How to care for diabetes.

Diabetes and the trouble of controlling your blood sugar levels

Do you know how to care for diabetes?

Or could you perhaps need some help getting control of it?

For some, it seems to be troublesome to get control of diabetes because the only tool they’re given is insulin. So that’s what they use. Every other relevant aspect varies and goes haywire. That’s not a good solution. It’s barely a solution. That’s like getting one tool to solve a problem without knowing how to use it. It’s as if you’re handed a pen when you’re going to write a book or a brush when you’re supposed to paint a masterpiece.

That one tool doesn’t quite cut it, even though it’s technically the one thing you need.

For some, getting good enough control of their diabetes isn’t hard. They cut down on the sugary stuff, move decently – and they’re set. If that’s you, I’m nothing but glad for you. Go at it, and have a great life. Keep moving, and watch what you eat. Be well, good luck, keep doing your best, and don’t forget to enjoy a little something once in a while.

For some, it’s not quite as easy. I’ve met some people who’ve been going at it for years – or even two-digit numbers of years – and they still don’t get things settled well enough.

I’ve met people who’ve gotten “More insulin!” as the primary solution and, in addition to that, just enough education in nutrition to get confused.
I’ve met people with leg ulcers who are too bitter to care about taking care.
I’ve met people who resent one white bread but practically praise another kind because “that’s a far better choice”.
I’ve met people who’ve said – or had doctors say that – their diabetes is “hard to medicate to get right”.

It seems common to find the whole problem quite confusing and intangible. There’s rarely a structured plan where you quickly follow things through from A to Z and get clarity. People seem to get tiny fragments rather than the big picture. Then, to fill out the empty parts, they make those bigger. Consequently, there’s poor sleep at night, and fatigue when the sugar levels are too high or too low. There’s an inability to focus and concentrate and no clue what to eat because “it’s not working anyway”. They’re too poorly instructed, the intervention is nothing but medication, and they’ve got no idea why. It’s often unclear why they’re supposed to eat what and why they’re medicating how.

There is plenty to know and a lot of mistakes you can make. It’s tricky because it’s complex. So I’m not surprised in the least when people do need help.

I’m not a nurse, and I’m not a doctor. I’m not a dietician, nor am I a nutritionist. But for some, that’s not what they need either.

I’ve had my nose in quite some books, and I have been at the university to collect some higher education credits to get a decent enough foundation in nutrition.

I’ve dabbled with nutrition and helped people here and there for 15+ years.

It’s not what I do most, and it’s not what I try to do primarily, but it’s necessary to keep around as a part of what I do.

Today, I mainly help people with diabetes because it seems highly possible to stress your way to diabetes. It’s another aspect of the stress-related lifestyle disease we’re bothered by. That makes me feel that treating diabetes needs to be a part of my arsenal. There are plenty of reasons why and they relate to both behaviors and physiology. As always, I look at the bigger picture. There seems to be more to it than simply “knowing your nutrition and medicating enough”. There’s life with everything that goes with it. Stress, emotions, and problems often hinder you from doing what you ought to – or must.

• Fatigue is expected when you’re stressed. If you’re tired, you won’t have the resources to care enough about taking care of yourself.
• Over-eating is a typical result of stress because it increases your appetite.
• Stress bothers your sleep, which in turn increases appetite and influences what you eat. Rarely for the better.
• Over-eating and moving too little often go hand in hand.
• If you’re “out of time” because you’re doing other things, you won’t “have time” to move, and you might not “have time” to care about what you eat.
• Cortisol, one of the hormones you excrete when you’re stressed, elevates glucose levels in your blood. Could that increase your likelihood of diabetes, as if you overate too often?
• Speaking of hormones. If you constantly elevate – and treat – with more insulin, you’ll increase your tolerance to insulin, won’t you? What got you insulin resistant in the first place?
• Depression could make you just not care about it.
• Long-term pain could make you unable to move as you’d like to keep your diabetes in check.
• Anxiety might drain you of the energy you need to spend on doing what you should with your diet and exercise regime.
• Some researchers think that high levels of stress hormones might stop insulin-producing cells in the pancreas from working properly and reduce the amount of insulin they make.

