Dr. Gary,

I have had a year of surgeries, healing, and finally going back to work. I have put on 15 pounds of weight from not being able to walk well (due to two hip replacements and femoral fractures). I had excellent diabetic control (as a type II) but now am out of control. I need help getting myself back on track—do you have any suggestions? P.S. I am also a 5th grade teacher and am exhausted at the end of my day. HELP!!

-Poodle gal

Hey Poodle gal,

You have been through so much, my friend! And with a lot of health issues to manage. From what I’m hearing in your words, it sounds like lately you are feeling the burden of it all, and that you are tired out and frustrated. On top of it, being a teacher is an incredible responsibility and can take a lot out of you every day.

The starting place for out of control blood sugar should be your doctor’s office. I suspect that you have already done this but, just in case, I encourage you to have a talk with your doctor and/or a diabetes educator. Have a talk about what you are doing to manage your diabetes. See if there are any changes in your regimen that need to be made. As well as some help in putting a plan together to help you with managing your weight. Again,I suspect I am preaching to the choir here, but the importance of maintaining a close relationship with your health care providers always bears repeating.

Assuming you and your health care providers put your heads together and you have the optimal regimen in place, what I want to help you with is your emotions. Are you totally out of control or just not where you need your numbers to be? Are you having some good days among the bad days? How about replacing “out of control” with “experiencing some new challenges?” When you start using labels like out of control, you also set up the expectation that your problem is unsolvable. It might help to decide not to be so hard on yourself. But we know better than that. It might help to decide not to be so hard on yourself.

You mentioned that you had put on weight. That is not surprising, given your long period of inactivity. So how is your eating going now? When you are feeling bad about yourself, exhausted and frustrated, then that can be a trigger for overeating. It can become a cycle, feeling bad, eating to feel better, feeling frustrated about the weight gain, being self-critical, feeling bad… You get the picture.

Given that you are dealing with all of this, I am wondering if you might be experiencing some diabetes burnout. You know, that feeling that you have fallen off the horse and don’t know how to get back on. Or even on some days, asking yourself managing your diabetes has become a lost cause. Many diabetics go through this at some point, so you are not alone. Think of it as a bump in the road, not the end of the road. And you have a great track record.

Take it one day at a time. Prioritize what you most need todo to take the best possible care of yourself. Set limits on what you eat and when. Watch your eating triggers and find positive ways to cope with your emotions that don’t involve eating. Build in adequate rest into each day, especially after a stressful day at school. While your job gives you lots of exercise, you may want to consider ways to conserve your energy here and there during the day. Get support from friends and family who can give you encouragement and also help you to stay accountable in staying compliant with your self-care routine.

Be patient. Diabetic self-care isn’t easy and you have been through a lot. While getting back to where you want and need to be may feel like an uphill climb, take it one step at a time. So repeat after me: “I have done a great job of managing my diabetes in the past, and I can do it again!” Believe in yourself!

Stay in touch with us, my friend. Let us know how you’re doing!

Dr. Gary

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To learn more on this topic:
Time to Get Out of Your Mind?
7 Steps to Help Make a Bad Day Better
5 Tips to Manage Diabetes — Without Losing Your Mind