Managing diabetes can feel like riding a roller coaster. Sometimes, you feel confident that you’re on your way to perfecting your blood sugar-management techniques – your numbers are holding steady and slowly improving. Other times it might feel as if you are in a downward spiral –  eating what you know you shouldn’t, avoiding exercise, and maybe even skipping important medications.

While there are many factors that play a role in how well you maintain your health, many experts will tell you that effective, long-lasting behavior change begins with setting realistic expectations for yourself.

In other words, to get off the roller coaster, you need to get rid of your ‘all-or-nothing’ thinking.

Here are the four areas where my clients most commonly tend to think in extremes:

1. Limiting Carbs

While most diabetes-friendly diets limit carbohydrate intake, going too extreme in this area can be a mistake. Cutting out carbohydrates, or any food group completely will inevitably lead to short-lived eating habits. So, instead, try to focus on smaller, more obtainable dietary goals. Focusing on things like portion control among all food groups, getting in at least 5 servings of non-starchy veggies in per day, limiting your added sugar intake, or choosing whole grains as your source of carbs for at least 2 out of 3 meals can make a huge impact in the long-run on blood glucose levels. Many of my clients are surprised at how quickly their blood glucose can change by just focusing on smaller, sustainable goals and building on those habits little by little.

And remember, it’s not just carbs that you need to be watching – it is important to be mindful of everything you are eating and how it will affect your blood sugars.

2. Monitoring Blood Glucose

Many of my clients check blood sugars obsessively and then get so frustrated by their numbers that they end up avoiding the glucometer altogether.

So, rather than checking blood sugars constantly or only after each meal, which can lead to continuous frustration and disappointment, try developing a routine that will help keep you on track (ask your doctor for advice). Monitoring blood sugars throughout the day is not just about catching a “mistake” in the moment, but is more to help you understand your body’s natural patterns. For instance, if you chronically wake up with high blood glucose before breakfast, you may be experiencing something called the dawn phenomenon. Or perhaps you notice that every Saturday evening your numbers are soaring, which may alert you to be more mindful of weekend eating habits or eating out.

Establishing a routine can not only help to point out areas for improvement but can also make it easier to catch sugar lows or highs as you are more in-tune with your body’s natural rhythms.

3. Exercising

If you’re trying to build an exercise routine you can stick with, don’t start off by telling yourself that you must make it to the gym 5 days per week. Start by setting a realistic goal—perhaps 1-2 times per week, or 30 minutes per day, to begin with until that pace becomes the new norm and you are ready for a new challenge.

And don’t focus on just one form of exercise. Many of my clients try to tough it out on the treadmill day after day because they know cardiovascular exercise will help to reduce blood sugar levels effectively. For most people though, focusing on just one exercise – especially one you don’t even enjoy – will lose its luster rather quickly. Instead, explore a variety of exercises that work different muscle groups and prevent you from getting stuck in an exercise rut.

As with any health goal, be patient with yourself and your exercise level.

4. Reacting to Stress

One of the most harmful ‘all-or-nothing’ pitfalls: Dropping healthy eating and exercise habits entirely when life becomes particularly stressful. When your body is under stress, insulin levels drop and hormones are released that increase blood glucose levels, making it especially difficult to regulate blood sugars during stressful situations – so, skipping exercise or ditching your diet is just like dumping gasoline on a fire.

To keep yourself from throwing healthy habits out the window when life gets tough, take steps ahead of time to learn how to manage stress differently, such as through deep breathing exercises, meditation, or finding a supportive social outlet. If you find it particularly difficult to manage your stress, it might be a good idea to seek help from a therapist.

Keep in mind that maintaining your health should be viewed as a lifelong, ongoing goal. If it is your health itself that keeps you up at night, you can gently remind yourself that small, actionable changes can make a huge impact down the line. Rome was not built in a day and your health will not dramatically improve overnight, so it is important to be patient with yourself and prevent yourself from looking at your health through an all-or-nothing lens.

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