• Fresh Views

    DiabetesSisters are making a difference!

    DiabetesSisters 5TH Annual Leadership Institute, Chicago, IL

    It’s hard to believe that National Diabetes Awareness Month has come and gone! Lots of impactful events took place as well as lots of learning. We like to highlight people and organizations that are making a difference in the diabetes community, so this month we’re highlighting DiabetesSisters, a national nonprofit that strives to improve the health and quality of life of women with diabetes and to advocate on their behalf.  We spoke with a DiabetesSisters PODS leader in a previous post on travel with diabetes you can read here. (disclosure: Deb serves on the board of directors for DiabetesSisters)

    Thank you to Anna Norton, Karen Graffeo and Sara Mart for sharing the initiatives they’ve been focusing on to support the community during National Diabetes Awareness Month (#NDAM) and beyond.

    Sara Mart, Anna Norton and Karen Graffeo from DiabetesSisters

    FROM DIABETES SISTERS…….

    National Diabetes Awareness Month Activities

    This month alone, our Minority Initiative Program hosted events for women in underserved populations, with presenter Lorena Drago, MS, RDN, CDN, CDE sharing information, dispelling myths, and answering questions about diabetes. Two of these events, held in Miami on November 13th and 14th focused on culturally relevant information for Latina women and were conducted entirely in Spanish. On November 15th, we teamed up with Hip Hop Fit with Gene Hicks in the Chicago area, where Lorena discussed myths and misconceptions about diabetes. Then attendees participated in a fun Hip Hop Fit class. These events were open to community members, thanks to our sponsors.

     We also completed our third installment of our Facebook Live Series on November 15th. With partners The National Kidney Foundation and WomenHeart, we focused on the connection between diabetes, heart disease, and chronic kidney disease. It was hosted by Anne Dalin, who lives with diabetes and is a leader of our Bridgewater PODS Meetup group.

    PODS Meetups

     Our PODS Meetups are a signature program of DiabetesSisters and are peer-led support groups for women living with all types of diabetes and pre-diabetes. Held throughout the country all year long, volunteers lead Meetups in more than 40 locations! During National Diabetes Awareness month, thirty PODS groups met, with several of them focusing on conversations about diabetes and heart health. Earlier this year, many of our leaders also spent time in Chicago for our 5th Annual Leadership Institute, where they enhanced their skills in facilitating conversations and creating an open, welcoming atmosphere that encourages honest discussions. They brainstormed ways to promote, recruit, maintain, and grow PODS Meetups and shared with PODS Leaders from around the nation. DiabetesSisters also supports our volunteers with PODS Site Visits, where members of our staff travel to and attend PODS Meetups. Our staff spent time on the road this year to visit with groups in North Carolina, Minnesota, Texas, New Jersey, Rhode Island, and Massachusetts.

    Between the Lines Project

     At the beginning of the year, we launched Between the Lines, a digital page on our website sharing real stories of women living real lives with diabetes. Each story focuses on a different life event and discusses the challenges posed to managing blood glucose levels and the effects on quality of life. It is important to share these real stories that show examples of how life events can impact our ability to stay between the lines of our desired blood sugar range, and we are thankful for every woman who has shared her personal story with us. This on-going project welcomes new stories continuously and we invite any woman living with diabetes or pre-diabetes who is interested in sharing her story to email us at info@diabetessisters.org

    DiabetesSisters PODS Leaders

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

  • Fresh Views

    In All Things We Give Thanks

    Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow – Melody Beattie

    We are always grateful for the sunshine and beautiful outdoors

    On this Thanksgiving eve, we are reminded of ALL that we are grateful for…including YOU, our readers and followers!

    Gratitude is good for health

    According to the American Heart Association several clinical trials show that engaging in a practice of gratitude can lower blood pressure and help the immune system. “Grateful people engage in more exercise, have better dietary behaviors, are less likely to smoke and abuse alcohol, and have higher rates of medication (taking)”. Several studies suggest that gratitude can decrease stress and anxiety by activating the areas in the brain that the release feel-good hormones serotonin and dopamine. 

    Research discussed in the Jan/Feb, 2019 issue of Diabetes Self-Management also shows that positive psychological states such as gratitude are associated with improved physical health in people with diabetes, improved sleep, and increased self esteem. While the relationship is not fully understood, positive emotions such as expressing gratitude, are linked to healthier lifestyle choices. And healthy lifestyle choices including healthy eating and being active are in turn linked to overall health.

    How to get started with gratitude in this season of Thanksgiving? 

