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Introduction to mindful diabetes self management
- 1. LAURA ESTAN, RD, LDN,CDCES REGISTERED DIETITIAN AND CERTIFIED DIABETES CARE & EDUCATION SPECIALIST
- 2. Problem SolvingMonitoring Healthy Coping Healthy Eating Taking Medication Staying Active DIABETES SELF MANAGEMENT Reducing Risks
- 3. SOME TYPES OF MINDFULNESS PRACTICES • Yoga and Yoga Nidra, Pranayam and Bhakti chanting • Labyrinth Walking • Creativity/Art and Art Therapy • Silence • Meditation in Motion: Exercise. Dance, Swimming • Rosary Prayer or Mantra mala beads • Positive affirmations • Novenas
- 4. POSITIVE AFFIRMATIONS • “My body is healthy and strong. I decide every day to support my health.” • “I love my body and I will help keep it healthy and strong.” • “My goals are health, strength, love, and peace.” • “My body and mind work together to create health.” • “My choices affect my health. I will make healthy choices today.” • “I can achieve my goals by treating my body with love and kindness.”
- 5. WHAT IS MINDFULNESS? Paying attention, In the present moment, On purpose, In a non-judgemental way……
- 6. WHAT DOES BEING MINDFUL MEAN ………. NOTICING AND PAYING ATTENTION TO WHAT IS GOING ON IN THE PRESENT MOMENT, WITHOUT PASSING JUDGMENT ON IT. -
- 7. MINDFULNESS HAS BEEN SHOWN TO BE EFFECTIVE FOR: - REDUCING STRESS - IMPROVING EMOTIONAL BALANCE - INCREASING SELF-AWARENESS - HELPING WITH ANXIETY AND DEPRESSION - COPING MORE EFFECTIVELY WITH CHRONIC PAIN.
- 8. USE OF MINDFULNESS BASED INTERVENTIONS IN CHRONIC DISEASE MANAGEMENT Research has shown benefits of mindfulness in healthy persons and those with chronic health conditions, including Veterans with PTSD and persons with diabetes: • Relieves stress and distress • Boosts self-efficacy • Enhances mental focus • Improves blood glucose regulation • Boosts immunity
- 9. MINDFULNESS EXERCISES • Focus on breath • Body Scan • Mindful Eating • Mindful movement
- 11. MBSR OR MINDFULNESS BASED STRESS REDUCTION • MBSR is a nonreligious program that focuses on cultivating an enhanced moment-to-moment nonjudgmental awareness of experience. • Originally designed by Jon Kabot Zin at UMASS Medical Center to help facilitate adaptation to the stressors of medical illness and assist people in managing stress and pain, MBSR has evolved into a practice that is being applied to a wide variety of health problems as well as being used for general health and overall stress reduction.
- 12. MINDFULNESS HELPS US PUT SOME SPACE BETWEEN OURSELVES AND OUR REACTIONS, BREAKING DOWN OUR CONDITIONED RESPONSES…….
- 13. GUIDED MEDITATION WITH ZEN MASTER THICH NHAT HANH • "Mindfulness is the energy of being aware and awake to the present moment. • It is the continuous practice of touching life deeply in every moment of daily life. • To be mindful is to be truly alive, present and at one with those around you and with what you are doing." Thích Nhất Hạnh
- 14. MEDITATION & DIABETES MANAGEMENT • Mindfulness meditation is the practice of working with concentrated awareness to live each moment fully. • In other words, the point of this type of meditation is to learn to live your life more fully, not to sit in the lotus position for hours a day! Joseph B. Nelson, M.A.LP https://www.diabetesselfmanagement.com/managing-diabetes/emotional- health/meditation-diabetes-management/
- 15. THE BENEFITS OF MINDFULNESS PRACTICES FOR DIABETES MANAGEMENT • Deep breathing, which goes hand in hand with all mindfulness techniques, can help to lower your blood pressure and pulse, promoting relaxation and reducing stress. • Stress reduction has been found to have a positive impact on your blood glucose levels and make your blood glucose control easier throughout the day. • Reduced stress will help to avoid the endorphin cravings that lead you to overeat or eat what you shouldn’t. • These techniques can also assist with behavioral lifestyle changes such as quitting smoking and overeating.
