Setting Goals

With Thanksgiving, school, volunteering, doctor visits, and so on, things have been a little cray-cray around these parts. Christmas is coming up now, providing a host of other things to think about. I had a checkup with the endo last week and I’m supposed to get some labs done soon. She seemed to think I’m still doing pretty well, which is good, but without my A1C results to look at it was hard to say for sure. Note to self: get labs done before next doc visit. What I want to write about today though is setting goals, which is tough to do when you’re busy…but so, so important for diabetes management.

I’ve had the wonderful opportunity to help start a diabetes self-management pilot group for one of the free health clinics where I volunteer. The six-week program is for patients that have already been through an intensive diabetes management program that focused on education, blood sugar monitoring, diet and exercise. Unfortunately, many of the patients that go through the first program make great strides in bringing their blood sugars down during the program, but fall off the bandwagon almost as soon as it’s over. It’s as if the lack of accountability, support and encouragement really affects patients’ ability to keep up their good blood sugar control.

The PhD student that is in charge of this organizing the new group believes the mental/emotional component of diabetes management is just as important as educating patients on how to control their blood sugars. It may seem sort of self-evident, but this component of diabetes management is sadly not emphasized in healthcare as perhaps it should be. There’s good evidence in the existing research on this topic that supports her hypothesis. The group, then, focuses mainly on the psycho-social barriers to behavior management.

I bring up this group not to analyze its progress thus far or anything like that, but to try and apply some of its principles to my own life. Although I am a group leader, by virtue of the fact that I also have diabetes like our patients, I too could benefit from “walking the walk.” One of the first things the patients do is learn how to set and manage realistic, achievable goals. So, what is my goal? To be more on top of blood sugar monitoring.

I am pretty good at checking my sugars, but recording and analyzing the data I get from them is something I do only in fits and starts. I feel it’s important to improve my blood sugar monitoring because it’ll be a) easier to identify what causes my sugars to spike and drop, b) provide a resource I can refer to in the future when in doubt. My ultimate goal is to record my blood sugars every day and analyze them once a week to make adjustments. I’m not going to run before I crawl with this one, though, because that’s been my problem in the past. When I set a goal to do something every day right off the bat, things get in the way, I get disappointed, and ultimately I drop off completely. My big goal needs to be broken down into smaller, more realistic parts:

1. Log blood sugars, carbs consumed, exercise, etc. three days a week.

I have a handy spreadsheet provided by Rhodes over at The Diabetes Support Group which I’ll plug my sugars from Monday, Thursday and Saturday into every week (probably the morning after since I’m always foggy at the end of the day). I like having a sample of the different days of the week because my schedule varies from day to day and from weekday to weekend.

2. Pick one day to dedicate to carb counting every meal and snack religiously.

My goal is to do this tomorrow, Monday 12/10. I’ll need to plan ahead as much as possible what to eat, but even those little random things that I tend not to record (like a Christmas cookie here or there…) need to be tracked.

3. Spend 30 minutes reviewing each week’s sugars on Sundays.

This is another thing that I have trouble sticking to. If I set aside a block of time on my calendar and I’ve actually been diligent about recording my sugars for the week, I shouldn’t have trouble with this. This is such an important piece though…what good is doing all the work of collecting data if you’re not going to use it!

To get even more specific, I’ve identified some of the when/what/how/with whom details that will hopefully make it harder for me to slip up:

When: Monday, Thursday, Saturday – record; Sunday – review.

What: Test first thing in the morning, before each meal, before and after exercise, and before bed. Count carbs, not calories right now, at meals and snacks. Record all data on spreadsheet.

Who: The hubby will be helping me by reminding me to log and looking over my shoulder a bit more at what I’m eating. He’ll also review with me on Sundays so he knows as much as I do about my management.

It looks like a lot of information, but I feel like the more specifics the better when it comes to setting and managing health goals. Having a plan (and a backup plan) for a variety of situations is essential to diabetes care, but the elements of that plan have to be realistic for one’s lifestyle. Building in [healthy] rewards for good behavior is also important. My typical M.O. is to reward myself with food or a day of laziness, but that’s not a healthy reward system. I think if I do well for the next month or so my reward will be to spend a girly day pampering myself. I haven’t had a massage in months. A mani/pedi could be nice too… 😉