    Here are 5 strategies to help develop daily gratitude habits: 

    1. Have gratitude reminders. These are simple cues to remind you to focus on gratitude daily. Maybe it’s an alarm on your phone, a bracelet or wristband, a photo, a magnet, or a post it note. And with that reminder, pause, take a breath and focus on being grateful in that moment.
    2. Keep a gratitude journal. We both have found this to be a good personal practice to express gratitude more readily and maintain focus on finding things to be grateful for. Some log entries in their journal weekly, and others daily. Our personal goal is to identify at least 3 things daily for which we’re grateful.While the goal is to write in the journal daily, sometimes life happens and weeks may go by without an entry, but we pick right back up with our entries. 
    3. Start a gratitude box. Keeping a box (jar, album, folder, or whatever works for you) filled with notes, pictures, and moments you are grateful for can bring a boost when needed. 
    4. Voice or write down one (two, or three) good things that happened in your day. On the homefront, this is a gratitude practice Tami has used with her son over the years. In the days when she would take and pick him up from school, she found that the drive time was a good time to learn about his day. That conversation always began with these words, “Tell me something good that happened today.” He knew he needed to answer that, acknowledging something good, before talking about the challenges of the day. 
    5. Use gratitude apps. There are a number of apps with a range of capabilities including sending reminders, sharing uplifting thoughts, and organizing memories for which you are grateful. 

    You can glean other insight in this post we wrote on Gratitude here.  

    Happy Thanksgiving!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Reducing Risk

    You are braver than you believe, and stronger than you seem, and smarter than you think. – Christopher Robin

    National Diabetes Month is almost over, what informative and interesting activities were you engaged with this year?  

    Taking a solution-focused approach to diabetes self care

    As we near the end of the month, we are also finishing our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Last week we shared about taking a solution-focused approach to Problem Solving. And the prior weeks we focused on Taking Medications here, Monitoring blood glucose here, Healthy Eating  here, Being Active here, and Healthy Coping here. This week, we are talking about Reducing Risks 

    When looking at this picture above of the friendly neighborhood kitty balancing precariously across the covered porch rails, it reminds us of life with diabetes… trying to stay in balance never knowing when the bottom may fall out.  

    AADE7 Self-Care Behavior #7: Reducing Risks

    Taking care diabetes today can help people feel good today AND in the future. When blood glucose is in range, one is more likely to:

    • have more energy, both physical and emotional
    • be less tired and thirsty
    • pass urine less often
    • heal better and
    • have fewer skin or bladder infections

    Many say they are their “best self” when their blood glucose is in range. And managing diabetes TODAY means there will also be less chance of having health issues caused by diabetes over time. The important words there are “over time.” Taking care of diabetes now will help reduce the risk of heart attacks, stroke, damage to kidneys and nerves, and loss of vision. But It’s not just about the diabetes, it’s about supporting those with diabetes in living their best life! 

    A journey of a thousand miles begins with a single step. (Chinese Proverb)  Just one step.

    We want to support and guide our clients toward actionable steps they can take now to live well with diabetes and help reduce the risk or delay issues down the road. Then, the key is replicating that small step over and over again to build momentum and actually feel progress. Small steps add up. You may be surprised by the great impact these small, yet simple things can have! 

    The language we use when talking about diabetes complications is important to think about. When we use words like “prevent” as opposed to “reducing risk or delay progression” we imply that ALL complications CAN be prevented. Science tells us that this isn’t always true. Some people have genetic predispositions to either be “protected” from complications or to be at a higher risk. Healthcare providers can add to the stigma, shame and blame associated with diabetes when they don’t acknowledge the fact that some people will end up with complications……just because. We don’t want people to shy away from discussing health concerns, so let’s use our #LanguageMatters voice when we #TalkaboutComplications. That’s what The Grumpy Pumper (AKA Chris Aldred) has been doing this past year. Traveling around the globe, including a stop at #AADE19,  speaking openly and frankly about living with a complication from diabetes. You can read his blog here.  As Grumpy says, “Even with the best of care, people can get complications.” (from Diabetes Connections Podcast) So let’s use a solution-focused approach when talking with people with diabetes complications instead of rehashing any problems.

    When working with clients instead of focusing on what is not working well or what is “wrong”, here are 3 illustrations of how to flip the conversation:

    Try this:  By no means is smoking a simple habit to change. What can you do more of that may help you smoke less? Or what needs to happen to help you make changes?

    Instead of this: You need to stop smoking. Smoking is bad news with diabetes.

    Try this: How can you fit in an extra visit to see your eye doctor during national diabetes month?

    Instead of this: You are behind on getting your eye and dental exams.

    Try this: On a scale of 0 to 10, with 0 being never and 10 being always, how often are you able to get an annual flu shot to help prevent illnesses?

    Instead of this:  You haven’t gotten your flu shot.

