Coaching Diabetics

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Treat the Mind and the Sugars Will Follow

By Lisa Elaine Held

Diabetics live in a world ruled by measurements and numbers.

Doctors and other health care workers, such as Certified Diabetes Educators (CDEs), tell them what their blood sugar numbers should be, how to measure them and how much insulin to take.

But while numbers are crucial to controlling the disease, they make up just a tiny snapshot of the larger picture of diabetes management, a process that has emotional, psychological and social challenges.

Now, a small but growing sector of professionals is seeking to address those challenges through varied styles of coaching and counseling. In doing so, they believe they can help individuals accept and control the disease and live healthier, happier lives as a result.

"There's a whole psychology behind it that goes beyond what are you eating and what your numbers are," said Dana Hariton McQuade, a New York City life coach who works primarily with diabetics. "How you value yourself and how you take care of yourself are affected by how you embrace the disease."

McQuade primarily works with women, many of whom are dealing with social challenges like dating while wearing an insulin pump or managing pregnancy or motherhood and blood sugar at the same time. Some of her clients harbor anger at their own misfortune, as did a 30-year-old woman she worked with who resented her disease and therefore had a hard time taking control of it.

Eliot LeBow, a New York social worker who counsels diabetics, said that anger is a huge issue with many of his clients, along with depression.

In fact, the Centers for Disease Control and Prevention's National Diabetes Fact Sheet for 2011 reported that people with diabetes are twice as likely to battle depression.

They are also often misdiagnosed, said LeBow. If blood sugar levels are not under control, diabetics may exhibit the same symptoms as those suffering from clinical depression. "If their blood sugar levels are always high, they're going to be lethargic and have no motivation and basically feel depressed," he said.

In addition, the process of diabetes management is extremely stressful. It requires constant attention and measurement and is full of ups and downs each and every day.

Doctors and CDEs in clinical settings don't usually have the time to look at the larger picture. They can tell patients what their numbers should be and the biological changes they need undergo to get there, but they won't determine what in the patient's life needs adjusting in order to make that happen.

That's where life coaches and counselors come in. "When I get a new client in, I look at the whole picture," said LeBow.

After determining what they need to work on, he guides them through making positive changes. "Most go on to have their blood sugar under control, and their emotional life gets better."

This was true for Sysy Morales, a 28-year-old mother of twins who started a blog called The Girl's Guide to Diabetes after getting her disease and depression under control with the help of a health coach. Morales said her coach mostly listened to what she said and then asked interesting questions she wouldn't have thought to ask herself. This made her realize what the roots of her issues were and gave her a new sense of clarity.

"Using positive thinking helped me, and I worked on changing my diet and lifestyle habits," she said. "Getting out of the depression made me able to take care of my diabetes and that, in turn, made my mood even better."

The woman Morales went to for help was a health coach. McQuade is a life coach, and LeBow is a licensed social worker. While their credentials and approaches are slightly different, they're all working to address the emotional and psychological challenges associated with a disease that is often looked at as purely biological.

Most coaches and counselors in this field have another thing in common-they're diabetics themselves. McQuade and LeBow were both diagnosed as children, a factor that allows them to understand their clients in a more profound way.

Their services tend to be sought out mainly by individuals with Type 1 diabetes. This may be because of their personal experience with Type 1, or because those living with Type 1 are dependent on insulin, making management a more difficult, consuming process.

If the field continues to grow, it may expand to reach a larger population. "I'm trying to get other people on board," said LeBow, "so people will know that therapy is a big part of managing diabetes."

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