Nutrition is a part…

A big part of it all is to understand the foundation and mechanics and then treat it pragmatically. In short, you’ll just have to keep the glucose levels decent enough. Healthcare around here doesn’t even try to point people toward getting in the same range as healthy people. So you’re often good enough even if you miss. That means some acceptance about it all, and a tiny clue about nutrition takes you a long way.

If that’s not the problem, you’re often all set with a decent enough book about nutrition, prescription drugs like insulin and/or metformin, something to measure your blood sugar, and the knowledge that insulin lowers the levels of blood sugar by getting it out of the blood and into other tissues. Your goal is now to keep that blood sugar as if you were healthy, meaning somewhere around 3.9 to 5.5 mmol/L “while fasting”.

… But it’s not everything.

I’m not particularly interested in having you count grams forever without really knowing why.

I’m not particularly fond of forcing you to eat incredibly boring diets you hate.

My experience is this:
Eating, testing your blood sugar, and medicating accordingly isn’t necessarily the hard part.
Having energy enough to care is.
Having time to care could be.
Taking said time and energy and putting those resources to work where they need to be to solve this problem could be BOTHERSOME.

There are a lot of aspects to diabetes. Not necessarily because diabetes is extremely complex in and of itself, but behaviors are to a lot of people. Behaviors are the tricky part when it comes to a big part of medical care, actually.

• Physiotherapy is not necessarily particularly hard once you’ve got a good plan, but it might be BORING and often uncomfortable. It takes time, and it’s… meh, no fun.
• Changing your diet isn’t hard when it comes to ONE MEAL, but when it’s for life, and there are all those social situations to fit into, habits to create, and… you’re all out of creativity..?
• Taking your medication isn’t hard… Is it? It is. Some studies show that people suck at taking their medications, even if it’s just a daily pill, perhaps as a part of their morning routine.
• Reading and learning? Most people quit that when they quit school. And if they don’t, most of us don’t want to read quite boring stuff when there’s barely enough time and energy for the fiction we like in the evening before bed. Dry stuff we’ve got to learn unwillingly won’t likely fit anywhere in the calendar.

With diabetes, you’ve got to solve all of those suddenly even though you didn’t ask for it. At the same time, you’ve got other things to do. Diabetes doesn’t care.

Time for acceptance. I’ve met people who won’t care because it’s unfair, and they don’t understand how to do things – “so just fuck it”, more or less.

That won’t help. Not one bit.

A pragmatic approach

Balancing the blood sugar with all of the parameters you’ve got is the one thing and technically the main point, but my experience is that a lot of people don’t have the resources to do so. Some think nutrition is incredibly complex, and others can barely exercise even if they’re healthy. The choices are down to learning or being sick and dying uncomfortably far too early. To do so, you’ll have to accept the situation. Things are as they are and… well, it might not be fine, but this is it, anyway.

If you got your diagnosis, it’s time to include exercise and look at the diet. You’ll have to check your blood sugar levels OFTEN initially. To be able to act accordingly and to learn. Perhaps getting rid of most carbs is helpful because you’ll require less insulin. Aim for the levels healthy people have. You want to live as long as they do.

But to be able to spend the resources you need here, you’ll have to take care of life as a whole. Say no. Get away. Do what’s good for you. Prioritize yourself and reflect on your values. You’re in a pinch here. Time to do what you can to handle it. Have you prioritized well enough before? What got you here? Did you do the right thing? Did you neglect your health and put something else first?

When I help people, I look at the whole. Because there are a lot of parts to this, even though all of those boil down to said blood sugar. We need to look at all of it because if we don’t, far too many variables will be completely random – and an equation where you don’t know all of the variables isn’t likely to get solved right.