    Three follow-on questions to help you not only feel  better today, but to help prevent problems down the road:

    • What is one action you can take to reduce your risk? Work closely with your healthcare team to identify the best strategies for you to help manage them and prevent progression to live your best life.
    • What can you do NOW, right this second…to make life better now, as well as down the road.
    • What single change can you make over the next week?

    And consider how people in your life can help. Loved ones, family, and friends can be close allies in your diabetes management. (last week we discussed VIPs, you can read it here)

    We can encourage clients to keep taking those small steps each day. Consistency and routine build on each other. Small steps add up. If people do the best that they can do…then they can say at the end of the day, I did the best I could, and that’s a good feeling.

    We hope you’ve enjoyed our series and that we’ve made you think before engaging with clients. And if you’re a person living with diabetes, we hope our choices resonate with you. Each week we’ve challenged you to try some flips into your conversations. Let us know what impact they have had. Please reach out to us to share feedback.  Let’s continue to join together  to raise awareness of all issues that can improve living with diabetes.

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou


  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Problem Solving

    I will breathe. I will think of solutions. I will not let my worry control me. I will not let my stress level break me. I will simply breathe. And it will be okay. Because I don’t quit. – Shayne McClendon

    Tomorrow, November 14 is #WorldDiabetesDay! Deb and Tami have had some impactful moments in recent years during diabetes month and on #WDD. Deb has been involved in hosting events at the California state Capitol with speakers, music and lighting of the Capitol in blue. Deb’s also spend #WDD 2017 at the headquarters of  Novo Nordisk in Denmark. Tami has done TV spots, radio shows, Facebook Live and videos, provided community programs, participated in screening events and published articles – all to raise awareness and encourage people to know their risk for type 2 diabetes. 

    The theme of #WorldDiabetesDay this year is the impact that diabetes has on the family. One of the goals is to promote the role of the family in the prevention, management, care and education of diabetes. In a solution-focused approach, the family is important, and we call them VIPs – .and this definition is broad – it includes any one who is a “very important person” in your life. Someone who can provide support when needed, who will notice changes being made, and  who can respect personal decisions and choices. What’s really important is that these VIPs are not the “diabetes police”, or people who make managing diabetes harder. As you think about problem-solving, think about including VIPs in both the discussion and the plan to help foster success and respect.

    Taking a solution-focused approach to diabetes self care

    This is week 6 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Last week we shared about taking a solution-focused approach to Taking Medications here.  And the weeks prior we focused on Monitoring blood glucose here,  Healthy Eating  here, Being Active here, and Healthy Coping here. This week, we are talking about Problem Solving.

    AADE7 Self-Care Behavior #6: Problem Solving

    With diabetes, “problem” solving is part of the daily routine…figuring out when, what, and how to eat for meals and snacks. What kind, how much, and when to fit in physical activity. When to check blood glucose, how to time any medications, and the list goes on.

    And then life throws curve balls, and no matter how well you plan, unexpected things happen that can send blood glucose out of range. And that’s when more problem-solving skills are called into action to determine how to handle the scenario and what to do to prevent it from happening again. 

    Also, diabetes needs may change over time, requiring adjustments because previous solutions no longer work.

    In taking a solution-focused approach, we typically don’t focus on solving problems….as you know. We focus on solutions…looking for what is already working and trying to do more of that.  So this self-care behavior is not as intuitive to translate. Here are 4 strategies to help diabetes care and education specialists and people with diabetes flip the problem-solving paradigm.

    1. Practice self-compassion. Diabetes is different every day, even when people make similar choices. We learned from our Twitter research that people living with diabetes would like to practice more self-compassion. They want to be kinder and not blame themselves. 
    2. What has gone well today? When you are faced with challenges, think about what DID work for you during this challenging time. Instead of doing a deep dive into all of the issues that might have impacted you, spend some time focusing on your successes. Then tomorrow, try to do more of what worked.  
    3. Keep a journal of solutions. When things are going well, keep track of these small wins so the next time you are faced with a challenge, you have some “go to” solutions ready to try.
    4. Share with your VIPs. Ask your VIPs about their ideas.  Do they have some ideas about what works well for you and the times they see your successes.

    When working with clients, instead of traditional problem-solving exercise, try to focus on existing solutions to create change.  Begin by exploring these 3 questions to flip the conversation.

    1. Tell me about a time when you felt the happiest about your diabetes management?
    2. What was it about that day or time that made it better?
    3. Can you think of times when the challenge you are facing now was not present in your life? What were you doing then?

    We challenge you each week to try some flips into your conversations and let us know what impact they have. Let’s join together throughout the month of November to raise awareness of all issues that can improve living with diabetes.

    Join us next week for our final installment as we discuss a solution focused-approach to the self-care behavior around reducing risks.

