TLCDBU-2016: Barbara Anderson & Barb Schreiner

1. POURING THE BEST
EMOTIONAL
FOUNDATION FOR
MANAGING DIABETES
Barbara Anderson
PhD
Barb Schreiner,
PhD, RN, CDE

2. DIABETES IS DEMANDING.
Complex, unrelenting, expensive.
Behavior is the foundation of diabetes care,
yet not the only influence on blood glucose
(BG) levels.
Parents often feel out of control of BG levels,
yet hold themselves 100% responsible.
Arguments about diabetes are exhausting.
Worries and fears can be all-consuming.

3. THE DEMANDS TAKE A
TOLL.
Distress
Frustration,
conflicts
Burnout
Feel
overwhelm
ed
Burden
Exhauste
d

4. CYCLE OF
MISCARRIED
HELPING
High or low BGs
Worry. Fear.
Accuse, nag,
blame & shame
Feel
discouraged.
Don’t check,
fudge the truth
Based on Anderson &
Coyne, 1991
Parent
sKids
Diabet
es

5. YOU ARE NOT ALONE.
Distress and burnout happen.
Every family experiences some distress or
conflict around diabetes.
Sometimes this gets to the point of needing
outside help.
Keep an eye out for early signs:
 Feeling overwhelmed, no control, you can’t keep up
 Down mood, pessimistic outlook
 Sense of “giving up” or losing motivation
 Irritability, more arguments about diabetes
 Exhaustion, fatigue
 Feeling alone or isolated

6. WHERE TO GO FOR
SUPPORT
Friends, family
Local diabetes groups, diabetes online
community
Diabetes care team, your own healthcare
provider
Mental health professional
 Preferably a health psychologist with expertise in chronic
conditions (there may be one in your child’s diabetes care
center/medical center)
 Behavioral or cognitive behavioral approaches most aligned
with diabetes management

7. QUESTION
How do you know when
you need support?

8. BUT YOU CAN LIVE WELL
WITH T1D!
What does “living well” with
diabetes
mean to you?
How do you and your family
live well
with T1D?
What works for you?

9. STEPS TOWARD LIVING
WELL…
Developmentally
appropriate parent
involvement in
T1D management.
Less family conflict
about T1D
management.
More teamwork.
Better T1D
management.
Lower A1c, higher
quality of life.

10. DIABETES IS NOT DIY
• Early-middle
childhood
• Limited child
self-
management
• Parents
primary
Diabetes
Manager
• Adolescence
• Gradual shift
• Parents coach
and back-up
Monitor +
Support
• Young
adulthood
and beyond
• Support and
back-up as
needed
• Parents and
other loved
ones
Safety Net

11. What do we enjoy doing?
What are we good at?
What is going well in diabetes care?
How can we build on what is going
well?
How can we use our strengths for
FIND YOUR STRENGTHS
+ USE THEM.

12. QUESTION
What is going well
with diabetes
management
in your family?

13. So many influences on BG – most control over
management behaviors.
Diabetes is not a test, you don’t pass or fail.
Punishing numbers = “Blame and shame”
Catch your child being good! (more is going well
than you might think.)
Praise diabetes management behaviors:
 More likely to happen again
 Create positive atmosphere
 Develop confidence, feel ownership
PRAISE BEHAVIOR, NOT
NUMBERS.

14. Avoid Shame and Blame Around BG
That scares
me! It could
cause
complications!
Dad, my
blood
sugar is
385.
Dad’s really
mad at me!
He’d be
happier if my
blood sugar
were 120 or if
I didn’t check
at all!
385?! Why is it
so bad? What
did you eat?
1) OCCASIONAL HIGH BLOOD SUGARS DON’T LEAD TO COMPLICATIONS. It is normal
for growing children to have out-of-range blood sugars. An occasional blood sugar of
300 or even 400 or more will not cause complications.
2) THERE IS NO SUCH THING AS A “BAD” BLOOD SUGAR. Any result from blood sugar
monitoring is good because it gives helpful and important information that lets you be
proactive & make the best choices in insulin, activity, & food.

15. QUESTION
What gets in the way of
praising
diabetes management
behaviors?

16. WATCH YOUR
LANGUAGE!
BG checking or
monitoring
High or low BG/A1c
In- or out-of-range
numbers
Diabetes
management
BG testing
Good or bad
numbers
Diabetes control
(biology)
Say this… … not that

17. Major changes can be daunting
Small changes, one step at a time.
Focus on behavior goals
 Select with your diabetes care team
 Start with something achievable
 Choose together as a family
Celebrate each success to reinforce each
behavior along the way
Then pick your next most achievable
behavior goal…
SET REALISTIC GOALS.

18. SELF CARE IS NOT
SELFISH.
Get support when you need it
Ask for help with something
specific
 Who can you ask for a hand?
 What is a specific way they can
help lighten your load?
Set time aside for your own
needs so that you are refreshed
to take care of your family
 What energizes you?
 What can you fit into your
schedule?
MotivatingGiraffe.com

19. Diabetes is serious business. Also, funny stuff
happens.
Finding humor in stressful situations can be a
useful (and fun) way to get through it.
Great model for your children for managing
diabetes challenges.
Please share a funny story
with the group or your
A LITTLE LAUGHTER
GOES A LONG WAY.