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It IS What You Say

May 17, 2016

Working with a patient, a woman, 44 years of age, who has had type 1 diabetes 21 years. She had a day of high glucose levels. We worked together very hard all day correcting to bring it down. After being closer to her target range, not low by any means, she told me she just had some chocolate. I asked her why, after the day she had, did she choose chocolate.

When she visited next, I apologized to her. I told her I did not mean to put her down. I just wondered why. She said she gave that a lot of thought. She told me she realized she had it because she was mad. She was mad about not being able to manage her glucose levels and just overall mad about having diabetes. She found it very interesting I asked her that question. She said, “Other educators have just told me, You can’t have that. They’ve never asked me to think about it.” She said she was appreciative of that.

Since then, she has been stopping and thinking more about her behavior and response to her glucose levels. It’s helped her to make different choices and not feel judged or like she is good or bad or can’t do or eat this or that.

We are looking for a counselor who will be a good fit for her.

Lessons Learned:

  • The saying is usually, It’s not what you say, but how you say it. True, but a lot of times it IS what you say.
  • People can have knee jerk reactions, even in how they take care of or don’t take care of their diabetes.
  • Allow for more open discussions with diabetes patients rather than just tell them “the rules…your rules”
  • Know your limits. Refer to a qualified healthcare professional (behavior therapist) who would be a good match for your patient.


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