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Taking Medications

    Self-care is never a selfish act – it is simply good stewardship of the only gift I have, the gift I was put on earth to offer others. Anytime we can listen to true self and give the care it requires, we do it not only for ourselves, but for the many others whose lives we touch. -― Parker Palmer 

    Big Ben in London, England 

    @AFreshPOVforYou is one-year old!

    Happy birthday to us @AFreshPOVforYou! Our blog is officially one-year old, 56 posts later! 

    Over the last year we have focused on Possibilities, Opportunities and creating a Vision (POV) for the future by taking a solution-focused approach to life with diabetes. We’ve been excited to share our work and learnings by speaking at the AADE19 Annual Meeting, helping diabetes care and education specialists learn how to incorporate a solution-focused approach into their practice. We also shared our Twitter research findings at the European Association for the Study of Diabetes conference in Barcelona, Spain. And we’ve conducted a survey, focus groups, and have a few papers in process. It’s been a great year and we’re excited to see where this next year leads us!

    And it’s now national diabetes month 

    We purposely launched this blog right before #WorldDiabetesDay last year, to kick off our new adventure. And here we are again. What are you doing for diabetes month? Do you have an event or an idea you’d like to share with us or our readers? Please let us know in the comments. We’ll be adding in some diabetes month discussions throughout November, along with sharing insights about using solution-focused approach to self-care behaviors.

    Taking a solution-focused approach to diabetes self care

    This  week is week 5 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Have you tried any “flips” in the past 4 weeks? Please let us know if you have, and what your experience was. 

    Last week we shared about taking a solution-focused approach to Monitoring blood glucose – you can read it here.  And the weeks prior we focused on Healthy Eating  here, Being Active here, and Healthy Coping here.. This week, we are talking about taking medications. 

    AADE7 Self-Care Behavior #5: Taking Medications

    While taking medication of some type is often required somewhere in the journey with type 2 diabetes, it’s not always simple to engage in this self-care practice. We hear that routinely from clients we work with. Here are 3 challenges that frequently bubble up…

    1- Remembering. No matter what one’s age, remembering to take medication can be a challenge at one time or another. After all, life happens and can derail even the best intentions. In our experience, missing medication doses can also be linked to the dosing frequency, side effects, or diabetes distress. When it comes to remembering to take medication, solution-focused strategies to consider include, using a medication reminder app, using a pill box, pill packs, keeping the medication in view as a reminder (if it doesn’t require refrigeration), marking a calendar when a dose is taken, and setting an alarm on a smartphone or clock. (The mention of a clock, reminded us of Big Ben in London, so that’s our fresh view for today!)              

    2 – Stigma. With type 2 diabetes, there is often stigma associated with taking medicine. There is a false sense that people “should” be able to manage diabetes through healthy eating, being active and losing weight. But we know that is not always reality. Given that diabetes has a genetic link and is a progressive condition, things change over time. What works today, might not work next month or next year. So talking about diabetes medicine using a positive, solution-focused approach can help build a trusting relationship and a therapeutic alliance in which to discuss medicine choices and barriers while using a shared-decision making approach.  

    3 – Cost/Access. We must also be cognizant of the cost of medicine when considering options. Although there are some incredible, effective new medications that impact the patho-physiology of diabetes, these new drugs often come with a high price tag. And they may not be included on insurance formularies. And the cost of insulin is beyond crazy. The American Diabetes Association has a website to help people navigate this complex issue and provide a list of resources. Unless we have open conversations, we may not know that people are not taking their medicine because they are not able to afford it. How can we say they are “non-compliant” or “non-adherent” when this is the case?  We need to change the language we use in diabetes, especially around medication taking. The #LanguageMatters conversation is essential when talking about medications.

    When working with clients instead of focusing on what is not working well or what is “wrong”, here are 3 illustrations of how to flip the conversation:

    Try this: Diabetes is a progressive condition. It’s common for people to need more medicine over time. Can we talk about the benefits of adding insulin?

    Instead of this: You’ve failed oral medicine, you need to take insulin.

    Try this: What challenges do you have when taking your medicine?

    Instead of this: You’re not compliant with your medicine.

    Try this: How many days each week do you take your medication?

    Instead of this:  How often do you forget to take your medication?

    We challenge you each week to try some flips into your conversations and let us know what impact they have. Let’s join together throughout the month of November to raise awareness of all issues that can improve living with diabetes.

    Join us next week as we discuss a solution focused-approach to the self-care behavior around problem-solving.

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou


  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Monitoring

    Taking a break to enjoy the final days of Fall and the changing leaves

    Happy fall and Halloween eve! And welcome to week 4 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Have you tried any “flips” in the past 3 weeks? Please let us know if you have, and what your experience was. 

