Health Happens on a Continuum - A few observations about Diabetes (and other metabolic issues)

Two mornings a week I see patients at an Internal Medicine office.  The majority of patients I see have been diagnosed with Type 2 Diabetes.  While each patient is unique in their concerns, frustrations and goals, over the past 2-3 years I have found a lot of commonalities.  I want to share some observations with you.

  1. First and most importantly, I want to be sure to emphasize the fact that health issues do not happen overnight.  You don’t not have diabetes (or anything else) one day and then have it the next.  Clinical diagnosis comes when numbers hit a certain tipping point, but that doesn’t mean it was less of an issue before.  I don’t say this to worry you; I say it to put health and wellness in perspective.  Most people can sense their body is overstressed and/or isn’t functioning optimally far before diagnosis happens.  Health happens on a continuum so don’t wait for a diagnosis: “If you listen to your body when it whispers, you won’t have to hear it scream.”
  2. It may take some time for your blood sugar levels to come down.  That’s OK.  Also, medications are there for a reason but using them doesn’t make diabetes go away and the underlying issues will still be there.  What I would want you to know is this: health is determined by healthy behaviors (self-care) so health is something you can have right now.  At this moment you can tune into what your body needs, honor it by responding and therefore move towards health.  Health is not a destination.  It is a commitment to take care of ourselves each day.  
  3. It’s super common for me to hear “I can’t be an intuitive eater because I have diabetes”.  Wrong!  Intuitive Eating is absolutely inclusive given it’s all about taking care of YOUR body and it’s health concerns.  A little personal disclosure: I have a really sensitive digestive tract, and intuitive eating has been the BEST way for me to keep symptoms at bay and feel my best.  Just one example.  
  4. Those with diabetes believe they require a different approach to food than others.  While obviously their blood sugar will be effected in part by what they eat, so will everyone’s.  Again - health happens on a continuum.  We all feel and function better when we have stable blood sugar levels.  Eating balanced meals (protein, complex carbohydrate, fat, fruit or vegetable) with snacks in between while listening to hunger/fullness/satisfaction levels to guide how much to eat will be the best way to regulate blood sugar levels.  Fullness is your body’s way of letting you know it’s had enough.  If you continue eating, you may be over-stressing body functions (digestion, hormone/digestive enzyme production and insulin matching in regards to diabetes).  While we all overeat occasionally, consistently doing so can cause issues.  I’ve said it before - my experience has been that these issues are caused by not listening to our bodies, not by any one food or food group.    
  5. I find that most people with diabetes fail to realize that food is not the only thing that effects their blood sugar.  Sleep, stress (!!!), exercise, mental health concerns, medications, meal timing and patterns, digestion, rate of stomach emptying, etc.  The good news is that taking a holistic, big picture approach will allow you to avoid extremes and find balance - where your body functions at it’s best. 
  6. What you are really wanting is to find your rhythm.  Diabetes or not.  We are cyclical, rhythmic creatures.  We have sleep rhythms and digestive rhythms and seasonal cycles and hormone cycles, etc.  While we don’t need anything militant or rigid, we would all do well to establish some sort of regular rhythm, which I call a flexible structure.  It’s wise to have regular meal, snack and sleep times.  I think you’ll be surprised at how much more balanced you feel.  This is something I see lacking in most of those I work with.  
  7. Last but not least, you didn’t get diabetes because you gained weight and it won’t necessarily go away if you lose weight.  That's a super simplistic, unhelpful and ineffective view of health.  Health is determined by healthy behaviors, not by weight.  You would do well to put energy into taking care of yourself rather than aiming for weight loss.  If weight loss happens as a result, you can trust that is what your body needed.  

Diabetes, or any health concern, can be scary, confusing and frustrating. I hope these observations have been helpful in better understanding diabetes and accompanying beliefs and issues.

Emily Fonnesbeck RD, CD