Lifestyle Modification Program for the Management of Mental Health Issues in Diabetes

There are various medical conditions, not categorized under psychological or psychiatric disorders, but still impacting the mental health of the person having that disease. Diabetes is one of them that have a psychological response to the disorder. Psychological interventions have been found to be highly effective for the management of psychological impacts of diabetes amongst which life style modification program has been found to be most popular and widely used intervention. Following are the major aspects considered in a lifestyle modification program for diabetes; however, some may have separate issues that can be taken care in a one to one session.

• Acceptance: In order to be able to deal with any problem it’s important that we understand and accept that. Diabetes is a lifestyle disease and in current world with advancement in technology and medicine its monitoring and management both have become much easier. The more we deny the diagnosis, the more we delay the process of treatment and recovery. If it’s hard to accept the disease, try to analyze the possible contributing factors. This will enable you to have adequate rationale behind why such thing has happened, and gradually you will understand that in presence of particular factors the disease is likely to happen, it can happen to anybody, and it’s okay if it happened to me.
• Keep Yourself Updated: Reading about diabetes will make you well informed and updated about the disease, recent advancements in treatment line, and other guidelines that need thorough monitoring. Rely only on authentic sources and try not to get trapped in short cuts available online that claim “control blood sugar in one week” or “home remedies to cure blood sugar”, etc. Speak to your health care provider to share beneficial reading materials on diabetes like leaflets, brochures, booklets, etc.
• Practice Relaxation Exercises Regularly: Diabetes and stress are highly correlated and to manage blood sugar levels it’s beneficial to manage stress level too. Relaxation exercises have been found to be highly effective in managing stress and help individuals to cope better with life circumstances. Stress has become a common issue these days and getting diagnosed with any medical condition can surely elevate its level. Some of the most popular and effective relaxation procedures involve diaphragmatic/deep breathing exercise, progressive muscle relaxation, autogenic training, etc. and they are very easy to practice at home once they are learned adequately in professional supervision. Making relaxation exercises a part of regular routine definitely helps to reduce stress and subsequently helps managing blood sugar.
• Be Physically Active: In cases of diabetes, it’s very important to be physically active to keep your body energized, burn extra calories, and watching weight. Physical activities can be chosen as per your convenience and preference. There are various activities like walking, running, aerobics, zumba, workout in gym, rope skipping, depending on your current weight and comfort to perform that particular physical activity. If none of these are possible start with smaller tasks like taking the staircase rather than using lifts, avoid using vehicles to roam around nearby places, get involved in household chores that require physical movement, walking few steps while speaking to someone on phone, rather than keeping everything beside bed for convenience, keep everything at their designated places and walk few steps to get those things when needed (may include water bottle, medicines, glucometer, munchies/snacks/nuts etc).
• Track Your Blood Sugar Levels: It’s very important to keep a regular check on your sugar levels especially in the initial days. Take readings empty stomach in the morning and after every major meal. This will help your health care provider to understand the pattern of sugar levels and set your medication dosage accordingly. Also, Note down ‘what’ and ‘how much’ you ate. You will gradually understand that how your food is impacting the sugar levels. Do not forget to note down even the smallest details in the beginning, later on it may not be needed.
• Watch out Your Eating Habits: In diabetes, there are several restrictions on the items you consume on regular basis. Sugary things, high carb diet, sodas, canned and processed food items they all are restricted. It’s difficult to give up on your favorite things and leave them completely. To control the consumption of these things first you need to understand that these food items are not going to vanish from the market. They are going to be there, and if you control your sugar level, you can always enjoy them occasionally or may be frequently in a controlled portion. Don’t allow your-self to starve, keep eating on regular intervals. Replace the jars of butter cookies and potato chips with healthy multigrain low fat cookies, nuts, puffed rice, roasted grams, etc. Instead of storing soda cans and other sugary drinks, fill your bottles with lemon water without sugar, butter milk, jal jeera water, sattu drink etc. Also, you can put some mint leaves, cucumber slices, lemon slices, and lemon juice in a jar and fill it with water and keep sipping though out the day. If you really crave for sweets, rather than having a full plate of dessert after some time of your major meal, have a small portion of it with your meal itself and cut down on the quantity of roti/rice/other carbs. The quantity of your dessert may seem very less, but if you eat every spoon of it mindfully (feel it’s taste, texture, if it’s hot or cold, smooth or chewy, soft or hard, pay attention on every single bite ) you will surely be satisfied with the taste and quantity too. It only takes few days to train your brain to adapt to new things, once you adapt to this new pattern of eating, you will be doing it effortlessly and with much enjoyment.