    Last week we shared about taking a solution-focused approach to Healthy Coping – you can read it here. And the weeks prior we focused on Healthy Eating here and Being Active here. This week, we are talking about monitoring. Monitoring blood glucose. in the spirit of  Halloween, can be very helpful to see how a Halloween treat, and other things in life, impact blood glucose. 

    While many people use meters to stay in touch with their blood glucose, a CGM (short for continuous glucose monitor), may be a helpful choice for some. With a CGM one can see patterns and trends over time, not just one single number at one moment in time.  Also, they can receive real time alerts for when blood glucose is going above or below target. Around holidays such as Halloween, a CGM can be a great monitoring tool to see how the choices made impact glucose levels.  

    Let’s look at some examples…

    AADE7 Self-Care Behavior #4: Monitoring

    Below you see a CGM tracing over a 24-hour period, beginning at midnight. The goal is more green – more time in range – more time feeling better. Have you heard of the acronym FNIR?  It means flat, narrow and in-range. That is the goal of CGM tracings.

    Suppose this tracing below is a few hours after “throwing caution to the wind” and sampling a few more fun size Halloween treats than planned. The Halloween treats are just around for a day or two. It’s just one day. It’s important to keep the big picture in mind. 

    While the focus may be drawn to the time out of range (in red), let’s turn focus to the green (the time in range). How was that accomplished? We learn that the individual made it to the gym for an early morning workout and enjoyed a healthy lower carb breakfast. Monitoring helped them learn.

    From our years in practice we’ve learned that people who live with diabetes have different perceptions around monitoring. For some, it can become an obsession – they need to know where their blood glucose is all the time. It can certainly be a mental burden. And others may not want to focus on their blood glucose. Knowing their number may create negative feelings, fear of judgement and guilt. So, they choose to not check their blood glucose to provide a sense of safety and self-preservation.

    We know that glucose numbers are simply that……they are numbers, and numbers provide information.  The goal of monitoring is to generate data to help people make choices and changes. Numbers are not good or bad and are certainly not a test score. You may have recently seen this image below on Twitter and/or the discussion around it. This is NOT a solution-focused approach! 

    Photo credit: Renza Scibllia’s Twitter account

    When working with clients instead of focusing on what is not working well or what is “wrong”, here are 3 illustrations of how to flip the conversation:

    Try this: You’ve been working hard to fit in physical activity. In looking at your CGM tracinings, what small steps can you take in the direction toward the goal of seeing more time in range (green in the tracing)?

    Instead of this:  What happened when your CGM was red (out of range)?

    Try this: I know you’ve had a lot going on. You mentioned that you checked your blood glucose twice this past week. How did you manage to check twice?

     Instead of this:  You only checked your blood glucose twice this past week?

    Try this: I see that your A1C is in your target range. How did you manage to do that?

    Instead of this: Your A1C is outstanding, A+!

    We challenge you each week to try incorporating some flips into your conversations and let us know what impact they have.

    Join us next week as we discuss a solution focused-approach to the self-care behavior around taking medications.

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Disclaimer: A Fresh POV for You is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com. 

  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Healthy Coping

    In times of stress, the best thing we can do for each other is to listen with our ears and our hearts and to be assured that our questions are just as important as our answers. ~ Fred Rogers

    Getting some “beach therapy”

    Today we greet you from our first @AFreshPOVforYou writing retreat! “Writing Retreat”…those are BIG words that have been more than a year in our minds, and are now a reality as we sit across the table from each other drafting the content for our first book!  No small feat, but one we are excited about! We are passionate about taking a solution-focused approach to life with diabetes…so let your mind imagine just what this book may be about. We’ll share some sneak peeks as things move along.  

    Now back to our to our blog…

    Welcome to week 3 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Have you tried any “flips” in the past 2 weeks? Please let us know if you have, and what your experience was. 

    Last week we shared about taking a solution-focused approach to Being Active – you can read it here. And the week prior we focused on Healthy Eating here. Today we’re concentrating on Healthy Coping

    AADE7 Self Care Behavior #3: Healthy Coping

    It goes without saying that stress is a part of life…family stressors, work stressors, financial stressors, health-related stressors…at times it might seem like stress is all there is. Add to that the relentless demands of diabetes. The combination can bring a variety of coping challenges and ultimately impact self-care. On the flip side, there are many positive ways to deal with stress and cope with life with diabetes in a healthy manner. It’s all about having a tool-box of resources or tactics to pull out or call upon needed. Here are 6 ways that resonate with us to give you ideas:

