
- With Mayo Clinic diabetes educators
Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
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Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
Nancy Klobassa Davidson and Peggy Moreland
Nancy Klobassa Davidson, R.N., B.S.N, C.D.E
Nancy Klobassa Davidson is a registered nurse who has worked in diabetes education for 17 years. She is a certified diabetes educator (C.D.E.) and is currently in graduate school working on a Master of Science in nursing (M.S.N.) and health care education.Nancy works with adults who have type 1, type 2 and other forms of diabetes. Nancy is coordinator of the Diabetes Unit's intensive insulin therapy program within the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn. Nancy has worked extensively with insulin pump therapy and continuous interstitial glucose sensing.
Peggy Moreland, R.N., M.S.N.
Peggy Moreland is a certified diabetes educator (C.D.E.) in the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn.Peggy graduated with a Master of Science in Nursing and Health Care Education from the University of Phoenix and is a member of the American Association of Diabetes Educators and the American Diabetes Association. A certified diabetes educator (C.D.E.), Peggy enjoys working with patients to set and achieve diabetes self-management goals.
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Living with diabetes blog
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Sept. 21, 2010
Diabetes and procrastination — Not a good combination
By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
I know the things I ought to do but I sometimes put off doing them: testing blood glucoses, giving meal insulin boluses, counting carbohydrates, exercising, recording blood glucoses in my record book, foot care, getting to doctor appointments, and the list goes on. To procrastinate or not to procrastinate, that is the question.
An article by Rick Warren, who writes about faith and a purpose-driven life, describes five common reasons for procrastination. These reasons seem to apply to most situations in life, including diabetes management:
- Fear: Have you ever been afraid to go to your doctor's appointment because you knew that your diabetes control was poor and you didn't want to know your A1C results? Or perhaps you knew you were developing a complication like numbness in your feet but tried to put it out of your mind.
- Indecision: Should you start insulin? Should you go on an insulin pump? Should you attend the diabetes education class? It can all feel overwhelming.
- Perfectionism: Do you tell yourself that you're not going to the doctor until you get your blood glucose under perfect control? You will wait a long time if you want perfect blood glucoses — it's just not part of the balancing act of diabetes management.
- Anger: Delay can be a form of anger. Maybe you don't want to do what your health providers recommended because you don't like being told what to do. Besides, they don't have diabetes, so what do they know?
- Laziness: Ever felt like having diabetes is too much work? You've probably wished that you could be like other people and not have to worry about testing blood glucoses or taking medication. Maybe you've also skipped testing or didn't take your medication, thinking that missing once or twice wouldn't hurt.
Next time you find yourself procrastinating, stop and ask yourself why. Is it one of the above reasons? What are you going to do about it?
Have a wonderful week,
Nancy
24 comments posted
April 11, 2013 9:51 a.m.
Wow, I just read a lot of these posts and some of the people that posted negative comments about Nancy or Rick Warren need an attitude adjustment or just new reading glasses! If you read what Nancy said it was that some OF the reasons we may procrastinated are some OF the same in his article. Whatever happened to just listen take it in keep what you like from it and move on? No one said read this it's EXACTLY how YOU must feel and act! Take a deep breath and just relax! Great article Nancy!
- TB
November 9, 2012 10:41 p.m.
So Rick Warren tells it as he sees it, great! I am SO happy and upbeat at finding the Mayo site. The advise is wonderful, and I don't see why religious ideas should be over reacted to so much. Whether it is faith in a deity or a life style that includes meditation or eastern beliefs, why should anyone undermine anothers coping strategy? We are in it together. What ever works - DO IT! Let me be free to cope my way. Freedom of speech not elimination of others thoughts for me. Rude and grumpy? Go for it. Me positive, glad I am not in the situation my nana was in 40 years ago. Diabetics have never had better chances. Forget self pity and get on with life, after you don't exactly have cancer. Things could be so much worse...
- Gillian
October 5, 2012 1:33 p.m.
It always amazes me how the same folks who go ballistic at the slightest hint of religious reference are the same ones who expect you to listen to their curse words and show tolerance.
- Jim
November 21, 2010 6:45 a.m.
Thank you, Nancy. I am sitting in from of a bag of a variety of vitamin & mineral supplements and happened across this article. I have been a Type II Diabetic for 12 years and now is when I am least under control. For me it is Fear and Perfectionism. I have rescheduled my A1C 3x this year - fear of getting put on insulin. Thank you for keeping it authentic.
