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Article from the Diabetes Wellness Newsletter, October 2015

The greatest pollution problem is not found in the atmosphere, water, or soil; but in the minds of 90 percent of the population, which are contaminated with negative thoughts and beliefs. Like food is to the body, self-talk is to the mind. Don't let any junk thoughts repeat in your head. 

 ― Maddy Malhotra

 

Numerous jokes link talking to oneself with being less than sane. But we talk to ourselves most of the time. Watching television, eating, exercising, even when having a conversation with someone, the inner chatter rarely stops. Most of what we do coincides with the chatter occurring internally. Before taking medication or injecting insulin, you are likely talking to yourself about what you are going to do, why and when.

 

Self-talk Is Variable

 

On your way to a doctor appointment or an interview, you are likely to rehearse what you want to say at that meeting… talking to yourself as if the other party were present. Watching television or simply conversing with someone might trigger a memory that you begin to retell to yourself. When you are living in the past or future, you are either talking to yourself or telling your story to someone in your mind. In anticipating that something bad might happen regarding some event in the future, anxiety is fueled by continually asking yourself, "What if the worst happens?" How many times have you made a mistake and repeatedly “replayed” that incident telling yourself how bad or stupid you are.

 

Consequences of Self-talk

 

The nature or quality of this inner discourse with oneself can have a powerful impact on one's health and happiness.

 

Consider the different effects of the optimistic and pessimistic inner voice on someone struggling to lower his A1C. The optimist's self-talk will be positive, fueling the determination to succeed: "With some help, I can do this." The pessimist will, at best, question his ability to lower his A1C: "I seriously doubt that I can get my blood sugar level down consistently." At worst, the pessimist may even stop trying.            

 

For individuals whose self-talk is focused either on the past or the future, self-care will be a losing effort. In Being in the Precious Present (February 2014), I quoted the contemporary philosopher, Alan Watts: "Normally, we do not so much look at things as overlook them." In focusing on what happened or might happen, we miss what is most important: what is happening now.

 

The past is unchangeable; being in the future is often fear-based. Either perspective is counter-productive. Lowering one's A1C requires attention to what is happening in the moment. Diabetes management is detail intensive. Being distracted by what has passed or what may or may not happen next week is counter to what is needed.

 

Benefits of Positive Self-talk

 

Research on the value of positive inner contemplation is not extensive; however, it is reasonable to accept that the benefits include:

 

Lower rates of depression

Better psychological and physical well-being

Reduced risk of death from cardiovascular disease

Better coping skills during hardships and times of stress

Increased lifespan

Certainly, a positive perspective−internally and externally−is ideal for coping with the challenges of diabetes and the daily trials and tribulations of life. A constructive outlook is essential to successful control of diabetes.

From Negative to Positive Self-talk

Change Begins with Awareness

 

Talking to oneself is unavoidable; it is often essential to our well-being—so long as the inner voice is rational, of sound judgment and good sense. However, some of us have programs embedded in our brains that continually activate negative messages. These irrational and, often, self-deprecating messages can be harmful.

 

Suppose you become aware that your internal messages are intensely negative regarding your future with diabetes. Every time you have a high blood sugar level, you hear yourself saying that you are a failure and simply incapable of managing the disease. Being aware of your negativity will enable you to test and challenge the self-defeating perspective.

 

Use unpleasant feelings as a signal to tune into your inner voice. Feeling sad, frustrated, angry, anxious or distressed may be understandable given the circumstances, or these feelings may be fueled by irrational, frightening internal talk.

 

Listen for words that may be baseless, but nonetheless persuasive such as "always," "never," "failure," "shameful," or "stupid." These and other terms that have extreme or self-demeaning connotations are signals to pause and ask, "How much truth, if any, is there to what I am telling myself?" None of these absolutisms are likely to have merit with careful reflection.

 

Testing, Challenging Negativity

 

Start with a fundamental question, "Given that there are millions of people who do well controlling their diabetes, am I just too stupid or incompetent to get it right? Of course not!” Rejecting the negativity leads to the probability of a favorable outcome.

 

Considering Other Possibilities

 

When you become aware of your negative self-talk and challenge the validity of the defeatist nature of those messages, you likely will realize that your self-talk is working against you.

 

If so, ask these questions: "What is deterring me from managing the disease effectively? Is a false belief or beliefs holding me down? Do I need help, perhaps a consultation with a professional care provider or participation in a support group? What are my options?"

 

"What if I made a commitment to change one piece of the overall problem at a time?" The inner voice saying, "I can't do it!," is often expressing the perception that dealing with the problem is too much. For example, if you need to modify your diet and begin to exercise in order to lose weight, the dual tasks may seem overwhelming.  But addressing one challenge at a time can be a game changer. Getting either your diet or a healthy exercise program going well will make the remaining task easier to achieve.

 

When the content of your inner voice is positive, the probability of success is enhanced significantly. Consider the words of psychologist Sheila Krystal: “You are only one thought away from a good feeling.” Replacing a negative thought with one that is positive puts you in the best place for facing the challenges of diabetes and life in general.

In a presentation at the American Diabetes Association’s 2015 Scientific Sessions, Dianne Fetchick, MD and Rosemarie Lajara, MD, endocrinologists with Diabetes America in Plano, TX, shared results of their use of the V-Go insulin pump with their patients.  The V-Go pump is a small 2.4 x 1.3 x 0.5-inch disposable manual insulin delivery device.  The device delivers 20, 30, or 40 units of basal insulin evenly over a 24-hour period, and the wearer can deliver mealtime bolus insulin in two units per click increments.

 

For individuals who are unwilling to give themselves multiple daily injections, this may be an alternative. Two studies were reported at the meeting: 72 patients—most of whom had Type 2 diabetes—had been switched from multiple daily injections (39); basal insulin only (24); or oral glucose-lowering medications (9).  The analysis of their electronic medical record showed a decrease in A1C levels.  At baseline, A1C levels were on average 9.6% at 88 days.  A1C decreased to 7.9% at 177 days—a decrease of 7.6%, and at 279 days—7.7%.  Patients who had been on basal insulin alone or noninsulin agents had the greatest reduction in A1C—1.9 and 3.5 percentage points from their baselines of 9.8% and 10.9%.  Patients who had already been taking insulin who used the V-Go reduced their total insulin usage by 20.5%.

http://www.npr.org/sections/health-shots/2015/08/26/434892642/texting-helps-diabetes-patients-fine-tune-insulin-dosing