- 16. Mindfulness Meditation for Persons with Diabetes | Health Sciences North Gary Petingola, Registered Social Worker, Diabetes Care Service Education *Introduction and testimonials of Health Sciences North's Mindfulness Meditation for Persons with Diabetes, part of the Diabetes Care Service Education program. Health Sciences North is an academic health science centre in Greater Sudbury, Ontario, Canada. HSN offers a variety of programs and services, with regional programs in the areas of cardiac care, oncology, nephrology, trauma and rehabilitation.
- 17. HOW CAN I USE MINDFULNESS IN MY DIABETES SELF MANAGEMENT? Incorporate key components: • tune into non-judgmental sensory awareness; • Practice self acceptance; • Be compassionate, starting with your self! • learni to ”pause” before reacting • Increase your awareness of your breath • take time to practice each day
- 18. FIRST STEPS TO LIVING A MINDFUL LIFE…….. • Pay attention. • Slow down and notice things in your busy world. • Live in the moment. • Try to intentionally bring an open, accepting and discerning attention to everything you do. • Accept yourself. • Treat yourself the way you would treat a good friend. • Focus on your breathing.
- 19. MINDFULNESS COACH • Mindfulness Coach 2 was developed to help Veterans, Service members, and others learn how to practice mindfulness. • The app provides a gradual, self-guided training program designed to help you understand and adopt a simple mindfulness practice. • Mindfulness Coach also offers a library of information about mindfulness, 12 audio-guided mindfulness exercises, a growing catalog of additional exercises available for free download, goal- setting and tracking, a mindfulness mastery assessment to help you track your progress over time, customizable reminders, and access to other support and crisis resources.
- 20. MINDFULNESS COACH | VA MOBILE - VA.GOV
- 21. TOP MINDFULNESS APPS * Priority for FREE content and DOES NOT REQUIRE a SUBSCRIPTION!! • Stop, Breathe & Think. ... Asks you to “CHECK IN” on your current state then offers short guided meditations based on your current state of being • Insight Timer : Awesome site! Check out the section on Managing Stress or do a 7 Day Course like “Learn to Meditate in 7 Days” • Oak Meditation App in the Apple or Android store asks you to choose from focuses on Meditation, Breathe or Sleep • Simple Habit has interesting specific meditations for stress, trauma, illness or Addiction and Craving! *Popular but now require a subscription • Calm • Headspace • Aura. ... Free only if you select 3 minute meditations on sign up
- 22. Centers in New England • Copper Beech • Kripalu • Omega • Barre Center • Mercy by the Sea • Genesis Spiritual Life Cente • UMASS Center for Mindfulness http://www.globalmindfulnesssummit.com/ online and free ... for those dedicated to inner and outer transformation. Online Sites • Copper Beech • Mindful.org • YouTube
- 23. REFERENCES • 1 US Dept of Veterans Affairs (2017). Fed Pract, S20-S2. • 2 Prisciandaro, et. al. (2011). Diabetes Technol, 13(1), 73-78. • 3 Fisher et. al. (2012). Diabetes Care, 35(2), 259-264. • 4 American Association of Diabetes Educators. (2020). The Diabetes Educator, 46(2), 139-160. • 5 Young-Hyman, et.al (2016). Diabetes Care, 39(12), 2126-2140. • 6 Kabat-Zinn. (2013). Full catastrophe living London: Piatkus. • 7 Kearney, et. al. (2016). The American Journal of Medicine, 129(2), 204-214. • 8 Bormann, et. al. (2018). American Journal of Psychiatry, 175(10), 979-988. • 9 DiNardo, et al. (2018). The Diabetes Educator, 43(6), 608-620. • 10 Miller, et.al. (2013). Health Education & Behavior, 41(2), 145- 154. • 11Loucks, et. Al. (2016). American Journal of Health Behavior, 40(2), 258-267. • 12 Zeidan, et al.(2010). Consciousness and Cognition, 19(2), 597- 605. • 13 Friis, et.al(2016). Diabetes Care 39(11), 1963-1971. 1 • 4 Black & Slavich. (2016). Ann NY Acad Sci 1373(1):13-24.
