourself so you have no time?
✔ Replace unhealthy coping mechanisms with healthy ones. Avoid the stress you’ve identified or make a change in your life. Adapt to the stress or accept it. You can’t avoid your diabetes, but you can make it less stressful by following my recommendations in Part III.
✔ Take time out for fun and relaxation. Here are some of the things you might do:
● Have a picnic lunch
● Get a massage
● Take a long bath
● Work in a garden
● Play with a pet or go to the zoo
● Listen to your favorite music
● Go to a comedy show or rent a funny movie
● Stay in bed with your significant other
Many other studies have examined the different aspects of diabetes that affect quality of life. These studies show some useful information on the following topics:
✔ Family support: People with diabetes greatly benefit from their family’s help in dealing with their disease. But does having a close family help people with diabetes maintain better diabetic control? One study in Diabetes Care in February 1998 addressed this question and found some unexpected results. Having a supportive family didn’t necessarily mean that the person with diabetes would maintain better glucose control. But a supportive family did make the person with diabetes feel more physically capable in general and much more comfortable with his or her place in society.
✔ Quality of life over the long term: How does a person’s perception of quality of life change over time? As they age, do most people with diabetes feel that their quality of life increases, decreases, or persists at a steady level? The consensus of several studies is that most people with diabetes experience an increasing quality of life as they get older. People feel better about themselves and their diabetes after dealing with the disease for a decade or more. This report shows the healing property of time.
Following are some other factors that improve quality of life for people with diabetes. Though I can’t cite any particular studies here, doctors and patients alike can vouch for their importance.
✔ Blood glucose levels: Keep your blood glucose as normal as possible (see Part III for tips).
✔ Continuing education: Stay aware of the latest developments in diabetes care.
✔ Your attitude: Maintain a healthy attitude. Remember that someday you will laugh about things that bug you now, so why wait?
You wouldn’t hesitate to seek help for your physical ailments associated with diabetes, but you may be reluctant to seek help when you can’t adjust psychologically to diabetes. The problem is that sooner or later your psychological maladjustment will ruin any control that you have over your diabetes. And, of course, you won’t lead a very pleasant life if you’re in a depressed or anxious state all the time. The following symptoms are indicators that you’re past the point of handling your diabetes on your own and may be suffering from depression:
✔ You can’t sleep or you sleep too much.
✔ You have no energy when you’re awake.
✔
