How to navigate and use patience as a useful strategy in Diabetes Management
by IDS Director of Lifestyle and Nutrition, Jenny Smith
As a person with type 1 diabetes, a full-time job, and life as a Mom with two active boys, it takes a lot to navigate patience. As I look at how everything works out, one factor that seems to be in place is the ability to step back a bit and wait.
I've recently started to learn how to make my own bread — sourdough to be specific.
A month ago, my good friend surprised me after our 5:30am yoga class with a very bubbly, goopy looking mason jar of "starter". I had been talking about doing this for a while with my husband as well as a few colleagues and kept putting it off for lack of time. Step in my friend's generous donation of "George" (her name for her starter…so I guess mine is "George Jr?) and I had to take action.
The funny thing about a bread starter is that you must have some patience. The feeding, waiting, mixing, rising, waiting and then baking (with more waiting) is really an act of patience, especially when you know how good homemade bread is compared to the stuff from the store.
As I was mixing in more to feed George the other day, it struck me how similar it is to wait patiently to see if the changes made by adjusting the doses or the tactics for diabetes management are working. Sometimes you can see this in a few hours, but many times an adjustment that is made takes several days to really see a new trend to the positive. This is a waiting time when it can be frustrating.
To turn this around in your mind and think of the positive aspects to waiting:
Sensor start-up – Waiting for a sensor to warm up for those still using G6 is a time when you could get in a few hours of evaluation of basal. On the other sensors that allow calibration – there is a time of waiting to ensure it has improved in accuracy. This is a time that many are concerned they don't have data – but that isn't true. It is a time that you can revisit the use of your glucose meter and ensure it still has batteries that work!
Adjustment to settings/doses – Make an adjustment when you see a trend above your target and then use your time for evaluation for meals/foods that are common. Do the post meals now look more in your target? Is there room to adjust for meals that are less common? You might be able to see change in a few hours, or it might take a few days to find the right adjustment.
Endocrine or Diabetes team visits – the time between visits gives enough room for you to collect data, to be ready to navigate your next visit or e-chart note with more of your own personal input. This puts you in the driver's seat so you can get what you really need out of the interaction.
Prebolus for meals/snacks – if you are the one preparing the meal, it gives you time for more precise counting and consideration of what goes into the meal that might impact BG.
Correction for high BG – Who wants to wait for a high BG to come down? No one! But, because our insulin is not instantaneous in action, we must practice some patience in the time period after we correct. This can be frustrating, but I find it helps to use that waiting time to take care of other things. In the moment I don't need more insulin, but to take my mind off the annoying high, I can get other things done while waiting.
Exercise adjustment – the preparation time heading into the workout takes patience to see if the changes set you up for a workout where you don't have to stop 15 minutes in to treat a low. Even these changes take some patience to find out what works best and/or adjust and try again.
Addition of alternative tools – Adding in another medication besides insulin has become something more and more people with diabetes are doing to navigate weight and insulin resistance. The use of these is not an overnight fix. Just like lifestyle changes, the use of these medications takes time, analysis and adjustment to find the fit that works best for your goals.
In all, life with diabetes teaches us a lot, and if we slow down a bit and add in some patience you might find you were able to learn some things in the waiting space.
