We know that diabetes is a hormone problem and that problem is digesting carbohydrates. Carbohydrates include foods such as bread, rice, biscuits, fruit and sweets. The type of carbohydrate and amount that you eat affects your diabetes in different ways. For example, white bread can spike your blood sugar levels higher than grain bread.
People living with diabetes are told all the time to cut down on their carbohydrate intake and make better food choices. This message has been promoted widely and sometimes causes discomfort or shame.
But what if the person with diabetes doesn’t have a choice about what kind of foods they eat? What if they can’t afford another choice of food?
A client once told me that her son dropped off his 3 children and was gone for days. She had very little money and hungry children to feed. All she could afford was the least expensive loaf of bread. This was white bread and had to feed them all and as a consequence of her not being able to afford a ‘healthier choice’ her blood sugar levels were quite high.
No amount of education around food choices and guilt-tripping would have changed her situation. What this woman needed was understanding and compassion, not judgement. She knew that what she was eating was not helping her blood sugar levels but her priority was her grandchildren and her health had to take a back seat.
Another client drank 2 litres of Cola a day. This was to give him the energy to get up in the morning and function in the day. My initial reaction was one of ‘oh no!’ however I sat and listened to the ‘why’. This person living with diabetes was taking essential medication for another health condition that had a side effect of making him feel exhausted. The only way that he knew to counter this tiredness was to drink lots of sugar and caffeine. We had a chat about how his choice of drink was having on his weight and diabetes and I gave some suggestions on small changes that he might be able to make. A few months later, he returned and he told me that he was now drinking diet cola instead. He was able to make the changes that we discussed in the time that he was comfortable with and the outcome was improved diabetes and some weight loss as well.
Judgement causes people to avoid seeking help. Shame keeps people quiet. As a health care provider, in order to help someone, I need them to tell me what’s going on. The difference it makes is my knowing if someone’s situation is temporary or if they require more information or guidance. It’s the difference between saying to a client ‘see you in 3 months’ or having a chat about food choices.
When people tell me why they make the choices they do it gives me a great insight to their life. It also lets me know if ‘it is what it is’. This is the situation at the moment and it is not likely to change any time soon. By showing understanding and compassion, I hope that the person sitting in front of me will be willing to take on board my advice and when the time is right, make the changes needed. Also, by building that level of respect, the person is likely to talk to me when they need advice on how to make some changes.
No-one is perfect and gets everything right in life. We all have demands on our time that directly influence the choices we make. We are all doing our best with what we have. It’s important that clients aren’t hard on themselves if they’re not able to do the things that their health care provider suggests. Let them know that just by being open to the information they are given means that when they have the means and ability, they will make those changes.
They shouldn’t be afraid and should feel comfortable going back to their health care provider and seeking help, so it’s crucial to find one who is supportive. If they’ve fallen off their diabetes routine for whatever reason, and are now ready to get back on track, encourage them to go and get the help they need.
I have found that by supporting someone in getting through a time in their life that is having a negative effect on their health (diabetes), instead of judging them, providing encouragement gives them the strength they need to get back on track. And when that time comes, I will be there on the sidelines cheering them on!
