Time to get SMART, set goals addressing diabetes
Diabetes takes a disproportional interest in the minority community and one Baton Rouge area mental health professional thinks it’s time for the community to return that interest with deliberate game plans aimed at limiting the devastation caused by this chronic-disease killer.Charles Martin, Capital City Health Center director of behavior health, has both professional and personal viewpoints regarding the challenges of diabetes. His parents and grandparents were insulin-dependent and he is recovering from a diabetes-related limb amputation. Even when the challenges seem great, Martin invokes the daily prescription of NFL coach Chip Kelly: Win the day.
Instead of simply resolving to turn the tide on diabetes, Martin encourages another tactic: Goal setting.
“We people living with diabetes may have the fear that we will be gun-ho in January with everyone else making New Year’s resolutions,” Martin said. “But then, are we going to burn ourselves out?”
“We start fast and we fizz quickly, but it goes back to Chip Kelly and that motto ‘Win the day.’ We are just going to take it one day at a time. It goes back to this attitude that this is something that we have to do daily. When we think about renewing the mind, we should be reminded that our prayers ask ‘give us this day, our DAILY bread.’”
Martin encourages the ‘attitude of daily’ as a tool in diabetes management. “We must remember that we are consistently inconsistent,” he said. “The goal is to be consistently consistent. To do that, we must take it one day at a time and try to max out that day.”
This deadly opponent packs a daunting record against Blacks who are greatly disproportionately affected by diabetes. More than 13 percent of all Blacks above the age of 20 are living with diabetes. In addition, Blacks are 1.7 times more likely to have diabetes as non-Hispanic whites.
Diabetes is one disease that can spawn serious complications or makes a person susceptible to related conditions. Blacks are significantly more likely to suffer from the diabetes complications of blindness, kidney disease and amputations.
No matter how great the challenge, Martin said setting goals helps properly address the fear. “A goal is just a tool to put you to work,” he said. “It puts me in charge!”
Good health is important, but it will not just happen. SMART Goals provide a road map to success because those goals are Smart, Measurable, Attainable, Realistic and Timely.
If you want to accomplish a task, you set a plan, you set deadlines and you take action. Most people are familiar with SMART goals in the workplace, but they also apply to health. For example, let’s say you wanted to an A1C of 7.5, but your level is now 11. It would be unrealistic to say you wanted reduce your A1C to 11 in next month. It would be more realistic to set up a SMART goal:
• Specific – I will decrease my average fasting blood sugar by 2 points each week.
• Measureable – I will keep track of blood sugar levels three times daily so I can track my
progress towards my goal.
• Attainable – Is the goal attainable for me? Your diabetes care team should be consulted about ways to reduce your A1C and risk of complications.
• Realistic – Is the goal realistic for me? Lowering one’s blood sugar is a great goal, but drastic drops can increase changes of hyperglycemia.
• Timely – I will make an appointment with my care team every three months in 2016 to evaluate my A1C with hopes to start 2017 near 7.5.
Other goals that will impact blood sugar control include getting regular and sufficient exercise, gaining or losing weight, following a diabetes nutrition plan, and being more compliant to medication schedules.
Diabetes is associated with an increased risk for a number of serious, sometimes life-threatening complications in minority communities. Good diabetes management, however, can help reduce risks, but many people are not aware that they have diabetes until they develop one of its complications.
Martin warns that even those with the best goal-related intentions can face the obstacles of anxiety and depression. Anxiety can feed the overwhelming fear of failing to control one’s diabetes. “It is the fear that I’m not going to reach my goal so I stop before I even get started,” he said.
It is important to know the warning signs of depression and plan ahead to combat it. “Exercise does help with depression,” Martin said. “Take a walk. If you are bound to the inside, use can goods to do arm curls. You will feel better if you make efforts to get more exercise.”
“We often get so depressed that we isolate ourselves and we don’t have the social connections that we need. If you are aware of the possible pitfalls of depression, you are able to make a plan and incorporate that into your ‘I’m going to win the day.’”
The counselor puts himself in the classroom in which he is teaching. In this calendar year, he will attempt to achieve tighter blood sugar control and with the aid of physical therapy, learn to walk using a prosthetic limb. There will be 365 days in his year, but his mantra will remain “win the day.”
By Frances Y. Spencer
Special to The Drum