Ever feel like you're making the same New Year's Resolution over and over and over again? I know I do. I have several changes in my life that I'm planning to make this year, but the No. 1 thing on my Diabetes List is logging my blood sugars.
I feel like a broken record! Wasn't I just talking about this a few weeks ago? Don't we spend loads of time here at the 'Mine talking about all the shiny new apps I could download on my iPhone? Haven't I had diabetes for going on 18 years?! Making New Year's Resolutions is the easy part; it's sticking with them that's hard. In fact, I make the "New Year's Resolution" of logging my blood sugar at least 48 times during the year. And yet somehow it never sticks.
Why is that? I just had to do some research into why I seem to be "failing" all the time...
It's all part of the puzzling process called behavioral change. When it comes to changing health habits for better outcomes, you would think that simply knowing something would make you a healthier person would be enough. A common belief is that having a good motivation is enough to make and maintain a behavior change. But unfortunately that's not the case at all, as illustrated by the Stanford Tech Lab in their humorous slideshow presentation on the Top 10 Mistakes in Behavior Change. Relying on "motivation" and "willpower" appears to be the No. 1 mistake people make!
Instead, Stanford's suggestions for making meaningful, lasting change is focusing on small, incremental changes within a fixed time period. Makes perfect sense. After all, the idea of doing anything forever is daunting, even when you know it's something you should do. Instead, creating a plan of action that involves doing something for a fixed period of time can help you "get into a habit" without feeling like it's a life sentence. There's really no scientific proof that a certain period of time develops a habit, but in general, most experts suggest three to four weeks of commitment before a habit starts to form.
Zen Habits, a terrific blog dedicated to sharing simple "lifehacks" for living better and happier, has a great list of suggestions for how to either incorporate a new habit or replace an old one. The first suggestion is: Do one habit at a time. This is crucial, I believe, for people with diabetes. So often I see folks in the diabetes community who want to lose weight or lower their A1c, but there are multiple components to each of those goals and it can be overwhelming to try to do all of them all at once.
Last Spring, when I lost 15 pounds before my wedding, I did it by calorie counting. That's it. If I found time to exercise, that was great, and I didn't even focus on changing my eating habits explicitly. I just counted calories... and everything else kind of followed along.
Another suggestion offered by the Zen blog: Write down your obstacles. Wow — where to start?! Distraction with work / life, not having access to the tools / technologies when you need them, and worst of all, mental stumbling blocks, like burnout and depression. But if you can define your own challenges, only then can you begin to find ways to work around or work with those issues so you can still accomplish your goals.
One of the things I most enjoy about being part of the diabetes community is the constant support and frequent suggestions that we give each other. Turns out, support is a crucial component to behavior change. D-journalist Riva Greenberg recently interviewed Dr. Michele Heisler, a research scientist focused on giving people with chronic illness the flexible, long-term support they need. She was involved in several studies on the concept of peer mentoring in behavior change. In one study, a group of type 2 patients were paired with other type 2 patients of similar backgrounds, and the study showed that those who worked with a peer mentor had an A1c about one percent lower than those just working with a nurse practitioner.
"Patients who aren't on insulin often have a lot of fear about it, that it's going to be this horrible thing. But when patients in the partner group heard from a fellow patient, 'Oh, it's only one shot a day, it's actually not so bad,' that carried a lot of weight. More weight than their doctor haranguing or threatening them with what would happen if they didn't start insulin," Dr. Heisler explained. (This is old news to us DOC'ers, right?)
Not only can peer support be encouraging for people who need to start or stop a habit (like smoking), it can also be helpful just to have public accountability. And of course, it's great to have someone to pat you on the back and say, "Good job!" We often don't see our endocrinologists or diabetes educators more than a few times a year, so it can be difficult to self-motivate at home.
Although it's January 3, I'm still working out details on my plan for becoming a better blood sugar logger. I know that if I can get a handle on writing down all my information (or uploading it, or organizing it, or whatever I decide!) I'll be in a better position for wrangling in my blood sugars. What I've learned from writing this post is that I could really use some community support as I take these baby steps. Because trying to make big changes, all on my own, clearly isn't a recipe for success.
What are your New Year's Resolutions for this year? And what strategies are you using for making sure your "behavior change" sticks? I'd love a little DOC peer mentoring right now!