Self-Management Made Simple

Web Development inMotion

Volume 15 · Issue 6 · September/October 2005 | Download PDF

by Cecilia Kayano

Self Manage 01

Tony Grant (Confederated Salish and Kootenai Tribes) self-manages his diabetes.

Tony Grant (Confederated Salish and Kootenai Tribes) had a dream he was drinking a soda pop. Suddenly there was a voice: “Put that down! It will make your blood sugar go up. It will give you a hemoglobin A1C reading of over 7!”

This voice was not the voice of the Creator. Nor was it the voice of his healthcare provider. It was Tony’s own voice.

His dream simply shows what the term “diabetes self-management” means. It means having an educated voice in your head to remind you of facts and figures to help you choose what to eat and what not to eat. This voice is a guide, showing you the way to manage your diabetes by eating healthy foods, exercising, checking your blood sugar and taking your medication.

Practicing self-management is like making a new friend, someone who gently gives you diabetes advice whenever you need it. Self-management is almost like having a “diabetes angel” sitting on your shoulder talking to you, giving you advice, letting you know you can do it, and showing you the way.

Learning a Little Bit at a Time

So how do you get your own diabetes angel? How do you go from being overwhelmed and a little scared about diabetes to practicing self-management?

Almost everyone who first hears the words “diabetes self-management” is a little confused. “When I first heard about self-management, I was surprised. I had never heard about portion sizes and counting carbohydrates,” says Keith Haines (Mescalero Apache). “At first, I was overwhelmed with all the information,” agrees Tony.

But those who practice diabetes self-management say that learning comes slowly. In fact, diabetes self-management is not a goal to reach; it’s a process. The way to learn self-management is to learn bit by bit.

“I talk to each healthcare provider about diabetes. I get a little information from each one,” explains Keith.

Self Manage 02

Keith Haines (Mescalero Apache) was at first confused by diabetes and blood sugar control. He attended a diabetes education class and continues to learn more by reading and talking with his healthcare providers.

Monitoring Comes First

The first thing to learn is the importance of blood sugar testing and what the numbers mean. Healthcare providers can show you how to use a blood sugar monitor. The monitor is your friend. Making friends with it is the first step in diabetes self-management. People who begin practicing self-management test their blood sugar at least twice a day. Then, they test as needed.

When Tony was first learning how to self-manage, he tested his blood sugar four to seven times a day. It is recommended that a person test his or her blood sugar two times each day.

Since then, Tony tests his blood sugar less often. “Now, I test only when I am curious. Or, I test when I don’t feel right,” he says.

Second is Your A1C Number

The second thing to learn about is the hemoglobin A1C test. If you talk to people who practice diabetes self-management, you will find they know all about the A1C. In fact, they could give a speech on the subject. “The hemoglobin A1C test shows your blood sugar levels over the last three months,” says Gayle Eaglewoman (Crow Creek Sioux). “The ideal level is between 6 and 7. Mine is 9, and I have a goal to reduce it to between 6 and 7.”

Second is Your A1C Number

The second thing to learn about is the hemoglobin A1C test. If you talk to people who practice diabetes self-management, you will find they know all about the A1C. In fact, they could give a speech on the subject. “The hemoglobin A1C test shows your blood sugar levels over the last three months,” says Gayle Eaglewoman (Crow Creek Sioux). “The ideal level is between 6 and 7. Mine is 9, and I have a goal to reduce it to between 6 and 7.”

Self Manage 03

Gayle Eaglewoman (Crow Creek Sioux) feels confident she can choose foods that will help her control her blood sugar. She no longer chooses baked beans, which contain a lot of sugar. Instead, she chooses beans canned in water.

Testing blood sugar and understanding A1C is the start of diabetes self-management. They are great tools, because they show you exactly what is going on in your body. Diabetes is a disease that might not show damage right away. The tests can be evidence that your blood sugar is high and is hurting your body. The test results can help you take more steps in self-management.

Keith says the tests help him stick to self-management. “The hardest thing was to understand it would take time to see the damaging effects of diabetes. There was nothing bad happening to me immediately. I had no pain in my body.” But when he learned his A1C level was 15, he knew the condition of his diabetes had become serious, and he needed to take action.

Lift Your Fork With Confidence

Now, here comes the action part of diabetes self-management. It’s a simple action that involves lifting a fork. Choosing the right foods to eat and adequate amounts are key to self-management. But what to eat, and how much? Talk to a diabetes health staff person, read diabetes information and ask questions. You can learn what you should eat. You can learn what carbohydrates are and how to count them. You can learn about the different kinds of fats and how much you should eat. You can learn how to read food labels to make good choices. “A lot of the secret of self-management boils down to what you put in your mouth,” says Keith.

Looking Good! Feeling Great!

Learning about food doesn’t have to be a full-time job. Those who practice diabetes self-management start slowly and keep learning. With each passing month, you will feel better. You might lose weight. Tony lost 70 pounds. Gayle lost 30 pounds. By losing weight, you will gain energy. “I’m in the best physical shape I have ever been in,” says Tony. “I can work around the house, change car tires, clean up. My son says, ‘Dad, where did you get all your energy?’”

The best benefit of diabetes selfmanagement is gaining a feeling of control. After you learn about blood sugar tests and food, you are able to make decisions for yourself. Gayle says she feels less restricted about food because she knows she can make choices. Self-management doesn’t mean you get a piece of paper with a diet on it. It means learning about food so you can create your own diet.

Diabetes self-management gives you confidence. You are confident when you make food choices and when you talk to healthcare providers. “When the doctor says something about diabetes, I understand,” says Gayle.

“I am able to understand almost everything my doctor tells me about diabetes,” says Keith. “I feel a lot better during clinic visits.”

It’s a Journey

Self-management starts with a prick of the finger. You test your blood sugar. You go in and ask for a hemoglobin A1C test. Then, you talk, you read, you ask questions, you understand! Diabetes self-management is a process that never ends. There is always more to learn. There are always new goals. “I’m not really knowledgeable, but I’m learning,” says Tony.

“I still don’t know everything. I know I have diabetes and I know I have to take care of myself.”

And, best of all, he knows how.

Reprinted from IHS Health for Native Life magazine.

Are You Self-Managing Your Diabetes?

A Person Who IS NOT
Self-Managing Diabetes


  • Takes diabetes medicine, if needed. Thinks that taking medicine alone will prevent diabetes complications.
  • Is quiet during clinic appointments. Is not sure what kinds of tests are due. Might feel a little scared
  • Is not sure about the meaning of blood sugar tests or a hemoglobin A1C test. Is not sure how to count carbohydrates.
  • Eats a chocolate sundae, then feels guilty because it is not on his or her “diet.”
  • May not have health goals.
  • May feel out of control and depressed due to lack of control over diabetes.

A Person Who IS
Self-Managing Diabetes


  • Takes diabetes medicine as directed, if needed. Knows taking the medicine, plus eating the right foods and being physically active, will help prevent complications
  • Listens and asks questions during checkups. Knows if it is time for a foot, eye, heart or kidney check. Is not afraid to remind the healthcare provider that it is time for a check. Feels confident.
  • Knows what his or her blood sugar levels are and his or her most recent hemoglobin A1C level. Knows about how many carbohydrates are in each serving of food. Can eat healthy portions.
  • Eats a small scoop of ice cream, then goes for an hour-long walk to bring his or her blood sugar down.
  • Has goals to improve eating habits, gain more muscle, get rid of stress. Understands how healthy habits will help prevent

Many people learn to self-manage diabetes.
Ask your healthcare provider about diabetes self-management.
Reprinted from IHS Health for Native Life magazine.