By Lisa Tsering, as told to Hallie Levine
Life with type 2 diabetes can be overwhelming. I speak from experience: I have lived with this condition for 17 years. There’s a lot of focus on medication and lifestyle changes to get blood glucose levels under control. But there’s one important part of treatment that often gets short shrift: self-care.
It’s a topic that should be front and center for anyone with type 2 diabetes. There’s so much shame, self-hatred, and blame among patients, especially those who are newly diagnosed. There’s this unspoken belief that it’s your fault: if you’d only watched your weight, monitored what you ate, and exercised just a little bit more, it wouldn’t have happened. But while all of these lifestyle factors may play a role, much of a diabetes diagnosis simply boils down to factors out of your control, like genetics, or even just plain luck.
I was diagnosed with gestational diabetes at age 43, when I was pregnant with my son. While the condition resolved once I gave birth, I was diagnosed with type 2 diabetes four years later. I wasn’t surprised, as my father had type 2 diabetes and ultimately died from its complications. That’s why I take it so seriously. If you don’t get it under control, it can kill you. Over the years, I’ve brought my A1c down to 6.8 from a high of 8.3.
I credit some of that success to self-care. Over the years, I’ve learned to give myself grace and space, and honor the little steps I take every day to improve my health. Here, I share some of the tools in my toolbox, in the hope that they will help you.
I test my blood sugar daily. I don’t wear a continuous glucose monitor (CGM), because I don’t think it helps me with self-care to constantly check my blood glucose levels. But I do prick my finger to measure my blood sugar every morning. Do I like it? No. But I consider it an important part of my self-care.
It gives me a baseline as to where I am that day, and I look at that number without judgment. What happened yesterday? How much exercise did I get? Did I eat foods that are supportive of lower blood sugar levels? (Notice that I don’t use the words good or bad when it comes to food. That sort of shaming language doesn’t help anyone to eat more healthfully.) But I use that number, whatever it may be, as a sort of baseline to help me structure my day.
I meditate every morning. Research makes clear that there’s an association between stress and higher blood sugar levels. When you’re anxious, your body churns out more of the stress hormone cortisol, which raises blood glucose. As a result, it’s harder to get your type 2 diabetes under control.
It can be hard to fit stress management into your life, so I make sure that I do some sort of mindfulness exercise every morning for two to three minutes before I get out of bed. It can be prayer, mediation, or even a gratitude exercise. The important thing is that I do it. That moment of meditation definitely sets the stage for the rest of the day. I find that I’m less irritable. If someone cuts me off in traffic, I’m more relaxed and able to just let it go.
I eat a nourishing breakfast. This morning meal is a must for people with type 2 diabetes. It helps to keep blood sugar levels steady, and it’s also an easy way to nurture and fuel your body. Most of the time, I try to have a high-fiber, high-protein meal, such as a scrambled egg or cottage cheese on whole wheat toast, or oatmeal topped with walnuts and fresh berries. But I also let myself indulge, too. If I crave a bagel once a week, I eat one. I adore carbohydrates. Part of self-care is allowing yourself to splurge every now and then.
I spend time in nature. I’m a reluctant gym goer – I force myself to get there once or twice a week. I get most of my exercise at Point Isabel, a 23-acre dog park right on the San Francisco Bay. I take my dog, Jaden, and we spend an hour twice a week walking on flat paths that overlook the bay. Sometimes, we walk in silence while I feel the breeze on my face and inhale the fresh air. Other times, I listen to a podcast or an audiobook. There’s even research to show that exercise outside helps improve blood glucose control among women with type 2 diabetes.
I don’t skimp on sleep. Increasingly, research points to getting enough sleep – and getting good quality sleep – to help control blood sugar levels. But like many postmenopausal women, I struggle to stay asleep throughout the night. The smallest thing can wake me up, and once I’m awake it’s hard to nod off again. I try to make my bedroom my temple. I keep the room dark and cool, and I wear earplugs to block out noise. Ideally, I aim for nine hours of sleep each night.
I let myself enjoy food. I follow a plant-based diet. Since type 2 diabetes can damage your heart, it's important to me that I stay on top of my heart health. What works for me is a three-pronged approach: medication for high cholesterol, a largely plant-based diet, and lots of walking. Research shows that when you replace animal protein with plant-based options like nuts and beans, it reduces risk of both heart disease, type 2, and premature death.
But as part of my self-care, I try to be compassionate to myself every day. And one way I do that is to occasionally indulge in my greatest passion: food. I like to travel, and food is the most divine part of that experience.
A few years ago, I flew to France with my teenage son for a series of foodie adventures. I explained to him that at least once in life, you have to experience hot chocolate in Paris. Some people would call me crazy. But for me, food is part of who I am and part of living. When I’m home, I mostly follow a diet rich in fruits, veggies, whole grains, nuts, and seeds. When I travel, it’s time to indulge.
I pamper my skin. On low-energy days, I love to baby my skin. I exfoliate, apply some beautiful- smelling lotion, and even treat myself to a manicure. It boosts my mood and gives me joy to have these little pieces of beauty in my life. To top it off, I let myself lounge on my couch with a good spy thriller. Sometimes the best self-care is to let your mind and body veg.
I live life intentionally. It’s way too easy to fall into a pattern where you blunder through the days. It’s important to make conscious choices that align with your values, goals, and overall vision. It can be as simple as meeting a work deadline or reading a thought-provoking book. I also make it a point to travel solo as a form of self-care. Last October, for example, I visited Karlovy Vary, a small spa town in the Czech Republic. Whatever I do, I try to make it have some sort of meaning.
I try to stay away from social media. This is one of the most important rules of self-care. Social media and self-care don’t go hand in hand, no matter what TikTok influencers try to tell you. I find that when I spend too much time on it, it makes me feel anxious, depressed, lonely, and frankly just down about myself. There’s a lot of focus on physical appearance, and carefully curated images. Every time you log into social media, you miss a chance to make a real, personal connection with someone else.
There are some silver linings to social media, of course: the chance to connect with others who live with type 2 diabetes. But if you spend too much time in online chat channels, it can become overwhelming. Put down your phone and go for a hike, meet a friend for coffee, walk your dog, or read a good book. These are all forms of self-care that will ultimately improve your physical and mental health, so that you can better manage your type 2 diabetes.
One final thought: Take your type 2 diabetes seriously, but be compassionate with yourself. Watch the language you use around your type 2 diabetes and watch the language you use with yourself. Don’t fall into the trap of labeling things “good” or “bad” for your diabetes. View your diagnosis as a chance to love yourself and listen to your body a little bit more.
It’s a mentality that’s served me well. My doctor is happy with my A1c numbers, as is my diabetes pharmacist. And I’m happy, too. I’ve settled on a routine and pattern that works for me. Life is messy with all of its ups and downs. Once you reach a certain level of acceptance and awareness, you’ll be better able to manage your type 2 diabetes and its effects on your life. Just remember, you’ve got this!
Show Sources
Photo Credit: Maskot/Getty Images
SOURCES:
Lisa Tsering, type 2 diabetes advocate, San Francisco.
Cureus: “Stress-Induced Diabetes: A Review.”
Journal of Behavioral Medicine: “The effect of time spent outdoors during summer on daily blood glucose and steps in women with type 2 diabetes.”
Cell Reports Medicine: “Coordinated human sleeping brainwaves map peripheral body glucose homeostasis.”
BMC Medicine: “Substitution of animal-based with plant-based foods on cardiometabolic health and all-cause mortality: a systematic review and meta-analysis of prospective studies | BMC Medicine.”
