What I Wish I Could Tell Every Person with Diabetes from My Journey to Become a Diabetes Educator
By Michael Hattori
This National Diabetes Awareness Month, the nation is honoring nurses. In this article, Michael Hattori, a nurse who has type 2 diabetes in remission, is on his way to becoming a Certified Diabetes Care and Education Specialist, and he shares advice on managing diabetes and how to work toward better health
It has now been nearly a year and a half since I was diagnosed with type 2 diabetes, and a lot has happened since then. Some of you may have followed my journey, starting with my articles “Imagine 288 Fingersticks a Day: The Power of CGM,” and “Type 2 Remission: How I got Here and How I’ll Stay Here.” I’m happy to say that I’m still in remission, and the big news is that I’m also well on my way to becoming a Certified Diabetes Care and Education Specialist – something I’m truly excited about!
I see my diabetes diagnosis as a cloud with a silver lining. Besides being the wake-up call I needed to become more physically active and to change my diet, as a long-time nurse, it also put me directly on the path to helping others with diabetes – and what a journey that has been! In this article, I’d like to share with you some of the insights and lessons I’ve learned on my way to becoming a diabetes educator, with the hope that they may help you manage your own diabetes. First, I’ll share my advice, and next, my story.
The biggest piece of advice I can offer you is this: try something new! Take a look at your daily routine and ask yourself two things:
What am I doing that might not be working?
What am I doing that is working well?
You may spend a lot of time asking what you’re doing wrong, but how often do you ask yourself that second question? Because of the negative stigma in diabetes, it is all too easy to get stuck thinking that you are doing something wrong, instead of paying attention to what you are doing right. Adam Brown has written an entire book on the subject, which you can download for free or order online: "Bright Spots and Landmines: The Diabetes Guide I Wish Someone Had Handed Me." So, how to you go about finding what you’re doing well? And how do you make that a pattern?
First, I encourage people to take small steps. It takes time to reverse something that you’ve been doing for a long time. The best way to get started is to make a goal. Your goal doesn’t have to be something huge – if you want to accomplish it, it should be doable for you and realistic. This is called making a SMART goal. A goal that is:
Specific: record exactly what you’re going to do; for example, “I’m going to walk ten minutes every day.”
Measurable: your goal should be concrete. Instead of saying “I’m going to walk,” say “I’m going to walk for ten minutes every day.”
Attainable: your goal needs to be something you know you can achieve; otherwise you’ll set yourself up for failure. Can you walk for ten minutes a day? How will you do it? If you can’t walk for ten minutes at a time, maybe five minutes is doable for you. So, you can walk for five minutes two times a day. Something like that.
Relevant: why is this goal important for you? It’s got to be something that means something to you. If you know that you feel better when you move, making a promise to walk ten minutes every day will set you on that path. (And more likely than not, it will propel you toward bigger goals!)
Time-bound: it’s vital to set a time frame to keep yourself accountable – “someday” or “sometime” won’t cut it. Instead, say, “I’ll walk ten minutes each day, starting today.”
SMART goals apply not only to diabetes but also to just about every other part of your life. Setting goals moves your life forward, keeps you from getting stuck in unproductive patterns, and most important, gives you a sense of accomplishment.
Besides setting goals, it’s important to focus on the things you’re doing right, the bright spots, and know that you canmanage your diabetes! As I mentioned, in August of this year, I was hired to train as a Diabetes Care and Education Specialist (DCES) at my hospital, working mainly with inpatient care. I knew this would be a challenge, since many of these people are in the hospital for severe health conditions. We see people who have heart attacks, strokes, diabetic ketoacidosis (DKA), end-stage kidney disease, and leg and foot infections – which can all be complications of diabetesand result from years of high glucose levels.
As an inpatient diabetes educator, my job is to support people in any way I can. I work to help them find their way back to a healthier, happier lifestyle, and an improved quality of life. For some people, that can be an especially tall order – not because they can’t do it, but because they’ve been told they’re “non-compliant” or “out of control” so many times that they have given up. In many cases, I am the last person they want to see – someone who they think will scold them, or blame them for being “non-compliant” and “out of control.” These are what I call “words of doom,” and as Diabetes Care and Education Specialists, we are on a mission to do away with the negative language, attitudes, and treatment that lead people to feel bad for having diabetes. To read diaTribe articles on the stigma around diabetes, click here.
However, old habits die hard. Over the last few decades, there has been an attitude of blame and shame around diabetes, with commentary such as, “you brought this on yourself,” “if you’d just eat less…,” or “why can’t you take better care of yourself?” I often find phrases like “uncontrolled, non-compliant diabetic,” or “long-time, out-of-control diabetic” in the notes from healthcare professionals. The problem with that kind of language is that it maintains the “I know what’s best for your health, so why don’t you do what I say?” attitude; yet people with diabetes are also told, “managing your diabetes is YOUR responsibility!” It’s no wonder that so many with diabetes throw their hands up in despair!
The truth is that the last half of that message is actually correct: managing your diabetes is your responsibility. And that’s really the beauty of diabetes. I really just said “the beauty of diabetes.” If there were one message I could share with all the people I see with diabetes, it would be “you can do it!” – because there is so much you can do for your diabetes.
So many people I see in the hospital have either never been told this, or have forgotten the message in the day-to-day challenges of managing their diabetes. Let’s face it – if you’ve had diabetes for years, your diabetes management might take on patterns. One day you may realize that you feel lousy and your A1C isn’t coming down, despite doing everything you’ve been asked to do (or mostly, at least). That is a frustration I hear all the time.
That’s why I focus on bright spots with people in the hospital. This is not only because they need a lift of positivity, but because being in the hospital puts them straight into an “I’m here because I was bad” frame of mind. And that can only make a bad situation worse. So, let’s work to eliminate “words of doom” from our vocabulary and do our best to avoid language that shames people for having diabetes. Let’s acknowledge our landmines, the things that may not be going well, but more important, let’s celebrate our bright spots, all those little things we’re doing right! And finally, let’s take those bright spots and let’s use them to help us make SMART goals – goals that are specific, measurable, attainable, relevant, and time-bound. We all need to feel like we’re doing something right, and the world of diabetes has been about what we’re doing wrong for too long. Let’s change that!