Reviewed by Robert Ehrman, MD

Dave was recently diagnosed with type 2 diabetes. He was shocked because, as far as he knew, his blood glucose had always been normal, and he didn’t have anyone in his family with diabetes. Dave’s doctor referred him for diabetes education. That’s when Dave met his diabetes educator. He attended the diabetes education program with his wife. Together, the three of them designed a plan that made sense to Dave, one that he could live with—or so he thought.

Dave hadn’t been very active. He is a lawyer and spends a lot of time sitting down, both at work and at home. At first, he said he would think about increasing his activity. He said he would get up to change the television channels instead of using the remote control and would get up to get things he needed rather than asking someone else to get them.

When it came time to learn about checking his blood glucose, though, he couldn’t imagine sticking his fingers with a needle. The educator suggested he get a blood glucose monitor that would let him check his blood glucose from his forearm. He explained to Dave that he must test on his fingers when his blood glucose is rapidly changing, such as following a meal, insulin dose or physical activity. Dave also learned that if his blood glucose is low, it is very important to do a fingertip test, because it will show the low blood glucose level sooner. He then agreed to check his blood glucose twice a day at different times.

Dave came for his follow up visits. For the first two months, Dave met the goals of his plan. He had even lost 15 pounds. He felt good enough to start taking a daily walk. His blood glucose levels were all normal. Dave appeared to be a success story. He was doing all the “right” things. He then set up his three-month follow-up diabetes education appointment.

The Plan Gets a Wrinkle

Dave returned as scheduled. He had gained nearly all of the weight back. He was not following his eating plan, and he wasn’t taking daily walks. Once he ran out of his blood glucose strips, he didn’t buy more, so he wasn’t checking his blood glucose either. What happened?

When Dave was first diagnosed with diabetes, he had been overweight for more than 25 years. With a busy practice, he hadn’t taken care of his health. His wife took care of the family and household, which included Dave and his health.

Dave’s story is not unusual. Here is someone who for many years had not made healthy choices. He was successful in his profession and, as far as he was concerned, he was doing just fine. He didn’t think he was overweight for his age, and he couldn’t see how he was going to fit activity into his busy life.

Taking responsibility

Dave is now taking care of his diabetes more successfully. He decided that he wanted to lose one pound per week. To his educator, that meant he finally understood the need to make lifestyle changes one at a time in order for them to stick. He was being realistic with his goal. When he was first diagnosed with diabetes, he had tried to make too many changes all at once. This usually doesn’t work over the long term.

Dave has kept his word and has lost an average of one pound per week over the last year. How did he do it? First, he found a reason to change. He realized his old ways wouldn’t keep him healthy into his retirement years. Now, he is taking charge of his own health. He has cut back on his food portions and is more active physically. He checks his blood glucose regularly. And he won’t go back to his old ways because he knows he can’t.

have a realistic plan.

How about you? Have you given up because you thought you had to do everything all at once, just to be overwhelmed by the huge number of changes you had to make? You might try Dave’s second approach. Choose one thing at a time to work on. When you feel comfortable about the changes you’ve made in one area, pick another area. Give each change time to become part of your new way of life before you move on to the next change. Remember, small steps, one at a time, are what will help you change your unhealthy habits into healthier ones in the long run.