Chapter 3

Planning Your Lifestyle

You may already have a plan that allows you to live with diabetes. But it’s likely that you’re reading this book to find a better way to improve and enjoy your health. It is no secret that planning ahead for any endeavor is crucial for success.

Lifestyle is a personal matter. It represents who you are, what you believe in, and what stage of life you are in. So why should you make plans for a new lifestyle? You already know why glucose control should be your goal. You also know that exercise needs to be a part of the process in obtaining the goal. So why don’t you just go on a diet, start an exercise program, lose weight, and control your glucose? I’m sure you already know the answer: It’s easier said than done! To do all of these things, you must make your own plans in your life that will lead to accomplishing your goal.

Understanding the process of what you need to do to accomplish a goal is paramount. For example, say you are the lead planner on a project for a spaceship company. This project’s main goal is to send humans and several tons of cargo to Mars and safely return the people to Earth. Before you actually start to write anything down on paper, you would first think about what you were asked to do. You may consider your qualifications in taking on such an endeavor. You’d concern yourself with whether you had the right resources to take on such a project. This initial process will happen in your mind in a matter of seconds after receiving this task. You will then move on to the second process of organizing a team to help you gather the information to make this endeavor a success. Once you’ve completed the research and gathered the information, you will create a rough draft of a plan to get from Earth to Mars and back. From here, the process of refining the plan occurs, taking thousands of hours, millions of calculations, and hundreds of changes to the plan until the final process of putting the plan into action occurs.

Obviously, creating a lifestyle plan to thrive with diabetes is not nearly as complicated as the plan I just described. I used this example to illustrate the point that planning takes many steps to complete. As in the example, your initial process when you discovered you have diabetes took only seconds. When your doctor told you that your glucose was elevated and that you needed to control it, your immediate thoughts probably were How can I do that? or Can you help me? Your second process of organizing resources and gathering information started when you inquired about what you can do about your diabetes. Your “team” includes you, your health care providers, and your family and friends (see table 3.1). The information-gathering and research process is currently under way—you’re reading this book.

In this chapter I give you the information you need to create a rough plan, a guide to assist you in making personal changes to create a lifestyle conducive to attaining your goals for glucose control through healthy living. The following chapters show you how to refine it until it works for you.

But even before we can create a plan for your new lifestyle, you need to consider the type of lifestyle you have now. Do you have an active lifestyle? What kind of exercise do you do? Can you control your eating habits? Do you feel like food controls you? Is your current lifestyle meeting your life’s goals? Only you can answer these questions. You may already be active with healthy eating habits, but you’d like to know what you can do to optimize your action plan. But if you recognize that you do not have the lifestyle you would like or need, this chapter will help you most.

The accountability that comes from joining an exercise class, such as water aerobics, can help you stay on track with your own program.

Your Current Lifestyle

As I mentioned previously, lifestyle is representative of the choices that you make. So in creating an action plan for diabetes, you must be able to go through the many processes of making healthy choices that will last throughout your lifetime. Honesty is key here. If you know that overeating is your major fault, then admit this to yourself. Do you hate to exercise, or think that you would not enjoy it? Do you know anyone who exercises? These are the types of questions you should ask yourself.

I have created a lifestyle-assessment form (see figure 3.1) that can help you work through this process and identify potential barriers to attaining your ideal lifestyle. There are no right or wrong answers; it is designed to get you to think about your current lifestyle while creating your action plan. A good way to use this form is to fill out the questionnaire portion now, then keep a daily log for two weeks. Then look back at your answers to see whether they correlate to what you thought. By then you will have read this entire book and discovered better ways to eat and exercise, and you’ll be able to apply it to your lifestyle.

Figure 3.1 Lifestyle assessment form.

This is the initial process, such as when the lead planner in the spaceship project thought about her qualifications in taking on such a large endeavor. Ask yourself about your own qualifications to understand what your challenges will be in creating your action plan for diabetes. Start with thinking about what you know about diabetes. If you have read this far into the book, you have more than enough information on what diabetes is and how it can affect you and how you can affect it. This is a considerable amount of information to know about your disease. You know more about your disease process than many others know about their medical problems. You are up to the personal challenges that lie ahead.

The next question to ask yourself, as the spaceship project planner did, is whether you have the right resources to create a successful action plan. Most of the resources that you need are likely already in place. The mere fact that you have been reading this book shows that you have no difficulty finding resources. I’m sure that you’ve spoken with someone who has diabetes or that knows about someone who does. That person along with other family and friends will be your support group and will help you plan your new lifestyle. They may even be a significant part of it.

Recognizing Necessary Changes

Nearly all of us understand that change can be good without coming easy. In fact, some of the most difficult changes we make in our lives can be the most rewarding. I’m sure everyone reading this book has at least one story that validates this point. But sometimes recognizing what you need to change in your life to allow you to succeed can be difficult.

Let’s look at three principles that you must abide by to help you recognize changes you need to make in your lifestyle.

First, if you have type 2 diabetes, then you must do some form of exercise. I’m certain that you understand this point, and I will not belabor it. But I will cover some helpful ways to incorporate exercise into your life without losing balance.

Second, you must control your food consumption. Easy to do? Absolutely not, but in chapter 5, I’ll discuss ways to overcome this often- difficult obstacle.

Third, you must allow yourself to make mistakes. But more important, you must learn from your mistakes. Just as the spaceship project planner performs the thousands of calculations to refine her plan, this is the process that will help you refine your plan for a healthy lifestyle.

To ensure success, your lifestyle plan must incorporate these three principles. (The following chapters discuss these issues in more detail.)

Defining Your Lifestyle

Everyone has different needs and different likes and dislikes. But diabetes can affect everyone in very similar ways, and this is what gives all people with the disease a common thread when developing an action plan for diabetes.

