Why Do Some Diabetics Refuse to Take Care of Themselves?
Why Can't They Do Better?
Unlike most chronic illnesses, like cancer and migraines, for example, people tend to blame diabetics for their illness. They see it as a rock bottom, whether it's the person's fault or not, and expect the diabetic person to start taking care of themselves better.
Family members and doctors get frustrated sometimes when someone's blood sugar grows out of control, even though certain factors besides poor eating can result in high numbers, like getting a cold.
When they see a diabetic eat chocolate day after day, refuse to take their medication, or refuse to exercise, they can get angry and lash out at the diabetic person. They don't understand why someone would behave that way and see it as extremely self-destructive.
Every diabetic has their moments when they act this way. Whether it's a lot of the time or only a little. As a diabetic, let me explain to you some reasons why this happens.
Sugar-Free Gummy Bears
1. It Takes Too Much Time
This is one of those reasons that most people are going to see as an excuse, at least at first. But that's because they don't actually realize how much time diabetes takes out of someone's life.
There was a time when I had to go to the doctor for my diabetes and complications of it, twice a week. You know how doctors can make you take hours waiting in their office before they'll see you? Well, I had to do that twice a week for six months.
Diabetics are supposed to cook every meal and do dishes every meal. And they can't just cook it, they're supposed to measure everything individually on scales or in measuring cups. The rice can only be half a cup and the meat can't be larger than a stack of cards. This creates even more dishes and makes it take forever to put their plate together, while people without diabetes just quickly serve themselves.
They have to take time every day to check their feet to make sure there aren't any sores. This is because diabetics lose limbs, sometimes from tiny cuts they develop on their feet that grow infected and refuse to heal.
They also have to check their blood sugar several times a day to make sure the medicine is working right.
They also have to take time to measure out and take their medication. With insulin there are always extra steps because they have to change needles several times a day and make sure their insulin is always kept in a place where it won't get too hot.
Then if they have any sort of complications, which pretty much every diabetic does, they have to do their daily rituals of taking care of those, too.
I have dentures, for instance, and that takes a lot of care every day of soaking, scrubbing, cleaning my gums, and tongue, etc.
While other people can get away with only exercising a couple of times a week, they might have to every day because the days they don't, their blood sugar is higher.
Before they know it, diabetes has become like their new job. It takes such a large chunk out of their life and yet they're expected to keep up with everyone else and all the things they accomplish. Diabetic people are supposed to work the same and clean their house up the same. They're supposed to do as much as people who are already busy all the time, even though they have more responsibilities than the average person.
Their work is not going to be understanding if the boss wants them to work through lunch and they say,"No. I have to take my break and carefully measure out and eat my diabetic meal after I take my insulin." The boss is going to be angry at them for taking up time when they are needed elsewhere. The boss isn't going to understand a diabetic person needing time off of work twice a week (and even if they are, they're not going to pay them for it!) to go to the doctors. Luckily for me, I work at home as a writer, otherwise I would have had to be unemployed during that time.
So there are a ton of diabetics who won't do things just because they don't have the time to do them.
2. It's Not Simple
A lot of people who are "expert" nutritionists--okay, lets not give them credit where none is due. Let me start that sentence again.
A lot of people who are just trying to get people to go on their diet and buy their book, so they can make money, will shame diabetics. They'll say it's easy to get over diabetes. Just a simple exercise and diet routine will cure "everyone" of it.
They get away with it because there are many variations of diabetes. Some people have it only mildly. Some people have it to an extreme. Some people have type 1 and some type 2. Every diabetic is an individual.
So there are some diabetics who can temporarily (or permanently if they are older) reverse it after eating right and losing some weight.
But most diabetics aren't in that boat. For most of us, we either have type 1 diabetes or type 2 that's so bad, nothing can reverse it completely. Eating right and losing weight helps, but it's never going to be enough for those people because of genetics and because type 1 diabetes doesn't work that way.
