The challenge of change

Rosemary Flynn explains the four changes needed when diagnosed with diabetes.

When you are diagnosed with diabetes, you have to make some important changes in your lifestyle to remain healthy. The main changes will be: to eat differently, to be more active and to take medications (whether they are tablets or injections).

All people find it difficult to change and it usually takes a whole lot of effort to establish the new way of living and thinking. As Einstein said, “We can’t solve our problems with the same thinking we used when we created them.”

So, what changes do you have to make with your thinking?

The first change:

Find out all you can about diabetes and how to apply the treatment you are given. That means you have to both gain knowledge and apply the new knowledge. You will have to unlearn some things and relearn another way to do it.

The second change:

You need to know that although a doctor can support you and prescribe the right treatment, diabetes is a condition that you have to manage on a daily basis, and you will need to practise a lot of ‘self-healing’.

With Type 1 diabetes, you have to figure out how much insulin to take for the meal you are about to eat. You have to know how to test your blood glucose and work out your dose of insulin. You have to know how to treat high or low blood glucose. You have to know how to exercise safely so that you don’t have hypoglycaemia.

With Type 2 diabetes, you have to know what food is good for you and try to stick to those foods. If you are usually a sedentary person, you have to become more active to keep your circulation healthy and reduce your insulin resistance. If you are overweight or obese, you have to make an effort to lose weight. You have to be conscientious about taking your medication.

The doctors and others on your diabetes care team can help and guide you, but you will have to practise these things on your own and take responsibility for managing your diabetes. Diabetes is not a condition where the doctor tells you what the recommended treatment is and fixes it for you. You have to work on your own body on a daily basis, making decisions that will keep your body as healthy as possible. You can’t just live from a previous appointment to the next appointment to care for yourself.

The third change:

This change, you need to make, is in your attitude towards having a chronic condition. You have to move onwards from the disappointment and distress of having diabetes, to accepting it and learning to work with it. Then, you will develop the right attitude towards it which will enable to manage it successfully.

The fourth change:

Develop a working relationship with your doctor, so that you feel free to discuss your pitfalls and problems without feeling judged or criticised.

If your doctor does too much, you will not do enough. If your doctor is too critical or judgemental about your control, listen to what he/she is criticising. If he/she is right, work on the first three changes and try to achieve better control. If he/she is wrong or does not understand your situation, or involve you in decision making, tell him/her the truth about the matter. If he/she remains critical and judgemental after you have addressed the situation, change doctors, but remember that ultimately, you are your own best doctor.

Changes worth making

It can take many months to feel comfortable with the new lifestyle, and you will be able to develop internal motivation to continue your new lifestyle. You will feel less distressed about your diabetes and you will be able to act on your knowledge to manage well even in difficult times. There may be occasions when you feel like giving up, but these will become fewer as you become more resilient and able.

Success feels good and when you feel healthy, you feel good. Now you are ready to develop a new appreciation for life and your purpose in it. It really is worth making the changes!

Rosemary Flynn


Rosemary Flynn is a clinical psychologist at the Centre for Diabetes in Johannesburg. She has worked with children, families and adults with diabetes for 24 years, enabling them to overcome their anxieties about their condition and to deal with the difficult events in their lives.