Focus areas are personal training to get moving, looking at the diet, and LIFE to get a good solution that fits you. You need to feel decent enough overall, or this will be too hard. Doing something hard in an environment where you’re not alright enough or where you don’t have time and sufficient energy to spend on solving the problem is bound to fail. And staring at insulin isn’t the best solution. Exogenous insulin is great, honestly, but it’s one part. One tool. That alone is not what’s going to save you if I’m involved.

Personal training helps you spend some of the currency we call glucose here – to do something good. Hopefully, to do something amusing you like. This will also help you get some glucose out of your blood by using other transport paths than insulin-dependent ones. So you’re getting the same effect but without the medication.

Looking at the diet is absolutely necessary. If I look at the diet of someone with diabetes, I prefer removing a decent chunk of the carbs because it makes everything easier. You’re in trouble because too many of those are in your blood. Get less of them into your mouth, and you’ve removed a part of the problem. Fewer carbs and slower carbs. That makes things less volatile, and you’ll require less insulin. Sugar could be changed to sugar-free options. I don’t mind those the least. We’re trying to get rid of glucose from your blood here. Ice cream, candy, and similar stuff could be tricky, but you’ll likely live decently without them.

Some say that some carbs are absolutely necessary. I’m not entirely sure they’re that essential, but let’s say they are for you. If so, go for it. We’re looking for balance and quality of life as we do this. Getting to zero demands more of your creativity and nutrition-and-kitchen skills as well.

I want people to learn a thing or two about nutrition when I help them. Writing down what you’ve eaten and how much could help you figure out what’s in it to gauge whether it’s a good idea or not. What did that portion of food mean physiologically? Then, in relation to that, you could get a clue about how much insulin you might need. If any. You should have a clue about insulin when you use it. What is insulin? What does it do? Why do I have to inject it? Great questions initially, but they should be answered quite soon.

We need to know a thing or two about behaviors. Why do we do the silly things we do? This is a very subjective matter but highly relevant practically always. Why the heck do we do what we do – despite that cost? Routines and habits make things easier when we try to change. We might very well try to establish some good ones if we do this together.

It’s a science – but also a balancing act.

Solving this is at least a few things at the same time. You’re supposed to manage carbs and have a hunch about how fast they are (as you’re taking the amount of fat in your meal into account, of course!) and how much of them you did get in there, how much you’ve moved, and how stressed you are at the same time as you’re supposed to get the dosage of your meds right.

That’s hard. You’re learning how to do something your body ought to do on its own. But the body is far superior in measuring glucose and excreting insulin… when it works. So, you’ll have to learn how to balance this. My guess is that you might be just alright if you try enough. It’s something you’ll have to practice. Sometimes you’ll miss by a long shot. Occasionally, you’ll use too much insulin, and sometimes you’ll laugh because “nothing happened!” even though you medicated.

You’re like a little researcher when you do this. Test, try, and look what happens. Adapt and change the approach. Too little insulin is better than too much. Use some, test again, and keep experimenting.

I’ve seen people lose weight, start exercising, quit drugs and alcohol, and become far better people than they’ve been in a long time when they got their diabetes diagnosis. It might be challenging, but it could also be a wake-up call. That depends on how you look at it.

In short, the diabetes part is in large pure physiology and balance. That’s what’s broken. Those things could require some knowledge to sort out well. To manage that manually, you’ll have to do it the hard way, and the truly HARD part is generally the behaviors and managing life and everything relevant. A food diary and the Dolor Detection Diary could help you on your way if you want to do it yourself. If you’ve already tried doing it yourself and would prefer to get some help hands-on, I could be at your service. Friend request and message me on Facebook or mail me through the contact function at https://mbdolor.com/contact to get in touch.

Oh. I HAVE met diabetic people who need insulin through a syringe, but they’ve got a phobia of needles. Not a great combo. There’s a solution for that too if you need it…