Wednesday, June 10, 2009

MANAGING MY DIABETES

Hello everyone.

It has been a while since my last entry.

I have been struggling with some of issues about my Diabetes. I have discovered that I may know the science and theory behind managing Diabetes but, I have difficulty balancing the emotional aspects and belief systems to successfully manage my Diabetes. I have suffered setbacks and failures in consistently doing the necessary things at the best time. I will explain this cryptic statement in the follow paragraphs.

I agreed to work night shift for my hospital because of their staffing shortage. I failed to consider how the schedule change would affect my health. I did not just agree to changing my schedule from days to nights but, also agreed to a series of constant schedule changes as I reverted back to days to care for my family when off work and revert to nights when working.

I was controlling my Diabetes with Glucophage, Actos, Byetta and diet before the shift change and was considered "well controlled" by my Doctor. After the schedule change my blood sugars became erratic. I began to "forget" to take my medications at least once a week in the morning and 3-4 times a week in the evening. I could not remember if it was "My Morning" or evening. What a mess.

My Byetta was even worse. I needed to take it 30-60 minutes before eating but could not establish a "Routine" that worked. When I got up to go to work, I would eat in less than 15 minutes after waking. When coming home from work, I would eat as soon as I got home so I could go to bed. When not working, I could not regulate sleep or eating. What a mess. I would miss 60% - 75% of my Byetta doses. I could not understand why I could not maintain a consistent compliance with my medications.

I was very disappointed with myself because I should be able to take my medications "on time." I began to discuss some of the behaviors other Diabetic nurses used to regulate their disease and learned some very important things.

The first thing I learned is that we cannot rely on memory to remain consistent. Most people form behavior patterns because it helps their life become "stable." We wake up at about the same time. We eat about the same time. We go to bed at about the same time every day. These routines are what we organize our daily routines around.

We eat the "foods that we like" and these foods are usually a small part of all the choices available to us on a daily basis. While we may "try" new foods, we do not often adopt the new foods into our daily routines. Our lives feel unsettled when our routine is too far out of balance. We tire easily and become forgetful.

The nurses who were controlled Diabetics have leaned to follow the same eating and medication routines whether working or sleeping at night. They eat breakfast in the morning, Supper in the evening and a snack at noon or midnight. They take their medication at the same time every day and do not change it for their work schedule. They still experience a broader range of blood sugar results than they would like.

The poorly controlled Diabetics are just as inconsistent as I was when they try to alternate their daily schedule with their work.

So rule one to compliance for me is a consistent schedule. I am back on Day Shift now and this should be easier to accomplish. I hope so!!

Rule two is a consistent medication schedule. Habits can be formed that will overcome a bad or confusing day. These habits of when and how to take my medication will help me to remain consistent.

Rule three is consistent eating habits. I can control my simple carbohydrate intake best when I eat at the same times and similar foods. Consistent habits can be altered in small ways for consistent improvement. This will be one of the most difficult for me to maintain.

Rule four is consistent activity levels. (This is the hated "Exercise") I need to do the same activities about the same time each day. I need to get some organized activity several times a week. (Walking, Biking, Running, Swimming.)