Editor's Notes
- Healthy Coping is recently being recognized more significantly by health care Providers but has always been an underlying concern by those living with diabetes. Today we’ll start our discussion of mindfulness with a check in on our group’s current knowledge and/or experiences with various types of mindfulness pactices -
- -Yoga nidra or yogic sleep is a state of consciousness between waking and sleeping, like the "going-to-sleep" stage, typically induced by a guided meditation. There is evidence that yoga nidra helps relieve stress Prāṇāyāma is the practice of breath control in yoga. In modern yoga as exercise, it consists of synchronising the breath with movements between asanas, but is also a distinct breathing exercise on its own, usually practised after asanas. A labyrinth is an ancient symbol that relates to wholeness. It combines the imagery of the circle and the spiral into a meandering but purposeful path. The Labyrinth represents a journey to our own center and back again out into the world. Labyrinths have long been used as meditation and prayer tools.,particularly as an instrument of change or transformation The Rosary,, using Rosary beads refers to a form of prayer used in the Catholic Church and to the string of knots or beads used to count the component prayers. A mantra is a sacred utterance or group of words said in Sanskrit using a Mala bead necklace and is believed by practitioners to have religious or spiritual powers. A novena is an ancient tradition of devotional praying in Christianity, consisting of intentional prayers repeated for nine successive days or weeks. Positive affirmations are phrases that you repeat to yourself, which describe a specific positive outcome or who you want to be. At first, these affirmations might not be true, but with constant repetition, your subconscious mind will start to believe them.
- MBSR is offered in medical centers, clinics, and hospitals across the United States and abroad and consists of a 2.5-hour/week, 8-week course with a 1-day retreat. Participants receive training in formal mindfulness meditation techniques, including a body-scan meditation, a sitting meditation, and gentle Hatha yoga involving simple stretches and postures. The primary focus of the program is on the progressive development of mindful-awareness through the practice of mindfulness meditation.
- Here’s how to tune into mindfulness throughout your day: Set aside some time. You don’t need a meditation cushion or bench, or any sort of special equipment to access your mindfulness skills—but you do need to set aside some time and space. *If you have a BP cuff or know how to manually check your heart rate, in addition to checking your current BG by scan or fingerstick, you may see some interesting physical responses to meditation by checking these indicators before and after a session! Observe the present moment as it is. The aim of mindfulness is not quieting the mind, or attempting to achieve a state of eternal calm. The goal is simple: we’re aiming to pay attention to the present moment, without judgment. Easier said than done, we know. *Sitting or laying comfortably, Place your left hand on your lower abdomen and your right hand on your upper chest, allow your eyes to gaze down or gently close and lightly press your tongue to the roof of your mouth with your mouth slightly opened…… Let your judgments roll by. When we notice judgments arise during our practice, we can make a mental note of them, and let them pass. Try to resist wondering if you are doing this 3 part breath practice “right” or “wrong” and acknowledge this is a practice… it takes time to evolve into it! Breathing in through your nose slowly for a count of 3, inhale your breath deep into your belly and note your left hand raising, pause…..then release that belly breath even more slowly to a count of 6, feeling your hand drop and gently pull your abdominal muscles in to fully expel the breath Now belly thenlungs Now belly, lungs then upper chest or clavicle area Notice when your mind wanders from your breath. Inevitably, your attention will leave the breath and wander to other places. Don’t worry. There’s no need to block or eliminate thinking. When you notice your mind wandering gently return your attention to the breath. Be kind to your wandering mind. Don’t judge yourself for whatever thoughts crop up, just practice recognizing when your mind has wandered off, and gently bring it back. That’s the practice. It’s often been said that it’s very simple, but it’s not necessarily easy. The work is to just keep doing it. Results will accrue.
- It can also help you live with diabetes more fully. By developing an accepting attitude and fuller awareness of how your life and the management of your diabetes interact, you can learn to respond thoughtfully, rather than just react, when challenging situations arise.
- There are a few different things that come together when you meditate, practice self-hypnosis, or simply enjoy a few moments of quiet mindfulness:
- On YouTube, hear testimonials from people with diabetes who participated in this study
- Mindfulness is portable, self-sustainable and has positive effects even with limited regular “dosing” •Can help individualize diabetes care and support