They're still going to have to take medicine, still going to have to go to the doctor for the rest of their life, still have to see specialists for their complications. On and on.
They assume everyone is coming from the same healthy place. But all our bodies are different, our genetics are different, and for some, the struggle is harder than others.
There is more for those people that themselves and society expects them to do in order to be healthy. These expectations grow so high, that they just start failing over and over again. They never feel good about themselves, they never reach their goals, so they just give up.
Like, for me, I have to take at least five shots of insulin a day, plus I take my blood sugar between two to ten times per day. Those numbers can change and they're something I have to do in addition to exercise and eat right. Some days are busy and I accidentally skip doing some of these things.
Even if a diabetic is reaching their goals for awhile, sometimes the intense work doesn't feel worth the end result. This is called diabetic burnout and it's the biggest reason diabetics give up trying.
It's like when a cancer patient finds out about all the chemotherapy and radiation that they are going to need and that the end result is that they only have 5% of a chance to live. The end result is not worth all that pain. They'll have no quality of life and without a quality of life, what's the point of living anymore? Or trying anymore? They just want to enjoy the time they have left.
In the same way, diabetics still go through complications even when they have their blood sugar under control. Their medication can be too strong on certain days and send them to the hospital. They have to sacrifice all their favorite foods and sometimes if they exercise too hard it raises their blood sugar rather than lower it. If a really horrible complication, like kidney failure happens, they might already be on their deathbed anyway. So what's the point anymore of trying? To them, it's just draining their quality of life and not actually helping them.
Not to mention that nobody is perfect and expecting someone to always eat right, always exercise, always do everything good is setting themselves up to eventually crash and burn from the exhaustion of trying to keep up with all of that.
3. Depression And Anxiety
I knew I'd probably get diabetes someday. It runs in my family and my family members are by no means fat. My father, for instance, walks several miles every day and eats low carb, he's average weight, and he still has diabetes.
Still, nothing could prepare me for the pain of realizing the actual diagnosis. It hit me like a ton of bricks.
I had depression, knowing that I'd struggle with this disease for the rest of my life. It changed everything, from how I viewed the future (suddenly there was the possibility of being in a wheelchair or getting kidney failure) to how I planned my meals to how I left the house (you can't leave without a portable kit in your purse that allows you to take care of your diabetic needs on the go!) Nothing was the same anymore.
I cried non-stop for awhile, fearing what was going to happen to me and how I'd have the strength to get through this disease.
When a diagnosis hits someone like that or a complication of the disease hits them, it can be hard to fight back the depression and anxiety. Depression and anxiety makes taking care of themselves more difficult. It's hard to have the energy to cook healthy meals when they barely have the energy to get out of bed or take a shower. It's hard to not reach for some candy to comfort themselves with, when their minds are racing through negative thoughts.
4. Low Self-Esteem And Guilt
People need to love themselves first before they can take care of themselves and unfortunately, with this disease, diabetic people face a lot of people who have a lot of criticism for them. Some people will judge them for getting the disease in the first place, regardless of how it happened. They'll lecture, thinking they know everything about a disease they've never had to live with.
Everyone also has their own inner critic. If they've believed all their lives that diabetes only happens to people who mess up, then when it happens to them, their inner critic is going to be very angry at them.
Shame and guilt always have to do with the past, instead of the future. When someone is ashamed of themselves and the fact that they just ate a candy bar, they're dwelling on the wrong thing.
They should be taking it one day at a time, exercising forgiveness of themselves, and patience. Shame causes people to give up instead. They go,"I already messed up and am a failure. What does it matter if I keep messing up? It's just who I am and I can't change the past."
Doctors and friends sometimes encourage this behavior by being overly critical.
Someone who loves themselves will take care of themselves and shaming them into taking care of themselves will backfire and might lead to longer term mental illnesses in the future. Instead, they will withdraw from the situation and the people, refusing to seek medical care, sometimes even when it's an emergency.