    1. Move your body. It might be simply taking a walk. Physical activity lowers stress hormones and triggers the brain to release chemicals that make you feel better. (We’re finding that taking short walks to clear our minds is helping us to feel less stress and think more clearly during our writing effort).
    2. Take a break. It might be taking a walk on the beach or simply having a cup of coffee and listening to the waves hit the sand (as we were in the photo above…wishing we were there now!). Or you might enjoy curling up in a comfy chair and reading a book. Or standing and stretching, taking deep breaths inhaling and exhaling slowly.
    3. Use positive affirmations. When life is feeling especially challenging, we’ve found that practicing “daily affirmations” greatly helps us: I can do this. I am strong. Each moment brings choice. I will not hold onto bitterness.I can live an overflowing life. An affirmation is a short, positive statement that you say to yourself to build yourself up. Have you ever tried affirmations? The reality is that we believe what we tell ourselves and what we hear others say about us. Using affirmations can help to “rebuild” negative thinking and strengthen positive thoughts.When working with clients in a solution-focused way, we can  help them to create their own affirmations as one Healthy Coping mechanism.
    4. Get enough sleep. In our experience, many people discount the value of sleep. When chronically sleep deprived the stress response can be even greater. (yep, we’re getting our zzz’s this week!)
    5. Spend time with people that make you happy. Stress can cause some to turn inward and isolate themselves. Talking to others about your stressors and seeking their support is one way to de-stress. Maybe it’s getting together with a friend for lunch. Whenever we are together we have lots of fun and laughter. That is one way we cope with stress.  
    6. Practice gratitude. You can read more about this in a blog we wrote on gratitude here.  

    When working with clients instead of focusing on what is not working well or what is “wrong”, here are 3 illustrations of how to flip the conversation:

    Try this: How do you manage on the most challenging days with diabetes to keep moving forward?

    Instead of this:  Managing diabetes requires a lot of time and effort. It’s something you just have to do.

    Try this: On the nights you’ve been able to get to bed earlier and get more sleep, how were you able to do that? How did you feel the following morning?

     Instead of this: You mentioned you’re only getting 5 hours of sleep each night. You need to get to bed earlier. 

    Try this: Where is your stress level around ____ on a scale of 1-10? What would it take to reduce it 1 point? What do you need to accomplish that? How can I support you?

    Instead of this: You just need to stop thinking about this issue and move forward.

    Focus most of the time and energy on thinking about and discussing what is already good, effective, and successful then leverage that to identify solutions.

    When you meet again, here is a 3-step follow-up approach to try:

    Try to incorporate this approach with clients to reframe conversations and see if you can help them to focus on the exceptions (those times when the “problem” could have occurred but somehow did not) and their desired future state, rather than ruminating on what is not working.

    • Step 1 – Have you seen any improvements since we last met? (if yes, ask about it. If not, go to step 2)
    • Step 2 – Have you noticed times when the problem (defined using the clients own words) did not occur or happened less? (here you are identifying exceptions. If yes, ask about it. If no, go to step 3)
    • Step 3 – Describe for me what would be different if the problem had been solved? (this is the Miracle Question approach we’ve written about many times. Here and here are two of them)

    The solution-focused decision tree is adapted from Fredrike Bannik’s 1001 Solution-Focused Questions.

    We challenge you each week to try incorporating some flips into your conversations and let us know what impact they have.

    Join us next week as we discuss a solution focused-approach to Monitoring

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Disclaimer: A Fresh POV for You is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com. 

  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Being Active

    Remember that any exercise is better than no exercise. – Anonymous


    Pisgah National Forest in the mountains of Western North Carolina. It was a beautiful hike to the falls!

    Welcome to week 2 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. Last week we shared about taking a solution-focused approach to Healthy Eating – you can read it here.  Today we’re focusing on  Being Active. Being active can take many forms, from simply moving more during the day to intentional bouts of exercise. You can also find ways to incorporate fitness through activities that bring you pleasure or joy (such as our beautiful hike to the falls pictured above).  

    As a refresher, the AADE7 is a framework for organizing diabetes self-management education and support, as well as for identifying key areas for behavior change to manage diabetes. The 7 core behaviors are:

    Our series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. 

    AADE7 Self Care Behavior #2: Being Active

    “I hate to exercise” may be a familiar comment heard by many diabetes care and education specialists (DCES). (In fact, it’s the title of a great book too, The I Hate to Exercise Book for People with Diabetes) For those who are challenged to fit physical activity into their day we feel empathy and understanding because some days it’s a challenge for us too! Life happens! 

    Some people are born athletes. And physical activity may always be a priority them. If you fall into that category, you might find it hard to understand the challenges other people face with being active. If you can relate, try to take a step back, and think of something that is really challenging for you to engage in. Then try to keep that frame of reference when you’re talking about being active with your clients.

    Beyond lack of enjoyment in exercise, finding time to fit physical activity into a busy, challenging day, can also be hard. As DCES’s, solutions that we may generate and propose to others, may not always be realistic. Using solution-focused talk, together, we can help clients identify what they like, and what makes sense to them. We can also guide them in identifying things that make them happy, and find existing strengths. From there, we can help them create opportunities to be active.

