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Taming the perfectionist: a helpful approach to diabetes control

We all know there’s no such thing as a perfect diabetic… So why is it so hard to accept that? Let’s talk about being a perfectionist with diabetes.

perfectionist with diabetes

In our 2021 Diabetes Journal, sponsored by Abbott FreeStyle Libre, we talked about how hard it can be to be a perfectionist with diabetes – particularly Type 1 diabetes. Of course, the same can be said for Type 2 diabetes. (Here’s a reminder of the difference between the two!)

Living with Type 1 – and Type 2 – diabetes

When you explain Type 1 diabetes to someone who knows nothing about it, it seems like a superhuman feat just to get through each day. You have to inject insulin every single time you eat? You need to check your blood glucose and figure out how much insulin to take all by yourself? If you dose wrong you could end up in a coma or with long-term complications? You’re a superhero! Yes, you are.

And yet so many Type 1 diabetics beat themselves up for blood glucose that’s out of range. A high reading can ruin your mood, a low reading can mess up your day. Even though all you’re doing is calculating – and possibly miscalculating – it somehow seems personal when it’s blood glucose. What is this perfectionist tendency about, and how can we deal with it? We asked Type 1 diabetic and clinical psychologist Daniel Sher to share some insights.

Living with Type 1

The thing about living with Type 1 diabetes is that you can apply everything that you know, but that isn’t always going to work. “Expect the unexpected” is the only thing to count on. 

It’s helpful to look at perfectionism as a personality trait, not a symptom. It’s part of who you are. The goal isn’t to eliminate or treat perfectionism, it’s to embrace it and work with it – to channel it in a constructive way.

Ask yourself: How can I enhance the positives and reduce the negatives?

Daniel Sher, Clinical Psychologist

Perfectionism can be incredibly valuable, it keeps you motivated and driven. But if it’s severe or critical, it’s going to pick up on those moments when you can’t be perfect and create emotions that aren’t helpful – shame, guilt, frustration, worry. A perfectionist with diabetes isn’t always a good combination.

Make friends with your perfectionism

What can be helpful is to look at the tendency to want to be perfect, understand where it comes from and befriend it. Decide which aspects work and which don’t.

If you’re beating yourself up about blood glucose that’s out of range, that’s not helpful. (Here’s an explanation of time in range, if you need it.) If you’re feeling guilt or shame over out-of-target readings, and then throw some more guilt and shame on top of that because you know you shouldn’t be so hard on yourself, you can quickly find yourself in a negative spiral. What can help? A dose of mindfulness.

Accepting the emotions

When you identify the emotion that comes up (frustration at unexpected readings, guilt from eating the wrong thing or not taking insulin, anger at having diabetes), you can recognise that the emotion doesn’t arise directly from the situation (high blood glucose). There’s a hidden thought between the number (high) and the outcome (upset).

It can be just below the surface of awareness – the voice inside that is making you feel upset. Perhaps it’s saying things like, “You never get this right, you’re a bad diabetic, you should know how to do this by now.” None of that is true – and on some level, you know and understand that. But the first step is becoming aware of the thoughts.

Perfectionist with diabetes

Nobody is the perfect diabetic. If you were the perfect diabetic, you wouldn’t have diabetes. The idea of a perfect diabetic is a myth, it’s never going to happen. What can help is accepting that nobody has this figured out… It’s not like there’s a group of people living with Type 1 diabetes who never have to think about it (we promise!)

Changing what you can

There are some things you can change about living with Type 1 diabetes (what you eat, your medication, how much you exercise, for example) and some things you can’t (all the other factors that influence your blood glucose on a daily basis!) The goal is to notice when you are feeling upset by your diabetes, change the things you can, and accept the things you can’t. This is much easier said than done…

If you find perfectionist tendencies creeping in, take a deep breath. Notice the feeling, notice the thought behind it, try not to judge.

Daniel Sher, Clinical Psychologist

Imagine you had a dear friend going through the same thing, what would you say? When you’re in a mindful state like this, you’re simply noticing without judging. If you can do that to your blood glucose level, to your thoughts and emotions, that’s going to result in a much healthier, happier approach to diabetes control. 

What about you – are you a perfectionist with diabetes? Do you have any tips to share?

What to read next?

Time in target: what it is, why it’s important, and how it can help: Understand the new measure that’s more helpful than the HbA1c.

What is a CGM? Flash glucose monitoring and CGM: Not sure what the difference is, or what these words mean? Read this article.

Gillian Fraser: my journey with Type 1 diabetes: Gillian tells us about her diagnosis, her attitude towards diabetes, and the tech that changed her life.

Photo by Jonathan Hoxmark on Unsplash

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Sweet Life is a registered NPO/PBO (220-984) with a single goal: to improve diabetes in South Africa. We are funded by sponsorships and donations from aligned companies and organisations who believe in our work. We only share information that we believe benefits our community. While some of this information is linked to specific brands, it is not an official endorsement of that brand. We believe in empowering people with diabetes to make the best decisions they can, to live a healthy, happy life with diabetes.