03/08/2017
https://www.facebook.com/sugarsurfing/posts/1392768170801508
PUNITIVE DIABETES PARENTING LIVES...
After the creation of blood sugar meters and the A1C test in the late 1970's, the way diabetes was managed at home shifted in a slow and somewhat subversive way. Let me explain.
A number of years ago a diabetes camper shared that he often got spanked for high blood sugars by his parents. I never forgot this. After hearing first hand of the dark side of diabetes numbers in this shocking revelation, my approach to teaching d-families (especially new families) forever changed.
When I was a d-child, the measures of diabetes control were expressed in colors. It's harder to equate brown or orange from a urine test kit as good or bad. My folks and I were largely spared the pressure of numerical self-condemnation.
When teaching pattern management of blood sugars, I like to emphasize how blood sugars can be steered, but never forced. I share with parents that I can't "will" my blood sugar to be a specific value. I'm a diabetes specialist who has lived with the condition for half a century and I can't do this, so why should I expect others to live up to this unrealistic standard.
It's one reason I created Sugar Surfing. Dynamic Diabetes Management allows me to steer the direction of flow of my CGM trendline but it cannot pinpoint a BG value, at least not for very long.
Recently one of my CDE colleagues shared a similar story about parents punishing their d-children for out of range numbers: either blood sugars or A1C results. But rather than outright physical contact, now the punishments are actions like grounding, loss of privileges, basic, or withholding common childhood or teen freedoms.
Should I be surprised? Probably not. After all, parents themselves tend to look at these values as reflections on their abilities as an effective d-parent. An A1C value higher than a prior visit, even if only by a tenth of a point, is followed by what often sounds like an apology wrapped in a variety of explanations (my child was recently ill; was away from home for a few weeks; stayed with grandparents over the summer, etc...). And my brethren in the medical profession often seem to behave as judge and jury towards the parents and family.
There should be no need to apologize for BG numbers. That's because they should possess no moral weight. BG data are simply guideposts (as blood sugars) or backward reflections of past BG control (the A1C) collected along the path of one's journey towards glycemic self-efficacy.
Internalizing these BG data and equating them, even in the smallest of ways, to one's self worth as a patient or a parent is a slippery slope to shame, self condemnation and emotional abuse. And as above, it can devolve into outright parental bullying and self-righteous judgment by the very loved ones we depend upon to combat this condition with us each day.
My moral is this: don't use the words "good" or "bad" in the same sentence with a blood sugar value or A1C. No one can "will" these values into being what you want. Diabetes self care is a series of choices, wrapped in hard work, and baked in the oven of experience. But it's a job which never ends. The diabetes genie does not reside in a bottle. She/he exists in the mind: your decisions and choices.
We are too likely to punish ourselves and our d-children because of their numbers. And while physical punishment and retaliation is thankfully rare, it still exists. Emotional abuse can insinuate itself into our lives in the most innocent of ways.
By far, most of our punitive actions reside in the realm of our emotions and attitudes towards each other. Disappointment is a powerful weapon which can be used to deeply cut into a loved one's self esteem. Blame and shame are disappointment's next door neighbors.
Share this post freely. Think about this message today. Take this week to make a fresh start with how you and your loved ones with diabetes interact. You will add years to each other's lives in my opinion.