    It’s important to take care to refrain from “all or nothing” thinking, described by Adam Brown in his book Bright Spots and Landmines (we interviewed Adam here). We need to help clients take small steps towards a more active lifestyle and acknowledge their success, even if it doesn’t align with our thinking of what being active means. Let’s flip the focus of the discussion and help people feel successful and recognize their strengths.

    Deb and Diana (Deb’s daughter) hiking in the Dolomite Mountain Range in Northern Italy

    Instead of focusing on what is not working well or what is “wrong”, here are 3 illustrations of how to flip the conversation:

    Try this: I know how hard it is to have a job where you sit at the computer all day. Tell me more about your office and work setting. Let’s think of some ways you can increase your movement and get you up from your chair. 

    Instead of this:  Did you know sitting is the new smoking, sitting all day is going to kill you. You need to move more.

    Try this: You mentioned you’ve been using the MapMyWalk app on your phone. How has this helped you be more active? What else can you do to be more active?

     Instead of this: You’re using the MapMyWalk app but you still not getting 10,000 steps a day.

    Try this: When you’ve been successful adding physical activity into your schedule, what did that look like? How did you do it? How can you do more of that?

    Instead of this: You’re falling short of the goal of getting 150 minutes of exercise each week..

    Focus most of the time and energy on thinking about and discussing what is already good, effective, and successful.

    During a solution-focused conversation, the DCES’s focus is on discussing and exploring what is already working, is effective, and is successful, then leveraging that to identify solutions, rather than focusing on past problems. 

    When you meet again, here are 3 follow-up questions to try:

    • How were you able to focus on solutions to try to fit fitness into your schedule?
    • What kept you on track toward achieving your activity goal? 
    • What was different about the days you were able to be more active?

    We’ll challenge you each week to try incorporating some flips into your conversations and let us know what impact they have.

    Join us next week as we discuss a solution focused-approach to Healthy Coping!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Healthy Eating

    Problem talk creates problems, Solution talk creates solutions. – Steve de Shazer

    Tasty, healthy grilled mussels in garlic and lemon

    We are excited to launch into a 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. As you probably know, the AADE7 is a framework for organizing diabetes self-management education and support and for identifying key areas that may require behavioral changes to manage diabetes.  The 7 categories are:

    For those of you that follow our blog, you know that we are passionate about flipping the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. We are advocates for the use of person-first, empowering language when speaking with and in reference to people with diabetes. #LanguageMatters in diabetes care and education; problem centered talk can make speaking about and managing diabetes more challenging.

    Each of the next seven weeks, we will focus on one of the above self-care behaviors and provide 3 practical illustrations of how to flip the conversation around it to solution-focused talk.

    AADE7 Self Care Behavior #1: Healthy Eating 

    “What can I eat?” is the #1 question asked by people with diabetes when they are diagnosed. Without a doubt it can be a confusing, challenging, and sensitive ongoing area of diabetes management. 

    Often the healthy eating discussion focuses on foods to avoid and “what went wrong” when blood glucose was out of range. The conversation continues with discussion on how to prevent that from happening again. This approach to eating can be painful and result in feelings of blame and shame. A solution-focused approach changes the dynamics of the conversation.  It helps flip the focus to what is working well and building upon existing strengths.

    Instead of focusing on what is not working well or what is “wrong”, here are 3 illustrations of how to flip the conversation:

    Try this: I noticed that you are drinking sweet tea or soda only three times a week now instead of every day. How have you been able to do that? 

    Instead of this: Are you still drinking sweet tea and soda? 

    Try this: I hear you saying that you’d like to lose 20 more pounds. I’m noticing you are down 5 pounds since we last met. I’m really proud of you. What do you think helped you lose those 5 pounds? 

    Instead of this: I hear you saying that you’d like to 20 more pounds. I see you’ve only lost 5 pounds. What have you been eating?

    Try this: We’ve been talking about trying to work in more non starchy vegetables at dinner to help fill you up without raising your blood glucose. How many days a week do you think it’s reasonable to start with? On a scale of 0-10, where 0 is not all and 10 is I can definitely do this, where would you rate yourself? 

    Instead of this: We’ve talked about trying to work in more non starchy vegetables to help fill you up. I want you to eat one at lunch and dinner every day. 

    Be a think partner

    During a solution focused conversation, the diabetes care and education specialist acts as the “think partner” in developing solutions by asking questions and helping the person with diabetes to use their own personal strengths to create solutions that work for them. 

    When you meet again, here are 3 follow-up questions to try:

    • What’s been better since our last session?
    • What skills did you draw upon to make changes?
    • What do you know about yourself that lets you know you can achieve what you want?

