It’s National Diabetes Awareness Month! A time to highlight the realities of living with diabetes and promote new and better ways to live long, healthy lives. In the past year, I have seen coaching emerge as a key talking point in the diabetes arena, so I thought I would share some insights with you.
Diabetes Self Management
Diabetes self management continues to be a priority to better outcomes. The CDC promotes the use of evidenced based diabetes programs such as “Diabetes Self Management Education and Services” (DSMES). These programs believe that individuals achieve far superior outcomes and health benefits when they are empowered with relevant diabetes information, support and tools. There is ample research to prove self management works, but it’s also logical. When you are better able to care for yourself, your “self” is better!
Most people living with diabetes spend very little time with a provider. If we assume 4 doctor visits a year (30 minutes each) and 2 appointments with an educator (1 hour), you get about 4 hours of diabetes help each year. The remaining 8754 hours we are doing diabetes on our own. Making choices all day long, such as when to take meds, when to check blood sugar, when to be active, how much sleep to get, how much water to drink, what foods to buy and prepare, what to spend your money on (test strips or your kids trumpet lessons), is it safe to drive, is the red spot on your foot something to be concerned about, who to share your worries with, and on and on.
The CDC states that “Since on average a person with diabetes spends less than 1% of their life with their healthcare team accessing services12, the focus of DSMES is to help “the person with diabetes develop problem-solving skills and attain ongoing decision-making support necessary to self-manage diabetes.”11
The Realities of Diabetes Care
I think it’s important to note that it’s new life skills that improve diabetes management, not more doctor visits. The truth is, you, are the only one who can feel what is going on inside you, know what you are willing to do (or not), and make decisions. Those three little concepts add up to how well you manage your diabetes.
Unfortunately, research also shows that very few have the skills and support necessary to achieve their goals. This CDC report states that less than 6.8% of newly diagnosed people with diabetes get adequate DSMES. Providers and educators tend to focus on the tactical aspects of managing diabetes (lab tests, medication, use of equipment & technology) and how food affects glucose levels. This is mission critical information, but then the individual is left to their own existing coping skills to figure it all out.
Coaching is the next big thing
Industry reports and insurance agencies are looking to coaches as the conduit to effect lasting changes in the home. This Harvard Health Blog states “Unlike health fads that come and go, health coaching has strong evidence behind it backing its effectiveness for improving health and well-being.” It understands that traditional medicine looks for something that is “wrong” to fix, while coaching seeks to harness and leverage your personal strengths and address very specific-personal barriers.
Coaching is uniquely positioned to improve Diabetes Self Management because the goals are the same. Working with individuals to understand what they need and implement personal strategies for lasting change. Coaching turns “doctor’s orders” into healthy habits that are agreeable to the individual. That “agreement” part is critical because it will take enormous effort to do things you don’t believe in or want to do.
Not everyone struggles with the same issues and coaching focuses on the most prominent barriers. Just like sports coaching, you must understand the talents and challenges of the player, agree on what areas they want to improve and then help the player improve his game – one swing or pitch or tackle at a time. Then repeat. You can never do it all at once or in a 15 minute visit.
Nurse coaching doubly effective
While health coaches and life coaches can be excellent resources to help individuals achieve specific goals, adding a nursing degree to the mix and a focus on Whole Person Care, take Diabetes Self Management to new levels. Nurse coaching is a relatively new role in diabetes. It seeks to promote optimal wellness for every person, not just “fixing” the diseased parts of a person. With this approach, diabetes management becomes a system of identifying and understanding the needs of each individual and includes many facets of a person’s life. Things like competing priorities (people deal with more than diabetes), financial limitations, support systems, educational needs, debilitating feelings such a shame, failure, and fear, pursuing passions, family obligations, career influences and so much more. Diabetes is just one of your needs that “needs” attention.
Nurse coaching understands that people are people first and any path to wellness must start there. Sure, we need to understand the medical side of diabetes, but it goes faaaarrrrr beyond diet and exercise. Your lifestyle choices are the result of how you feel – about yourself, your options, your goals, your beliefs, your motivation, and your sense of possibilities. Often, we need to start with what we believe is possible and then make a plan to get there. Spoiler alert – what you believe is possible changes each time you achieve a new goal!!!
The bottom line is this: if your diabetes isn’t where you want it to be, perhaps it’s time to stop focusing on trying to be a better sick person and start focusing on ways to live your best life. The latter always leads to more energy and wellness. And doesn’t that sound good? If you aren’t sure how to get started – a nurse coach is a great person to help you find your way.
Peace and smiles always,
PS – I offered a free 15 minute for people who downloaded my new eBook. Since I already sent the book to you, I want to extend this offer to you as well. Sessions are limited, so book your call now. CLICK HERE Let’s chat!
Out of ideas what can I do about high morning blood sugars
Hi Barb
High morning blood sugars can be a problem for many people. It is likely caused by the Dawn Phenomenon, where your liver releases glucose into your blood stream in preparation for the day ahead.
Depending on what type of diabetes you have, you would need to address it differently. I am on a pump and am able to adjust my settings for early morning hours. Some people adjust their insulin injections to cover this time better. I had one client who tracked his blood sugars for several days and learned that although his first reading of the day was a bit high at 7am, it came down on its own by 9am. His sugar levels were where he liked them for the rest of the day and he just let the Dawn Phenomenon occur. I obviously don’t have enough information, but those are just some basic suggestions. Step one is to really document and trend your blood sugars so you have great data. Sign up for a free call and we can chat!