- Abby
November 3, 2010 10:31 a.m.
When my 16 teen year old son was diagnosed with type 2 diabetes ..i helped him change everything..he lost weight and did what he had to do. he is no longer on insulin or pills..Now 8 years later i have been diagnosed with typed 2 diabetes and i feel so overwhelmed with all of it.yes i have been procrastinating..for all the reason you have listed. My son is now my coach and helping me stay focus it is a major change in my life ..but one that i plan on getting under control.
- Theresa
October 29, 2010 10:50 a.m.
Nancy, Thank you so much for the article.Every one of them hit the nail on the head for me.Please don't change your way (religious references). It's only through God that I can cope with this disease. I'm surprised by the "anger" that is being displayed about your reference to Rick Warren. I thought you were only using his 5 reasons for procrastinations to show us how common these areas are in every area of life, and yes all of them applied to me at some time or another. I was just so happy to realize that I am "normal"! Perhaps alot of these commentators are showing another sign of diabetes, which is "being irrational", when our sugar is out of whack. The points you made had nothing to do with religion, but about why we procrastinate. Sounds like some people are using their "anger" reason to take their diabetes out on you. People, let's not shoot the messenger!! Thank you Nancy for the 5 reasons, and for letting me learn from them.
- Brenda
October 27, 2010 9:04 p.m.
I am a life long procrastinator and a type 1 diabetic for 4 years now. I think it is hard to hear from someone who does not struggle with such a life altering disease that if your numbers are not right then your procrastinating. It is not that simple. Everything affects diabetes, everything and it gets overwhelming. Sometimes you just want to eat something or go to bed or start an exercise tape without checking your blood sugar levels. Sometimes medical cost holds you back from doing what is always necessary. We know it is necessary but I found that when I did everything that was asked of me to do my sugar levels were still out of control. I was getting blamed from everyone one especially the doctor and you know what it was her fault. I was in fact taking the wrong medication, she never bothered to test which type of diabetes I had. I felt like for months I was doing something wrong. It is much a mental adjustment as a physical one. Diabetes is a life long battle of choices and like I said it gets overwhelming.
- Rye
October 18, 2010 6:06 a.m.
Well, some of the attitudes presented are just the reason so many people do procrastinate. If you have taken the life out of living by being "diabetic" 24-7, you wouldn't understand the Rick Warren reference. And if you had read A Purpose Driven Life, you would not have been so offended. I have been diabetic for 5 yrs next month. It is still not controlled, and I struggle constantly. But when I realized that every waking moment was taken up with meal planning, medicine taking, and worry, I stopped. Now, I watch my intake, I take my medicine, I exercise. Period. There are others in my life, and other things that I feel as important as my diabetes. Because of information, like the book written by Rick Warren, and this blog, I know that I will be able to reach the goals I set for myself. Goals set by doctors who have never had the disease, or have never been overweight, are unrealistic. If you are depending on "other people" to control your situation, then you are allowing yourself to be deceived.
- Linda
October 7, 2010 5:07 p.m.
WOW! I can't believe there are so many non-procrastinators and people who have never had a lazy spell. I was diagnosed as "pre" diabetes and in the first batch of tests found a kidney problem. This may be just the first, but I know that at some point of time I will hit every one of the situations you have listed. People get real and please don't change the blog; this is still a freedom of speech country, (read fast) and a few people almost demanding that all be "politically correct" is just wrong. Keep it coming people. I'm lazy and procrastinate and am going to need all the help I can get! and P.S. you don't have to agree with Rick Warren or anyone but that doesn't mean someone else might get something out of it. Attitude adjustments are a wonderful thing and might help with the diabetes if stress is an element! Love you all and thanks for the GREAT blog.
- Pamela
October 2, 2010 11:51 p.m.
