Many people with diabetes are fearful about some aspect of the condition – scared of taking medication, using syringes, breaking old habits and/or adjusting their diets and this is just the day to day challenge of living with a chronic health problem.

What about those fears about the future – the possibility of developing long term complication such as blindness, kidney failure, heart attacks, stroke and lower limb amputation.?

I’ve decided to include this topic in a new Mister Divabetic Mystery podcast. As part of my ongoing research I contacted my friend, Dr. Beverly S. Adler, PhD, CDE aka “Dr. Bev” for her invaluable insight and advice on this subject.  She willingly agreed to share the blog post featured below, “Fear of Diabetes Complications” with our Divabetic community:

The topic of diabetes complications stirs up a lot of emotional issues. Some well meaning, but uninformed, people (they call themselves your family and friends) may tell you that if you eat that slice of cake you will lose a toe or go blind. Trying to guilt you into eating healthy does not work. It makes many people with diabetes become oppositional and eat that slice – and more – just because they want to be assertive.

Diabetes is the Leading Cause of…..

First, let’s examine that “advice” that you will lose a toe or go blind by eating a slice of cake. That is not a true fact. It’s important to remember that poorly controlled diabetes can result in long-term complications. That’s a good place to start when talking with your family and friends, if they worry about your future health. It is okay to eat that slice of cake if you’ve planned for it in your meal plan. You can’t eat the whole cake, but enjoying a reasonable size slice is not going to result in dire diabetes complications. If you take insulin, you need to account for the additional carbs and increase your bolus insulin dose accordingly. If you don’t take insulin, you need to “pick and choose” which carbs are your priority: try to skip eating the bread and pasta, so you can enjoy the cake. And remember this: Well controlled diabetes is the leading cause of……..NOTHING!

Helpful ideas to be Assertive

Second, let’s examine how to be assertive with the “diabetes police.” While it makes the point that you will do what you want, not what you’re told, the reaction cited in the example above is rather unhealthy. Here’s some helpful ideas to be assertive without being self-destructive:

• Acknowledge their concern. Express appreciation for their well meaning intent and thank them for their concern. Always be courteous.
• Educate your well meaning, but uninformed, family and friends. Let them know about carb counting and meal planning.
• Reassure the “diabetes police” that you know how to manage your diabetes. Correct mis-information. After all, you don’t want to live with those dire complications either.
• Keep a sense of humor. Try to be light-hearted if the situation gets tense.
• If all else fails, you have the right to choose to ignore the advice and the person dispensing the advice. It’s okay to do what you need to do to keep yourself emotionally strong and healthy.

What if You are the one Fearing Diabetes Complications

What if you are the one who is obsessively worried about the “what if” of possible future diabetes complications? It can make you feel hopeless.  An emotional consequence of obsessive worry, and trying to follow a strict regimen in order to avoid complications, can lead to “diabetes burnout.” Diabetes burnout can result in you feeling out of control and overwhelmed by your diabetes. If you feel like your diabetes is a prison, I advise you to “break out before you burnout!” When people with diabetes burnout, the pendulum of good self-care swings in the opposite direction to poor self-care. Try to be reassured with this good news: thanks to medical developments, people with diabetes are less likely to develop long-term complications than ever before!

Actions to Calm your Fear

Here are some actions you can take to help calm your fear for the short and long-term:

• Take a walk.
• Engage in regular exercise – because it can manage stress as well as blood glucose.
• Get enough sleep.
• Write in a journal.
• Learn to use some form of relaxation, such as deep breathing or yoga.
• Limit or eliminate alcohol.

Changing your Thoughts to Reduce your Fear

Here are some ways to help change your thoughts to reduce your fear:

• Approach your diabetes with the mindset “it is what it is” – then stress can be reduced.
• If you can accept your diabetes, you can feel empowered to manage it.
• If you change your attitude from hopelessness to hopefulness, you can change your perspective to focus on long-term good health.
• Psychologists see humor as a character strength.People living with diabetes can improve their mood by approaching life with a sense of humor – LAUGH!
• Have a positive attitude. As the saying goes, “you cannot live a positive life with a negative mind.” If you default to a negative mindset, that will limit you. Remember: A bad attitude is like a flat tire – you don’t get anywhere until you change it.

Help is Available

If you are so worried about potential complications that may happen in the future, I say to you: “None of us knows what the future will bring.” (If you did know the future, could you please tell me what the winning lottery numbers will be!) Worrying about future complications wastes your time and energy and does not make your chances better or worse. Take care of your diabetes management one day at a time. It’s an approach I’ve personally followed to successfully manage my type 1 diabetes for the past 42 years.

If you feel that your fear of diabetes complications is too difficult for you to manage on your own, you may be helped by talking with a diabetes psychologist or mental health provider who provides diabetes-focused therapy.

Dr. Beverly S. Adler, aka “Dr. Bev”, is a clinical psychologist and Certified Diabetes Educator with a private practice in Baldwin, NY. She was honored in 2016 with the “Certified Diabetes Educator Entrepreneur of the Year Award.”

She is the author/editor of two diabetes self-help books which include insightful lessons of empowerment written by successful men and women with diabetes.  She has published articles in print and online about diabetes management – always with the focus on emotional adjustment. Dr. Bev has been quoted in numerous magazines and contributed to a monthly diabetes advice column online. She is a frequent contributor to the Divabetic Diabetes Daily Wire, where she blogs about diabetes topics from the psychological perspective.

Dr. Bev has lived successfully with type 1 diabetes for 42 years. You can connect with her on her website www.AskDrBev.com and on Twitter @AskDrBev.

LISTEN NOW: Diabetes Late Nite podcast with music by Sia. We’re shedding some light on the emotional side of diabetes including depression with guests, Dr. Beverly S. Adler PhD, CDE, , Poet Lorraine Brooks, the Charlie’s Angels of Outreach, Mama Rose Marie and Zippora Karz, a former NYC Ballet Solo Ballerina with type 1 diabetes and author of the memoir “The Sugarless Plum”.