Help me regain my mojo when it comes to diabetes self-care.
I was diagnosed with what seems to be a rather mild form of Type-II diabetes about 11 years ago, when I was in my mid-20s. I'd like your advice about maintaining good self-care for the very long term, because it seems like I've let myself slip a bit in recent years, and I'm struggling to get back to where I want to be.
When I was first diagnosed, after a period of initial shock and surprise, I made radical and significant dietary and exercise changes that had almost immediate results. Within weeks I was adhering to a low-carb diet of 25-50 grams/day and I resumed running 10-12 miles a week; running was a form of exercise I'd enjoyed when I was younger and I was able to get back into it pretty smoothly. As a 5'8" male, I dropped from about 180 lbs to between 155-160 lbs. I completely gave up alcohol, sweets, pasta, bread, rice, potatoes... all the refined carbohydrates and starchy foods that a diabetic should reduce or eliminate from his diet. I felt and looked good.
For the duration of this time, I've been using a variety of oral medications (including, at various times, Actos, Metformin, Amaryl and Avandia), without noticing much assistance from any of them. For a time, I injected twice a day with the starter dose of Byetta, but I lost so much weight (from my usual ~160 to 140) and had so little energy that my endocrinologist discontinued it.
I was able to maintain this diet and exercise regime for about 8 years. About 3 years ago, I increased my running mileage so that I could train for a full marathon (a lifelong goal). I was very hungry during that training and incorporated more of the carbs that I'd given up just to maintain weight and energy. I ran the race and have since been running 4-5 half-marathons and 10-milers per year since then - the shorter distances are more to my liking. You can imagine what happened - I never eliminated the carbs, and now my diet has taken a moderate - but significant - turn for the worse.
There are a few things going on here, I think:
• Running increased distances in the past three years is enjoyable and I want to stick with it, but it requires eating more, leading to the temptation to eat more carbohydrates;
• My kids are now old enough to want to snack frequently, and their snacks (and meals) are fairly carb-intensive;
• Life is a bit more stressful in recent years, as I have had some other health setbacks and some job issues; and
• I’m now in my late 30s and my metabolism isn’t what it used to be.
Frankly, however, it feels like the main issue is that I've just lost my willpower. I'll drink a beer and not worry about it, or eat pasta with my wife and kids because I don't want to make another dinner. It's pretty much just laziness, and it's taken a toll in a higher weight (low 170s), a less healthy appearance in general, reduced energy, and slightly higher HbA1C numbers (6.2-6.5, as opposed to the very high 5's and low 6's before). I haven't exactly fallen off a cliff in terms of my self-care, but it's to the point that I just can't seem to get back to what I know will be effective.
I'd like guidance from any diabetics, or those dealing with other chronic illnesses, about how to get back my mojo when it comes to my self-care. I know what to do, but I'm increasingly reluctant to do it. I know that the long-term consequences of what I'm doing may be significant, which is a motivator, but a hard one to bear in mind day-in and day-out. I do feel guilty about my "struggles," since I know I'm a lot better off than many people with other illnesses and difficult situations with which they have to contend.
If you're aware of a particularly helpful online forum to which this question could be directed, please let me know. I'm turning to AskMe first because I expect the quality of the replies will be high. I haven't participated in online diabetes forums in the past but would be willing to do so at this time.
I should add that I read and enjoyed Julian Seifter's After the Diagnosis: Transcending Chronic Illness
. Any other book recommendations would be welcome, too.