Systemic Coaching & Diabetes

Systemic Coaching & Diabetes
Martyn Carruthers
Coach Training

Living with Diabetes
Diabetes brings many challenges. If you or a family member have been diagnosed with diabetes, it will strongly affect your life. This page describes diabetes types 1 and 2; common emotional complications and possible treatments.

1. What is Diabetes?
If your body produces little or no insulin (insulin helps cells absorb sugar for energy), sugar builds up in your blood and urine, causing excessive urination, thirst, hunger, and digestion problems, which interferes with cellular function. These symptoms are called diabetes.

Diabetes is most common if you are over 45 years old; if you are overweight and/or physically inactive; if you have family members with diabetes; and if you are of African, Hispanic or Native American descent. Diabetes cases are classified as Type 1 and Type 2.

2. Type 1 Diabetes
Type 1 diabetes is an autoimmune disease - the body's immune system attacks and destroys cells that produce insulin. Symptoms of Type 1 diabetes usually appear suddenly in people under 20 years old. Type 1 diabetes is called juvenile-onset diabetes.

3. Type 2 Diabetes
In Type 2 diabetes your body does not balance insulin production and your body cells cannot use insulin efficiently. Symptoms of Type 2 diabetes include those found in Type 1 , as well as repeated infections or skin sores, generalized tiredness and numbness in the hands or feet.

About 9 out of 10 diabetics have Type 2 diabetes. This usually starts after the age of 45, although the incidence of the disease in younger people is growing. The symptoms develop slowly, and may not be recognized. Type 2 diabetes is called adult-onset diabetes; and often follows pre-diabetes - a reversible condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes.

When a body does not use insulin properly or does not produce sufficient insulin, body cells stop allowing sugar to enter, reducing cellular energy. Levels of glucose and insulin in the blood become severely unbalanced, leading to weight gain and obesity – the underlying cause of pre-diabetes.

4. Signs and symptoms of diabetes
Most people have diabetes for years before being diagnosed. By the time diabetes is diagnosed, about 35% of people show signs of damage to kidneys, nerves, eyes and heart. Some symptoms are:

Frequent urination - particularly at night
Frequent hunger or thirst
Frequently feeling tired and drowsy
Frequent itching of skin and/or genitals.
Unexpectedly losing weight
Blurred vision
Tingling or numbness in legs, feet or fingers
Recurring skin, gum and/or urinary tract infections
Slow healing of cuts and bruises
Early diagnosis of diabetes helps avoid serious complications. Ask your doctor for a blood test.

5. Complications of Diabetes
Ignored diabetes may cause life-threatening complications, including coma or death. Other complications include blindness, kidney failure, high blood pressure, heart attack, and stroke.

Diabetes may also cause loss of feeling, particularly in the lower legs, which may prevent a person from feeling skin damage or infection until complications develop, possibly necessitating amputation. Burning, sensitivity and coldness of the foot can also occur. Other complications include higher-risk pregnancies in diabetic women.

There is a strong relationship between Type 2 diabetes and obesity. About 80 percent of people with Type 2 diabetes are significantly overweight.

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6. Psychological Complications of Diabetes
The successful treatment of diabetes resolves psychological difficulties as well as poor sugar control - which can cause further psychological problems. Common psychological factors are:

6a. Following the treatment
Diet and exercise
Insulin management
Injections
Insulin shock
6b. Relationships with families, friends and professionals
People with diabetes may respond emotionally to their hormone levels, and may experience strong mood swings. A person with diabetes may express long-withheld emotions - sometimes chaotically. A diabetic patient may be unaware of even severe mood swings; and act as if a current emotion is a valid basis for long-term decisions. Emotional outbursts may follow minor events.

For example, a person with diabetes may angrily criticize other family members, or suddenly announce an unusual decision to business associates. Yet a diabetic may quickly forget such conversations. Criticized family members, and business associates affected by hasty decisions may respond with their own emotions and reduced trust of the diabetic person. Emotional conflicts can spiral to create chaos.

6c. Managing Emotions, Beliefs and Stress
Guilt, anger, fear and sadness
Beliefs about cause, seriousness, treatment effectiveness
Depression
Stress and trauma
Diabetes & Emotions: Guilt, Anger, Anxiety & Sadness
Strong unpleasant emotions affect both mental stability and hormone levels. Conversely, hormonal therapy can precipitate displays of withheld emotions. The primary emotions are usually guilt anger, fear and sadness; which may support many secondary emotions.

Guilt is often a conflict about having hurt other people
Anger is often related to violated values
Anxiety is often a reaction to possible future events
Sadness is often regret about lost possibilities for happiness
If the whole family knows that diabetics may express wild emotions at unpredictable times - diabetics, their families and friends can better cope with emotional outbursts. Strong emotions may also indicate people who have identified with other people, following systemic rules:

people who have identified with victims express chronic anger and suspicion
people who have identified with a dead person express chronic sadness and melancholy
people who have identified with a hero express chronic fear, anxiety and panic attacks
Diabetes & Beliefs
People who blame themselves for having diabetes are often accurate, as type 2 diabetes is strongly related to lifestyle and obesity. However, some people diagnosed with diabetes may blame family members for "making them" live unhealthy lifestyles.

Although diabetes has potential unpleasant complications, most diabetic symptoms can be successfully controlled by diet, exercise, sugar control and medication.

The effectiveness of treatment is primarily the responsibility of the patient. A person with diabetes can become knowledgeable about the disease. A boost to health is to join or start a support-group, to help other people learn about the disease, its treatment and its consequences.

Diabetes & Depression
Depression with obesity predict adult-onset diabetes. Depression may also increase insulin production. People with diabetes are more likely to suffer from depression than normal. Depression may reduce the desire to take medications and/or to follow the prescribed treatment for diabetes.

Depression is often a healthy response to an unhealthy environment or chaotic relationships. Often, guilt underlies depression. If a person feels guilty for having hurt people, life may not make sense, which leads to depression. Much depression results from:

Abuse, betrayal or abandonment (violating trust; for example - abandoning a child)
Relationship transferences (mistaking one person for another; for example - perceiving an ex-partner as an abandoned child)
People who identify with their body may be deeply distressed by diabetes. Daily injections, mood swings and fears of complications may also become a source of depression.

Stress & Trauma
Stress influences the effects of diabetes. Emotional stress leads to the secretion of many hormones that can counteract the actions of insulin and disrupt metabolic control.

Stress-induced emotions can produce hyperglycemia, and disrupt a person’s relationships, eating habits, exercise and daily routines. This affects diabetes management and insulin dosage. A patient’s emotional needs and problems are an important component of treatment and an integral component of diabetes management. Systemic Coaching can improve the relationship between diabetes and life.

[ Stress . Trauma and PTSD ]

7. Systemic Coaching & Diabetes
As chronic high blood sugar may cause medical complications, a major goal of diabetes management is normal blood-sugar; to balance energy expenditure with insulin dosage. But adjusting sugar intake may invoke both historic and systemic relationship entanglements.

Soulwork systemic coaching supports healthy behavioral changes, such as controlling body weight, increasing physical activity, and increasing knowledge and skills.

Systemic coaching helps people improve relationships and emotional stability. Systemic coaching helps people live full lives by promoting great relationships, emotional well being, educational and vocational goals and appropriate recreational activities.

Ivana Sunibić says: 2009-09-22 10:19:29
Very excellent material. I have contacted Mr. Carruthers to speak in Bosnia on this topic.

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