I’m sitting on a plane as I write this, on my way home from the third-annual Roche Diabetes Summit: a gathering of leaders and prominent voices from the D.O.C. (Diabetes Online Community). This year, Roche invited us to meet in San Diego, CA.
(In our group photo you will find: Gretchen Becker, Jeff Hitchcock, Kelly Close, Leighann Calentine, Karmel Allison, Ginger Vieira, Kerri Morrone Sparling, Karen Graffeo, Elizabeth Edelman, Brandy Barnes, Sarah Jane Blacksher, Allison Blass, Gina Capone, Kitty Castellini, Charlie Cherry, Beatriz Dominguez, Will Dubois, Bennet Dunlap, Mike Durbin, Bernard Farrell, Riva Greenberg, Manny Hernandez, Michael Hoskins, Scott Johnson, Scott King, Sara Nicastro, Kelly Kunik, Crystal Lane, Ronald Gregory Machio, David Mendosa, Cherise Shockley, George Simmons, Chris Stocker, Scott Strumello, Amy Tenderich, Lee Ann Thill, Christopher Thomas Polack.)
Aside from knowing that if I run out of test-strips, I have 36 friends in the room to borrow a couple of strips from, this summit also provides all of us a chance to hug, talk, and mash our heads together to discuss what the D.O.C. is doing and what we haven’t done yet to further support people living with diabetes.
Our guest speakers included Jeffrey Brewer, President & CEO of the JDRF, Jean Claude Mbanya, President of the International Diabetes Federation, and his associate Isabella Platon. My favorite guest, however, was Dr. William Polonsky, Founder & President of the Behavioral Diabetes Institute.
Dr. Polonsky received his PhD in clinical psychology from Yale University, has served as Chairman of the National Certification Board for Diabetes Educators, Senior Psychologist at the Joslin Diabetes Center in Boston, and Instructor in Psychiatry at Harvard Medical School. He is also, of course, a certified diabetes educator, and author of Diabetes Burnout: What to Do When You Can’t Take it Anymore.
The issue we discussed the deepest? The usually secretive, guilt-ridden, shame-soaked act of taking a “Vacation from Diabetes.”
But wait, let me preface this a bit. You already know that living with diabetes is a 24/7 job. And while we’re supposed to strive on a daily basis for “absolute perfection,” managing this disease is exhausting. As Dr. Polonsky eloquently explained, there are so many daily habits and tasks we’re supposed to take care of and do every day, that there is no way we’re all going to do all of them all the time.
He’s talking about simple things, like measuring portions, counting carbohydrates, dosing insulin carefully, eat the perfect diet, exercising every day, checking your blood sugar before every meal, before you drive, before you sleep, before and during and after you exercise. Changing your lancets. Changing your syringes and pen needles. Changing your infusion site. Using alcohol swabs! (I can’t tell you the last time I used an alcohol swab before taking an insulin injection.) This “Diabetes To-Do List” goes on and on.
Perhaps there are a few mysterious marvels out there that can do it all perfectly. Good for them. But for most of us, it’s too much, and rightly so. We are not diabetic robots…we’re human.
Dr. Polonsky explained that we all make compromises with the tasks and to-dos we can do, while we leave behind other tasks because we simply cannot do them all. Coping with the immense responsibilities and weight on our shoulders that comes with diabetes is exhausting, and that’s where your diabetes “vacation” comes in.
Dr. Polonsky split these vacations into two categories: SAFE & UNSAFE. And yes, we know that both are obviously “unhealthy,” but if your choices are to take NO vacations and eventually breakdown…or take a SAFE vacation, have intentionally break the rules, and then get yourself back into your best version of self-care, then taking a vacation is actually very logical.
An UNSAFE vacation, he explained, can be defined by a variety of things: perhaps it lasts for a long time or is done in a way that would negatively impact our diabetes care in a grand-scale way, like having a higher A1C or overall blood sugar profile. Maybe it puts us at risk for DKA or even death. An UNSAFE vacation is unplanned and out of control. It is ridden with guilt and shame. When it’s over, you don’t actually feel rejuvenated.
A SAFE vacation is different. In the long-term, it doesn’t raise our A1C or threaten the well being of our overall health in a big, big way. It doesn’t put us at risk for DKA or death. It probably lasts a day or a few days. It is usually intentional, planned, and accepted.
In other words, it doesn’t come with any guilt. Instead, we’ve said to ourselves, “Okay, for two days, I am going to eat more carbs and dose more sloppily. I’m going to give myself freedom to not worry about diabetes, to not think so much about diabetes, to just step back and take a break.”
My fellow D.O.C. allies and I went around the room to share our vacation-like coping habits, and Dr. Polonsky shared a few of his patients’ habits as well. Whether or not we all realized our certain habits were actually an intentional attempt at giving ourselves a break from diabetes didn’t matter—we all had our own style of vacation.
Before you balk and scream, “HOW DARE ANYONE SUPPORT SUCH NEGLIGENT BEHAVIOR!!!”…I’ll simply ask you to not bother.
We’re all fully aware that taking a SAFE vacation from diabetes isn’t actually good for our health. But for many of us, that vacation is invaluably important to coping with a life of managing a disease that comes with so many tremendous responsibilities.
I raise my hat to Dr. Polonsky for not demanding perfection from his patients, and for being able to remember that people living with diabetes are not robots. We are not invulnerable to exhaustion. Sometimes, we do start to bend under immense emotional burden and the responsibility of keeping ourselves alive every day. We are human. And sometimes, we need a break from living with a disease that never sleeps.
When someone founds the “D.O.C. Vacation Island,”…I’ll be on the first flight.