The first time I talked to an endocrinologist about "my" diabetes was in 1987. I had many unrelated problems, few of which were diagnosed, and was given the answer, "You are going to have lots of symptoms," and told to see a psychiatrist. By the next year, I couldn't work and was getting tested for autoimmune diseases. Every doctor I went to said I had what his specalty was. In 1990 I saw a rheumatologist who finally helped me sort out all my symptoms, sent me to an endocrinologist, and let me know I was not going to die tomorrow. I have a full page of diagnoses, meds, surgeries, and allergies, but I am better off than I was then. If you think insulin dependent type "2" (is it "1" by now?) is a hassle, try rheumatoid, osteo, and fibromyalgia arthritises, bi-polar (mostly depression), all kinds of neuropathy - including autonomic - and spinal problems. Oh hell, I'm tired of listing stuff! Don't ever give up on your own body knowledge. Even if you are told some symptom is "probably" a diabetes side effect, or due to your "laziness," find out what else could be causing it. My inability to keep up with any exercising last year was a clogged femoral artery. My kidney doctor caught it. I still don't exercise much, asthma, too, but I don't use the electric carts at Wal Mart anymore. Be darned sure you are lazy before writing yourself off. I've been procrastinating eating for twelve hours now. Bad diabetic beha
- Edee
September 29, 2010 5:15 a.m.
Phew. The anger in the comments made me decided to read the article again and go through each point. Fear. Yup. I 'lost' a referral from one specialist to another relating to further testing prior to an op for incontinence and have never followed up to get another. Afraid that this is my first evidence of peripheral neuropathy. Indecision. Should I have the op or not. Perfectionism. Maybe I should just try harder with the Keegal exercises. Anger. At letting myself gain weight year after year while sitting behind various desks in one high stress job after another saying I couldn't go anything about the situation. Laziness. My initial Type 2 diagnosis spurred me into action. I lost weight. Joined a gym. Worked with my diabetes team. Always got praised for having my glucose under such good control, etc. After 3 years I started getting slack and allowing myself to have treats more and more often, seldom test and frequently forget to take my pills...yes I am a bit worn out from having to deal with a chronic lifelong condition that will not go away....but the result it that I have regained half of the weight that I worked so hard to get off and I am feeling really bad about that.
- Ellen
September 28, 2010 7:24 p.m.
I am offended that you have chosen to use the deceiver Rick Warren to help out us "poor" procrastinating diabetics. This is the one disease that people are totally in control of and for you to even mention something so unhelpful as the choice to procrastinate or not to procrastinate is beyond ridiculous. Please rethink your unapologetic apology sounds way too polictically correct to me...but I am a conservative diabetic ........An additional suggestion, for your blog, how about something helpful, to type 1 and type 2, as we navigate a challenging disease.
- susie
September 28, 2010 3:17 p.m.
My experience with the chief Dr. in Endocrinology was bad. He was condescending and informed me that being diabetic was a downward spiral the rest of my life and he bet I would be on insulin within 6 months. Thankfully the woman Endocrinologist was very supportive and encouraging and being her patient was pleasant. Some of these arrogant doctors need an attitude adjustment when they are dealing with patients. Since when is Rick Warren such an expert on the subject?
- Ferne
September 27, 2010 8:07 p.m.
wow....as a newly diagnosed person with diabetes I certainly can relate to this reasoning....I have felt most of these emotions and yes even laziness as I am the ONLY one that can take control and do what needs to be done to control my diabetes... Thanks you, Nancy, for helping me to acknowledge this ..... I'll write down all my questions and be prepared when I meet my educator for the first time in a couple of weeks.....Rick
- Rick
September 27, 2010 5:33 p.m.
Nancy, it seems you have hit a nerve. Nonetheless, I am a bit of a procrastinator and I freely admit that these causes have all played a part in the way I have dealt with my own challenges at one time another - even lazines. And I have seen them play out as my dear friends and relatives have navigated diabetes, depression and a host of other challenges. There is no shame in being honest with the fact that our reactions to the challenges of life don't always serve us well. It in no way implies that outside challenges such as lack of support, lack of understanding or the realities of life are any less significant, or in need of being addressed.
- Kristen
September 27, 2010 2:03 p.m.
Dear readers, I am truly sorry if I offended anyone. Procrastination is part of all of our human natures regardless if we have diabetes or not. That is if we are truly honest with ourselves. From now on I will leave any inkling of politics or religion out of my blogs. A good growing experience for me. Thanks, Nancy
- Nancy
September 24, 2010 9:30 a.m.
My husband is the worse and because of that he is currently in the hospital just having suffered a stroke. God is giving him a 2nd chance to do better. I'm sure one reason for not getting meds refilled is financial. Even though we have insurance, the Rx are expensive
- Ann
September 23, 2010 5:11 p.m.