    We’ll challenge you each week to try incorporating some flips into your conversations and let us know what impact they have.

    Join us next week as we discuss a solution focused-approach to Being Active!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

  • Fresh Views

    Seeing with new eyes: Perceptions of life with diabetes

    The real voyage of discovery consists not in seeking new landscapes, but in having new eyes. – Marcel Proust 

    A view of La Sagrada Familia through an arch on the roof of Casa Mila in Barcelona, Spain

    #EASD2019 is a wrap! Hi this is Deb this week. I represented @AFreshPOVforYou at the 55th Annual Meeting of the European Association for the Study of Diabetes (EASD) conference in Barcelona where I was excited to share the results of our study (more about that below). I learned much at the meeting, connected with friends and colleagues, and met Twitter followers in person for the first time! I also had time to do a little sightseeing and take in the food and culture of Barcelona!

    Front entry of the EASD 2019 meeting, Barcelona

    Our abstract, Perceptions of life with diabetes revealed through a solution focused brief therapy exercise via Twitter, was presented on the final day of the conference in a very large room. Often many people leave for home the last day of the conference so I feared the room would be empty, but it was not! Given that this was the only session addressing the psychology of diabetes, there was a great crowd. The presentation focused on the use of the Miracle Question, a solution-focused tool, to help people overcome challenges by using “solution talk” rather than “problem talk.” We wrote about it in our blog post about our AADE presentation here and here describing our World Diabetes Day 2018 #DSMA Twitter chat.

    I try to start all of my presentations with a slide reminding the audience (or sometimes educating them for the first time) that #LanguageMatters when speaking with or about people with diabetes. You can read our past blog posts related to this here and here.

    #LanguageMatters slide

    I asked for a show of hands to see how many in the room were familiar with the Miracle Question approach. I only saw one hand raised. Since this was a 15-minute research presentation, it was hard to cover a lot of the background, so the focus was on the study outcomes. It was exciting to see lots of Tweets about the presentation and that the concept of a solution-focused approach was being spread across the Twitterverse. You can read the full abstract here

    We have submitted the complete data to be published (fingers crossed that happens soon!). However, in brief, when we employed the Miracle Question approach during a Twitter chat there were five themes that evolved.  That means that these were the most common threads, thoughts, comments that were expressed by those who participated in the chat. The themes were: more of living life; laughter and humor; self-compassion; resilience; and support.  

    Deb at the podium presentation

    There were several questions at the end of the session and many people came up to talk about the approach. In fact, several researchers shared with me about their research and how they could see incorporating a solution-focused approach into their research study.  It was very exciting to see the interest in this tool.

    Most of the comments and questions were positive. Interestingly, one questioned the value of having people “think less” about their diabetes, and worried that diabetes management would be hurt. I responded by saying that Dana Lewis (creator of Open APS) might disagree. When I heard her speak earlier in the conference she indicated that with her Open APS system, she thinks less about diabetes, including not having to bolus when she eats carbs.The theme of “more of living life” meant different things for different people.  The Grumpy Pumper (Chris Aldred) commented, “For me, the issue isn’t how often I think about my diabetes, it’s the type of thoughts. Looping hasn’t made me think less, but my thoughts are more positive because I’m seeing the results I want.”  This was a great perspective. The overarching message was that they wanted to focus on the positive aspects of life.

    It’s important to acknowledge that people engaged in a diabetes Twitter chat are likely very engaged in their diabetes management. There was a question if the process would still be successful in others. We agree that we have the same questions and hope to conduct additional research in this area in the future.  

    We also had a Diabetes Online Community (DOC) advocate @Blue_sugar_cube reach out and ask how she and the DOC could get involved with our work. That was exciting! As well as seeing a few new subscribers to our blog!

    And lastly, a big thanks to @WeRateTalks on Twitter who gave our talk an 11/10!  Wow! We were honored!

    We’ll be seeing some of these diabetes friends in Busan, South Korea for the International Diabetes Federation Congress where Deb will be speaking on two panels, one on #LanguageMatters and one on digital health. 

    Kellie, Karen, Grumpy, Renza, Deb and Donna at the end of our presentation

    By sharing a solution-focused approach to diabetes management with a worldwide audience we hoped to inspire people to think differently and consider incorporating a solution- focused approach in their practice.

    We began this post with the quote, The real voyage of discovery consists not in seeking new landscapes, but in having new eyes by Marcel Proust . We’d like to encourage health care professionals to “have new eyes” when they think about diabetes management, and be open to new tools and solutions. 

    If you’re a researcher and would like us to consult on a future research grant, please reach out – we’d love to chat!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Disclaimer: A Fresh POV for You is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com. 

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