Some of us like to run for exercise, whereas others prefer swimming. These are two very different activities, yet they both can contribute to treating diabetes. The point is that you need to do some form of exercise and, more important, it should be exercise that you enjoy doing and that you can realistically incorporate into your daily life. If you choose an exercise now and it later becomes problematic for you, whether you become bored with it or you are unable to physically do it because of an injury, do not be afraid to change it.

The same principle applies to your eating habits. For example, if you’re not a vegetarian and you never found a reason to be, then don’t become one. Many people, including myself, who know that they need change in their lives will try to adopt the lifestyle of someone else. At first it seems like a good idea, but when they finally realize that they have their own needs, desires, and tastes that conflict with that person’s needs, desires, and tastes, it does not seem like such a wise choice.

When I was a medical student I felt the need to make a change in my lifestyle. I was somewhat overweight and had not done any significant exercise for at least two years. A friend and classmate of mine was a vegetarian and very fit. He would always find time to work out and was very energetic. As most of us would do, I compared myself to him and this motivated me to become healthy. I thought I could emulate what my friend was doing, so I became a vegetarian and started working out. My only problem was that I like to eat meat. So, needless to say, this only lasted a couple of days.

My point is that you cannot substitute someone else’s personal choices for your own if those specific choices do not fit your personality and individual situation. If you do this, you will likely fail sooner than later. But you can look at what actions are successful for other people, and adopt the aspects that fit your own personality and incorporate them into your lifestyle. Simply put, you should create a lifestyle that will meet your health goals based on choices that are compatible with you.

Three Principles of a Healthy Lifestyle

1. I must exercise.

2. I must control food consumption.

3. I must learn from mistakes to improve my action plan for diabetes.

Setting Goals

When thinking about setting goals in life, you typically take a look first at what you would like to accomplish in the distant future. Then you look at what you need to do now to reach your ultimate goal. We create the building blocks, or short-term goals, that you can stack together to realize a long-term goal. I recommend doing the same when setting goals for your health.

Take a look at where you are in regard to health status, and then think about where you would ultimately like to be. For example, Kathy, whom we will discuss in chapter 6, is an overweight person who has recently been diagnosed with type 2 diabetes. She is not on a diet or exercise program. Her ultimate goal is to lose weight, become an active person who competes in charity runs, and avoid having to take medication to control her glucose. Obviously, without training for the charity run, she will likely not succeed in the race. So her short-term goal (building block) will be to start an exercise program slowly and safely. As a result of learning how to improve her eating habits, she will start to lose weight. Then when Kathy’s fitness level improves she will begin to train for her race. Her goal of not taking medication will be in line with increasing her insulin sensitivity through exercise. She has to realize what her long-term goals are and then set up a plan or a series of short-term goals to achieve these ultimate goals.

You may have a long-term goal similar to Kathy’s, and you may have more or less detailed goals. But exercise and diet goals all have similar results—glucose control. Take a moment to consider your three most important long-term goals. Using table 3.2 as an example, write them down on the chart provided in table 3.3. Then think of the short-term goals, starting with an easily attainable goal (level 1) and working your way up to a more specific short-term goal (level 4), which you can add together to achieve your long-term goal.

Changing Your Perspective

How many times have your heard someone say in conversation, “Well, look at it this way . . .,” and found that their words gave you a new and sensible perspective on an issue? I have been in many of these situations, and I have been able to come up with many solutions to problems as a result. I would like to offer you a different way to look at how you can go about planning for a healthier lifestyle.

We all know that we have existed in the past, and all that we have done in the past affects us in the present. And the things we do in the present will come to pass and therefore affect our futures. Although this sounds obvious, we often question how things have evolved that have led to our current situation, without taking into account our past actions. For instance, we may ask, “How did my health get so out of hand?” Some of my patients gain insight into their own situation by thinking about their lives in this way. I ask them to think of themselves as three different people: their past, present, and future persons.

Your Past Person

It’s likely that your past person is directly responsible for your current condition. This past person is not changeable; what that person has done has already taken place, but the results of what that person did may not have fully come to pass. For instance, if you had not been exercising and eating well, then you likely have gained weight and may have a poor lipid profile or other related problems. But as I explain in detail in this book, these situations are changeable. If your current person acts to eliminate the problems caused by past behaviors, your future person will not suffer the consequences.

Your Present Person

This is the person who has created your past and perpetually waits to live your future; it is your master person. Recognize that what you do today will in some form affect your present person tomorrow. So your expectations of your action plan should be based on your present person. Use this book to gain a better understanding of how diabetes has affected your past person and how it will affect your future person if your present person does not change. From this, create your plan to make changes in your current actions and habits, and carry that into your future.

Your Future Person

Your future is really now, and the same will be true tomorrow as well. I am sure that you have heard similar statements, and you may find them cliché. But think about this in this way: We are creatures of time and cannot really experience our “true” future because we will always live our lives in the present. However, we can think of our futures as change in our present lives. Currently you may not be there; you may see changes that need to take place. Use this book to help you make changes now that will positively affect you later.

I hope this way of thinking helps you gain a new perspective on the control you have over your life, as it has for me and some of my patients.

Action Plan:

Planning Your Lifestyle

• Use the Lifestyle Assessment Form to get an idea of your attitudes toward exercise and eating.

• Monitor your exercise and eating habits daily for two weeks and record your findings on the form.

• Recognize where you need to change in the areas of exercise and diet, and customize these changes to fit your needs, likes, and dislikes (for example, what exercise do you like to do?).

• Find or acquire the resources and support group to help you stay informed about diabetes.

• Set specific and measurable goals for improving your exercise level and diet.

• Gain a new perspective on how change occurs in your life by recognizing your past, present, and future persons.