There are too many health professionals who work in an office environment with a strict 8 hour day and never leave the area except for a vacation once a year. I travel extensively around the world for up to three weeks at a time. My diabetes counselor told me to eat at the same time every day and carry my own food when traveling... always insist on eating in restaurants with salad bars... has she ever been outside the US? Salad bars are strictly a US concept... and you certainly don't want to touch any kind of lettuce or produce in India, China or other emerging countries that I'm frequently in. And how do you carry 3 weeks of food? She also couldn't answer whether ant eggs cooked in butter counted as a protein, carb or fat... one example of the "local treats" I'm usually served as guest of honor in these countries. I'm not lazy, just realistic!!
- Susan
September 23, 2010 10:44 a.m.
Well,I am disappointed that you show such poor judgement both professionally and politically.For you to quote the likes of Rick Warren on a page like this casts doubt on your ability to advise anyone on anything never mind advising people like me living with Diabetes. This is not a place for politics or religion.By quoting Warren you have failed on both counts. More upsetting is the questionable and insulting sum and substance of the Rick Warren material directed at Diabetics living night and every damn day,no holidays,time off ,down time with the effects of Diabetes as some sort of educational material. Really? Are you that out of touch with the needs of patients living with Diabetes that you would offer this 'junk' as advice? A lack of compassion and awareness replaced by foolish ignorance.Shame.
- Tam
September 23, 2010 6:53 a.m.
There are too many health professionals who work in an office environment with a strict 8 hour day and never leave the area except for a vacation once a year. I travel extensively around the world for up to three weeks at a time. My diabetes counselor told me to eat at the same time every day and carry my own food when traveling... always insist on eating in restaurants with salad bars... has she ever been outside the US? Salad bars are strictly a US concept... and you certainly don't want to touch any kind of lettuce or produce in India, China or other emerging countries that I'm frequently in. And how do you carry 3 weeks of food? She also couldn't answer whether ant eggs cooked in butter counted as a protein, carb or fat... one example of the "local treats" I'm usually served as guest of honor in these countries. I'm not lazy, just realistic!!
- Susan
September 22, 2010 4:53 a.m.
So feeling overwhelmed by a serious condition like diabetes = being lazy? I'd argue that all the issues listed here call for some kind of support or counseling. Instead I find your article shallow, paternalizing, and frankly insulting - hardly helpful at all.
- Maria
September 21, 2010 12:40 p.m.
People with Diabetes are not "lazy" when it comes to attempting to manage their disease. I think that yes, of course having diabetes is a lot of work, and of course people with diabetes may wish they didn't have to do it. But a better word would be EXHAUSTION. Frankly, having to face some medical professional who accuses the person with diabetes of being LAZY would be enough to keep many many folks from going in. What a stunning lack of understanding.
- Kate
September 21, 2010 8:08 a.m.
After managing my daughter Type 1 diabetes for the past 8 years, since her diagnosis at the age of 4, I've been many things, but I have not been "indecisive" or "lazy". I have been under supported, poorly trained, scolded, nagged, abandoned and ignored by Dr.s, nurses and CDEs though. Diabetes is a relentless task master and unless you live it, you cannot begin to understand that "lazy" is the last thing most of us are.
- Sarah
September 21, 2010 6:49 a.m.
1. Fear can often be a direct result of a judgmental endocrinologist/cde - so the team needs to ask themselves why their patients may be avoiding coming in and what they may have done to influence that. 2. Again, the team may not have been empowering. Motivational interviewing in health care can assist a person in figuring out what (s)he wants for him/herself and to help get to that goal. 3. Perfectionism/black&white thinking certainly gets in the way, and that too needs to be gently discussed by the health care professional. Also encouragement that when a person is struggling, that's when they should feel most proud of coming in and seeking the assistance they need - they should not cower because they know A1c will be high and they'll get "the lecture". 4. I don't believe people with diabetes are "lazy". Diabetes is relentless 24/7/365. People with diabetes (PWD) have to do so many tasks that others never have to do. PWD need support so when they are feeling exhausted by it all, they can turn to a loved one or friend and ask for what they need. There is a wonderful community online - the diabetes online community, who support one another without any judgment. Come to the #DSMA chat (diabetes social media advocates) on Twitter on Wednesday nights from 9-10 pm eastern, and meet others, and get the support you so lovingly deserve.
- Ellen
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24 comments posted