Humans are creatures of habit. Generally, we follow the same schedule everyday. Intentional or not, our schedules are engrained in our daily lives, and most of us have been following the same routine for years. But what happens when we try to change, or add new activities to our schedules? Usually, the addition of a new activity throws our entire schedule into funk.
During our simulation (read about the simulation here), one the largest themes I observed was how outside factors play a huge role in managing diabetes and the close relationship between diabetes management and scheduling. During our visit to Nemours Children's Hospital, the Fellows learned that self management of diabetes often worsens in summer, when schools are out for vacation, and improves in the fall, when patients return to school and have to follow a consistent daily schedule. Weeks later, this same notion of diabetes management relaying on a schedule resurfaced during our simulation.
For the simulation, my persona was a women living with type 2 diabetes, hypertension and high cholesterol. To manage her health she was on a cocktail of about 9 oral medications and insulin. Additionally, she wanted to start taking classes at her local recreation center. One last, and arguably the most important, fact is she relied the bus for transportation.
All of the Fellows readjusted our lives for two weeks to simulate our personas. I simulated my persona's medication plan by taking placebo medication of assorted of candies (I know- the irony) changing my diet and using public transportation to get everywhere.
First Came the Bus Schedule
Making these changes was extremely tough. I live in a suburban area where the bus only runs every 30 minutes during commuting hours. When planning out my week, one of the first things that I noticed is that I would have to plan my entire schedule around the sparse bus schedule closest to my house. To get to work on time, I would have leave my house at 7:00 am, travel for 2 hours, only to barely make it to work by 9:00 am.
The thing about managing diabetes is that it requires time and commitment. It is estimated that it takes an extra two hours a day to manage type 2 diabetes. Checking blood sugars, counting carbs, logging sugars, taking medication, and managing diet and exercise all add up.
Then Came the Gym Schedule
To add another layer of complexity, as I mentioned previously, my persona was trying add exercise to her diabetes management regime. So, in addition to the bus schedule, I also had to take into account the schedule of classes at my local gym. The number of classes I could take was restricted due to the bus schedule. If I left work at 5:00pm, I could get to the gym around 6:15pm. I had a hard stop and had to leave the gym before 7:45pm in order to catch the last bus that could get me home. After mashing up and filtering through the gym and the bus schedule, there were only two classes per week that I could attend. Well, to be exact, there was only one class I could take and it was offered twice a week. Unfortunately, the class started at 6:45pm and ended at 7:45pm (the same time the last bus arrived at the gym). On the days that I attended these classes, I had to jet 10 minutes before the class ended to make it to the bus on time.
Wait, There is More!
Another large driver of my schedule was meal planning. Planning what I was going to eat, what times I was going to eat (I tried to eat at the same time everyday), and what meals I had to take with me so that I could keep myself nourished while I was away from home.
In addition to these larger tasks, I also had to schedule in smaller tasks like testing blood sugar 3x per day, administering insulin about 5x per day, and taking oral medications.
Want to see how this all works out?! Check out my daily schedule below. These are all of the items that I added to my regular schedule.
A Day in the Life
6:00 am- Wake Up 6:10 am- Check blood sugar 6:35 am- Take insulin 6:45 am- Eat breakfast and take daily medication 7:30 am- Catch bus to the metro station 8:05 am- Metro to work 9:00 am- Arrive to work 11:45 am- Check blood sugar and then take insulin 12:00 pm- Eat lunch 2:00 pm- Check blood sugar 4:00 pm- Eat large snack 5:00 pm- Leave work and catch metro 6:00 pm- Catch bus to the gym 6:15 pm- Arrive at gym 6:30 pm- Check blood sugar 6:45 pm- Gym class starts 7:35 pm- Leave gym to catch bus 7:45 pm- Bus arrives 8:00 pm- Arrive home 8:15 pm- Check blood sugar and Take insulin 8:30 pm- Cook and eat at dinner 9:00 pm- Plan and prepare lunch for the next day 10:00 pm- Check blood sugar 10:05 pm- Take long acting Insulin
This simulation gave me a glimpse of how difficult it can be to manage diabetes, especially when you are first diagnosed. On top of learning about type 2 diabetes, you are expected to simultaneously make drastic changes to your life. I tried to fit all of the new activities to my schedule all at once, and it was extremely overwhelming.
I think the two largest takeaways from the simulation and this experience are:
Although it's time consuming upfront, sitting down and creating a schedule for yourself will save time in the end. This is true for everyone, not just people living with type 2 diabetes.
Don’t try to change your life all at one time. It is more manageable to slowly incorporate new activities, and you are more likely to stick with your new habits.
To learn more about the Fellows' take aways click here to learn about Amanda's great insights and click here to find out how Jake faired without carbs.