5. Food Addictions
People see the word "food addictions" and think "fat people." But anyone of any weight can be addicted to food or even a type of food. Like, someone can be thin and still have a sweet tooth. Maybe they don't eat much, but what they do eat usually has sugar in it.
For people like that, diabetes can be torture. They have a physical dependence on a type of food and getting rid of it can lower their serotonin levels. It can give them insomnia or make them moody. And in turn, when they are moody or tired all the time, they do less well in school, at work, and when interacting with loved ones. So it can be hard to give those things up completely, knowing how it will affect their performance and their life.
6. Fear Of Doctors, Medication, And Needles
Medical procedures are not fun. I'm not talking about waiting five hours in the waiting room and being bored. I'm talking about the fact that some medical procedures are awful and sometimes they hurt.
Like, usually, I am okay with my insulin needle. But every once in awhile, I put it in wrong or put it in a sore spot and it hurts really badly. There was one time I did that several times in a row and got scared to take my insulin on a regular basis anymore. I still did it, but I was bracing myself every time it was time to take insulin again.
People are afraid of doctors, medication, and needles. Often it is because they've had bad experiences. Having diabetes usually means facing all three of these fears constantly. Even if they're not on insulin, they usually have to use a blood sugar machine and prick their finger at least once a day, but probably many times. So there is no escaping the needle completely when someone becomes a diabetic.
It's like being arachnophobic, but having to carry around a live tarantula on your shoulder 24/7 in order to live longer. You'll probably adjust to it eventually, if you keep facing your fear, but you'll have a lot of panic attacks and there will be several days where you go,"I just can't take the tarantula today" before you get to that point. And if you think there's any chance that you don't have to face the fear that day and can live longer without facing it, even if it means being in denial, you're going to take that path.
There are some people who would rather carry a tarantula around all day, then go to the doctor, take medication, or use a needle.
7. Side Effects Of Medication
I used to take metformin, back when my diabetes was milder. It was already changing my blood sugar a lot, for the better, and I was only on a small dosage. I was excited about it for awhile.
Then, I started pooping my pants uncontrollably. It would just slide out with no warning. And I got so sick and exhausted from the medication that I couldn't hardly move or think. I couldn't watch TV, talking was difficult. I was light-headed all the time and miserable.
Pretty much all medications anyone takes has side effects of some kind. I've always had to deal with side effects, for instance, my insulin gave me weight gain, but this is something I feel I can work on managing. The side effects of my metformin, on the other hand, had completely destroyed my quality of life and it wasn't worth taking for me.
Sometimes, the side effects of medication are just too hard to live with and expecting people to handle those things and be normal is unrealistic. They have to find a medication they can be okay on and sometimes that takes a lot of experimentation and trying a lot of different medicines.
Some people will mistake a diabetic refusing to take a certain medicine with them being self-destructive or lazy when that is very far from the case.
8. Complications Of The Disease
Diabetes has many possible complications. I've learned that whenever I get sick with anything, it somehow involves diabetes. Like, when I started twitching my limbs in my sleep, I found out it was a complication of diabetes. Or when I discovered that I had extreme tooth decay, I found out that tooth decay is effected by diabetes. Even when I get a cold or a migraine, which aren't caused by diabetes, I have to think about my diabetes because those things raise my blood sugar.
There are some complications that make it harder to control the disease. Like I said, a headache will make medicine less effective and raise blood sugar, even when a diabetic person does everything right. If a diabetic person loses their foot, which is a complication that effects many diabetics, they can't exercise the way they used to anymore, which raises blood sugar.
The more complications they have, the harder it is to control the disease. Instead of doctors and family members being understanding of this fact, they usually get more judgmental because of it, which does not help. They're angry because now the diabetic person can't walk, for instance, because of the disease taking their foot and hope this is the rock bottom that will fix the person. In reality, they were already struggling before that happened and now it's going to be even harder for them to take care of themselves. That's not because they are a failure, but because diabetes is a degenerative disease and very hard to live with.
