Communicating With A Loved One Who Isn't Managing Their Diabetes

It is concerning when a loved one is not managing their diabetes well.

Out of caring and frustration, we may apply pressure, criticism or guilt to change their behavior even when we know these tactics will not work.

What can help is communicating in an autonomy-supportive manner. By focusing on your loved one’s feelings, needs and goals, you can encourage successful diabetes management without attacking or annoying them.

Autonomy-Supportive Communication

Encouraging a person’s autonomy requires you to understand their viewpoint and nurture their self-motivation. This is done by:

1. Showing that you understand and empathize with their point of view. For instance,“I realize it’s difficult going to parties where people enjoy food and drink not on your diet plan.”
2. Giving them the rationale for any advice offered. For instance: “I recall the doctor said if your evening glucose readings were consistently high you might need your insulin dose changed. I think we should give the doc a call.”
3. Showing concern. For instance:“You seem a bit scattered today, like you're having trouble focusing. I’m concerned about you.”
4. Offering options whenever possible. For instance,“What do you think, should we take our walk this morning or wait until this afternoon?”
5. Asking about their experience of the illness and acquiring an accurate understanding of their feelings and capabilities. For instance:“What does an insulin shot feel like? Has it become easier, or does it still make you anxious?” or, “What is the most difficult part of managing diabetes?”
6. Discussing the illness openly, and frankly addressing conflicts related to diabetes care. For instance: “Yesterday was the second time in a month we had to come home early because you forgot your insulin. We need to come up with a plan so it doesn’t happen again. I have a couple ideas, but what do you think would help?”
7. Focusing on successes. For instance: “Three months ago you thought you’d never get the hang of managing your blood sugar. Now you’ve lost seven pounds and we’re walking a mile three times a week!”
8. Planning and enjoying fun activities together. For instance: “It’s been a while since the family spent a day at the beach. How about if we drive there this weekend?”

Ultimately, it is the person with diabetes who must choose to manage their symptoms well. By focusing on autonomy support, you help yourself avoid the burden of shouldering too much responsibility and cultivate your loved one's self-confidence.

If supportive efforts are not enough to motivate this person, enlist the aid of their doctor or diabetes care team.

Source: California Healthcare Foundation
Photo credit: Renee Barron / flickr creative commons