Diabetes is a complicated illness to live with and even more burdensome to explain. Issues that loved ones have trouble understanding are vast and complex. So complex that is not possible to address all of them in one blog. Over the next few blogs, we will look at some of the most common ones that tend to come up when working with clients and their families during Diabetes-Focused Psychotherapy.
Not all misunderstandings are related to the actions of someone living with diabetes, but unrealistic perceptions from loved ones. Who believe if you follow the rules of management your blood sugars will always be in control.
Some of the misunderstandings are related to the conduct of those living with diabetes. Those not living with diabetes may not understand someone forgetting to take insulin, because they believe it wouldn’t happen to them, if they lived with diabetes. Most behaviors in question seem irrational and illogical to most people.
The truth is most individuals living with diabetes may not understand why they do these actions. Misunderstood behaviors like deliberately keeping one’s blood sugars high or not counting one’s carbohydrates are more complex than they appear. Today we will focus on forgetting, to do things that are needed to manage one’s diabetes.
It’s hard for loved ones to comprehend how people with diabetes could not remember to give a shot or checked their blood sugar. It’s true everyone forgets from time to time without the complications of diabetes. Depending on the individuals’ overall makeup, they may forget once a week, once a day, or several times a day. Whether it’s a doctor’s appointment, running the dishwasher, going to the gas station, grabbing the keys as you head out the door, and on and on and on. The list is endless, and that is without the cognitive complications that people with diabetes face every day.
Well, ask yourself how do you forget a phone number as you walk from one end of the room to the other? Just to have to go back and look it up again. Or how you, forget someone’s name seconds after they tell you.
The culprit is the short-term memory. Most people think that short-term memory lasts 20 minutes, but it only lasts a few seconds. To remember longer, you may have to repeat the information several times in your head and send the information to long-term memory.
Think about this, you just remembered to give your insulin but the phone rings, you pick up the phone, and the distractions begin. After a long conversation, your blood sugar is now in the high range and the self-blame starts. If that wasn’t bad enough, the very person who called, might be the one who comes home to argue with you, about not recalling to give yourself insulin. Oh, the irony!
For loved ones reading this, just think about all the things you’re about to do but forgot because you picked up the phone to talk or text someone. The importance of the task at hand can play a minor role in whether information exits the short-term memory to actual retention. There are many internal and external distractions every day that interferes with one’s ability to remember. For example, in a home that is filled with lots commotion, forgetting is more frequent, than in a household that is calm and orderly.
Surroundings play a huge role in one’s ability to remember which diminishes as distractions are increased. Even the most stable and responsible person or child can forget to take care of themselves in a household that is full of drama. It is important to understand how one’s environment influences memory.
Short-term memory holds small portions of information active and ready for use for only a few seconds. The average length of time short-term memory is available is about 15 to 18 seconds, but many things can effect the duration of time. Everything from the external surrounding to internal conditions (your mind and body) will impact the amount of time information is available.
Cognitive surroundings that influence memory are emotions, mental health issues, shifting blood sugars, and high or low blood sugars. These affect the minds ability to retain information.
High blood sugar levels slow the mind down while hindering the synapses from firing correctly. As blood sugar levels increase, the ability to retain or retrieve memory reduces. Therefore, blood sugar at 300mg/dL will cause increased levels of forgetfulness. A person can get used to living at high levels and may not be aware of the cognitive impact till they bring their blood sugars in control.
Low blood sugars have a similar effect on memory retention but speed the mind up causing synapses to fire rapidly and in turn causes an inability to focus. In either state, it is difficult or next to impossible to hold on to information. It can reduce the active retention of information from 18 seconds to less than a second; creating forgetfulness and causing missed blood test or shots when you are trying hard to manage diabetes.
There are some who don’t care whether their blood sugars are managed well, but for most, the task to manage is a difficult one. If you are having trouble managing due to forgetfulness, try not to beat yourself up over it, as diabetes causes forgetfulness from time to time regardless of how good your control is.
If you are struggling with diabetes management and forgetfulness, please seek out a CDE or mental health professional to help you regain control and increase your ability to remember.
Eliot LeBow, LCSW, CDE, is a diabetes-focused psychotherapist. His private practice, located in New York City and is also available via Skype. LeBow, who has been living with type 1 diabetes since 1977, treats the many diverse cognitive, behavioral, and emotional needs of people living with type 1 and type 2 diabetes.
All the advice included in this blog is therapeutic in nature and should not be considered medical advice. Before making any changes to your diabetes maintenance program, please consult with your primary physician or endocrinologist.