People get disappointed and I understand why. They don't want to see others suffer, but when someone is in pain and struggling, yelling at them and making them feel like even more of a failure is not generally the answer. They need compassion and for people not to forget that they are still (imperfect) human beings.
9. Diabetes Is A Degenerative Disease
Age makes diabetes worse. Every year that goes by, is a year where a diabetic person's diabetes is now harder to handle. So things that worked in the past will eventually no longer work to help them take care of the disease in the future.
Sometimes they're still taking care of themselves as good now as they did in the past, but because the disease has progressed, the results aren't the same.
Unfortunately, with diabetes, results don't always equal effort, so the amount of medications needed can increase, along with the amount of exercise, and the diet restrictions. Sometimes people have trouble adjusting to the new changes.
10. Because Not Taking Care Of Themselves Has Benefits
At least in the beginning, diabetes is a disease without many symptoms. It's a silent disease that is killing long term in ways that the diabetic person can't necessarily feel yet. It's easy to be in denial that they have it, easy to ignore it, and when they ignore it, they get rewarded for it.
They get to eat whatever they want, do whatever they want, and never see the doctor if they want. While if they face it, they have to look at a reality that is grim. They have to face that they have an incurable disease that kills a lot of people per year and that it's going to be hard work to get a handle on it.
People view this point of view as "laziness", but a lot of diabetics go through this. Denial isn't laziness, it's a coping mechanism for someone whose brain isn't yet ready to handle what is happening. Calling them lazy isn't going to help them handle it, showing them that they can still be happy even after the diagnosis is much more likely to snap them out of it and letting them take their time to digest what is happening to them.
11. Because They Don't Have Any Support
The worst part about having diabetes is that it not only drags down the diabetic, but their entire family. Often they want to tolerate having junk food or carbs around the house, for other people's sakes, but the more they tolerate it, the worse they eat themselves.
It's hard to live a healthy lifestyle if a diabetic's spouse and kids aren't willing to be healthier along with them, especially if they're the cook of the family and have to smell the delicious foods other people get every meal. When my Mom became diabetic and I was a little kid, there was no candy or sugar allowed in the house. Everything was sugar free. I was raised in a lot of ways on things like sugar free gum drops and I learned quickly not to eat too much of them if I didn't want want my stomach to get upset.
If the family of a diabetic person resents them for taking that stuff out of the house and gets angry at them, they're probably going to give in and bring all that stuff back in order to make their family happy and in the end, all of that is going to hurt them.
12. Embarrassment and Shame
Diabetes and a lot of things about it are not accepted in our society. For instance, I take insulin multiple times every day, especially before meals. When I go out to a restaurant, it's a problem. One, I have to take the shots in my stomach, which means lifting up my shirt and revealing a body that isn't bikini ready to a world of people who might mock me for it. And two, people are stupid and might think because I have a needle and am putting something inside of me that I must be using an illegal substance. Three, people judge diabetics in general so it's not something anyone wants to advertise to the world because they might get the judgement of strangers. (Says the woman who writes articles and posts them on the internet of what it's like to have diabetes!) I once had a waiter comment on my diabetes and ask me what number my blood sugar was because they saw me take my blood sugar and were studying to become a doctor. It was extremely awkward.
Because of this, I usually go into the restroom and take the medication before eating in the bathroom, which feels very gross and unsanitary. But if I'm at a restaurant alone, I'm not going to want to abandon my food or table to go to the restroom in case someone messes with it or takes it. There's also not always public restrooms available everywhere. And there's people who get nosy in public restrooms. Like, last time I was at a restaurant, I had someone knock on my stall door and ask me a question, which freaked me out when I was in the middle of taking insulin. I had to flush the toilet after I was done to pretend I was peeing.
It's easy in those moments to just ignore my needs and decide it's not worth the embarrassment. Some diabetics might not take their insulin because of moments like this, but later they see how high their blood sugar is!
Diabetics will sometimes fail to take care of themselves to avoid public shaming.