Mary* is receiving Hunter Primary Care's Diabetes Education services. After moving to be with her extended family following a relationship breakdown, Mary experienced a loss of motivation with respect to self-care, which impacted on her dietary choices, level of physical activity and inevitably led to weight gain.
Prior to her relationship breakdown, Mary said she was very fit, attending the gym frequently and when speaking about this, she spoke with a lot of emotion. Mary attended her first consult with a Diabetes Educator and after a thorough assessment was completed, it was revealed that recent changes to food intake, exercise regime, an increase in stress levels and non-compliance with medications would threaten sound diabetes control.
The application of motivational interviewing led to the identification of some changes that would help Mary to achieve her diabetes management goals in the short term.
It was determined that Mary would benefit from techniques to improve object permanence of food choices, including writing down lists of higher quality snacks and best placement and storage in her fridge. Food focused intervention included the recommendation of meal planning and preparation of her evening meal that morning.
With respect to Mary’s level of physical activity, it was identified that she previously enjoyed Zumba and other dance related exercise styles. She was able to identify that this would be a simple way to restart being active. Mary was encouraged to have the pain in her ankle properly investigated considering the impact it was having on her ability to exercise.
Mary was provided information to join our diabetes focused online Shared Health Appointments (SHAs). The SHAs would provide Mary with contact with other people living with diabetes, allowing for group problem solving, peer to peer support and social connection. The SHAs build on clients’ strengths and capabilities and facilitate clients learning from each other’s experiences.
During her attendance at the SHAs, Mary learned more about the following subjects:
· The reasons why diabetes happens
· Understanding food choices in diabetes
· Medications, how they work and their use
· Diabetes management technology
· How to break the rules and have fun
Mary has made changes to her food intake, resulting in an improved diet with reduced intake of simple sugars. Implemented sleep hygiene practices and have resulted in better quality of sleep. Mary has also reduced her intake of alcohol.
Mary shared with the group that she is looking forward to learning more of the basics in this group to help her get back into routine. She is making better choices at work with snacks, including yoghurt and veggie sticks. Mary has reduced the number of times she checks her own blood glucose levels and has also learnt that the HbA1c is the gold standard and is more useful in her circumstances. This is a very important outcome as it has reduced the burden Mary feels from managing diabetes. Mary is taking every option available to increase activity, increasing incidental activity effectively.
“I am choosing healthier lunches and reading labels. Thank you so much for today, I have learnt a lot. I have to get back to work and I look forward to next week”, says Mary.
*Mary’s real name has been omitted from this story.