A person living with diabetes will hear the same reactions to what they eat this festive season as in every other: “should you be having that while you’re managing your condition?” Well meaning though such comments may be, the reality is that someone living with diabetes is managing their condition every day of the year.
Come December 25, that’s almost a whole year they’ve already spent closely monitoring how their diet impacts on their diabetes management. Almost a whole year they’ve already spent dealing with potential anxiety arising from their condition. Almost a whole year they’ve already spent counting carbs and balancing medication and exercise. In short: they don’t need telling.
In fact, the festive season is a time for quite the opposite: for celebrating and enjoying spending time with friends and family, without guilt – for once – about eating and drinking the things we like most. Indeed, current diabetes self-management practices actually allow for the flexibility of consuming what you like, when you like, by covering the glucose response with diabetes medications.
That’s because emotional health is just as important as physical health. Research shows a clear link between living with diabetes and experiencing depression and/or anxiety; one study found diabetes will seriously impact on emotional health for as many as half of those who live with the condition. Diabetes UK, meanwhile, found that although 64% of people living with diabetes sometimes or often feel down as a result of their condition, fewer than 25% receive the emotional and psychological support they need.
From a personal perspective as a registered dietitian, every day we screen people for diabetes distress, and we see they’re anxious, often worrying about their actions and how they affect their diabetes management. These worries can completely override other trains of thought and become the person’s only focus – feelings which can be intensified further still at Christmas. It’s completely understandable, and we can work through strategies with each person to reframe this thinking.
Our society is one in which the pressures to be a certain shape and size, year-round, can be everywhere. It’s impressed on us that we must have perfect lives, whilst juggling numerous roles while looking perfect too. The reality, however, is that the festive season can magnify a different reality. Some of the factors causing this are out of our hands and restricting the food we eat and constant worry about the effects of foods are adding to this.
I instead practice a pro-choice, anti-judgment approach. As individuals, we each have choice, and our personal decisions, which may be based on our own health, will dictate our day to day practices. It’s entirely normal to gain a couple of kilos at this time of year, which will change once the festive season has passed as eating and activity practices resume to how they were prior to Christmas. It is more important to focus on what is consumed and diabetes self-management practices for the majority of the year, looking at the bigger picture – not just at Christmas.
Unhelpful fear-mongering by the diet industry and traditional, widespread medical paradigms can intensify a personalised, blaming effect. Without this outside judgement, much of the pressure felt by the person living with diabetes would be reduced.
For some people living with diabetes, January may seem a time for restriction, and the “all or nothing” approach is one almost all of us tend to adopt. But it doesn’t need to be like that either.
Instead, we should look at approaches to diabetes management all year round. We should remember that if for most of the year food choices include lots of vegetables, some lean protein, fibre, plenty of water, some movement/exercise and enough sleep, that’s an achievement in itself. We should know that if the person living with diabetes is doing what they can most of the time, which they almost invariably are, then breaking down the daily tasks is good enough.
So, this festive season: no judgement. No comments on what a person living with diabetes might be eating. It’s the time for every one of us to indulge in what we want to.
Anita Beckwith is a UK Dietitian specialising in diabetes, DAFNE board member and member of the iDEAL group’s multi-disciplinary panel, interested in education, technologies and improving the lives of people with diabetes.