• Socialize With People Who Have Common Health Goals: Socializing always helps to maintain an active life style and it’s even better if done with people who have common health goals. Look for the diabetes community around and gel with the members. If you are unable to locate something like this look for at least few people who have diabetes and it’s not that difficult. Share diabetes friendly recipes, workouts, etc. People with common health goals can understand and motivate each other in a better way. They can also share their experiences about managing life with diabetes.
• Follow Your Routine: Following a particular routine is very important especially when we talk about managing certain medical conditions. Diabetes is a health condition that requires regular monitoring, particular food habits, and physical activities. It is essential that all these stay on track even if you are visiting your relatives, attending gatherings/parties, or going for a vacation. Things that you are not allowed to eat humbly refuse to eat mentioning your health condition and pick healthier options only. If no healthy option is available, cut down the quantity of items you consume. Always carry some dry edible things with you that can be consumed in case of requirement. If you tend to forget about medicines, taking sugar readings, and performing your exercises, set alarms to keep you aware about your routine.
• Open Communication within the Family: It is important that not only the sufferer but other members of the family understand the disease as well. Be clear about communicating the food requirements. As discussed earlier, diabetes comes with certain food restrictions and it’s sometimes difficult to make different types of items in a single meal if each and every person of the family has different food preferences. The task might be difficult if the condition belongs to females and especially working females. If there is an option of house help who can prepare food according to everyone’s choice, then there is no problem at all. but, if the sufferer is female and supposed to manage everyone’s choice and her own health too, then it’s difficult to manage. In such a case it’s always good to sit together and agree upon a meal planning that is more nutritious, less hazardous and meets expectation of all members. Members can agree upon having a common meal on week days and meal of their choice on weekends. Weekends are off days where they can help to prepare the food and enjoy food of their choice.
• Never Say “I can’t”: The sentence “I cannot do” is the most dangerous and pessimistic sentence one could ever say. Every medical condition comes with some challenges and it’s obvious to feel anxious about it initially. With time, everything comes to normal as we learn to cope with it. The more we keep calm, the more we adapt to it easily. The more we panic, the more we take time to adjust to it. There are many people who have diabetes, and with proper lifestyle modification they have been managing it very well. There are proven cases that have been found to reverse their blood sugar levels with proper monitoring, diet control, and healthy lifestyle. If they can do, you can do too. Never feel de-motivated, it’s okay to fail, it’s okay to feel stressed, everyone goes through that phase initially, they adapted to this, you will also adapt gradually.
• Take Adequate Sleep: It’s very important that you complete a good 6-8 hours sleep. If you don’t have any sleep issue, nothing like it, but in case you have a disturbed sleep, start following few sleep routines that can help you have a sound sleep. These include following a sleep hygiene pattern like, washing your face, hands and foot and then going to bed, taking a warm bath if possible, before going to sleep. Changing the bed sheet before putting yourself to sleep. Don’t watch TV on bed before sleeping; if possible, don’t keep the TV in bedroom. Keep your room adequately cool, dark and use aroma oils for a beautiful fragrance that helps to induce and maintain good sleep. People who have very disturbed sleep have the habit of watching wall clock through-out the night. In such a case, cover the wall clock, keep it out of your sight, or remove it from the room. Try reading some peaceful articles or books that make you calm, perform deep breathing to make you relaxed before you go to bed.
• Trust Your Health Care Provider: There will be many people who will come up with N number of home remedies and tricks to control diabetes, but it’s always good to listen to your doctor and have faith on the treatment process. There is no harm in listening to the advice of people but following that or not following that should be a wisely made decision. Ask your doctor about diet, things to consume, things to avoid, everything should be clear and communicated openly.

In past some years, there have been various researches and studies quoting that lifestyle modification programs bring significant improvement in diabetes and other lifestyle diseases. It is important to understand that lifestyle modification programs are not meant to be followed for a week or a month or a year. These programs teach you a way of living that has to be accepted and adapted for the lifetime. After sometime with medication and proper lifestyle modification your medical condition may appear absolutely fine, but that doesn’t mean that you have to leave everything. To maintain that healthy state, you need to continue to follow a healthy and active lifestyle, keep reviewing and follow up with your heath care and mental health care provider if you stuck somewhere and unable to find a way to come out of any situation. Since diabetes is a condition requiring lifetime monitoring and medication, it is essential to bring changes gradually but permanently. Once the learning turns into habit it is much easier to manage diabetes and its mental health impacts.

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Neelam Verma, Clinical Psychologist