Ease Is A Basic Human Need

How do you respond when clients with diabetes feel that managing their diabetes is ‘not allowed?' Learn how to create a sense of ease that makes diabetes easier and fosters sustainable self-care.

Gina sits down, and her extensive body fills the space between the table and the wall. Her facial expression remains fixed as she listens as you speak. She finally offers, “I know what you are saying. I just need motivation.” Your session continues, and she states, “I guess I’m lazy.” With this comment, you know that Gina’s view of health has become entangled with stigma. 

Welcome to Inclusive Diabetes Care. 

The IDC can help you unpack stigma using The Inclusive Diabetes Care Pyramid, a visual representation and transformative tool that empowers healthcare professionals to see the benefits of inclusion in diabetes care. The article, Diabetes and Belonging, provides an overview of the IDC Pyramid, starting with a sense of belonging. 

If you are thinking, “Of course they belong; I am confused about how they would feel othered?” Consider whether there is an expectation for a coworker to go to the bathroom to check blood sugar.  Have you ever been irritated or concerned if a blood sugar alarm goes off during a conversation or meeting? Is it okay for a person to interrupt a business meeting to treat a low or high blood sugar or have to leave work to pick up needed medication and or supplies? Many clients with diabetes feel that these necessities are ‘not allowed,’ which creates the sense of being different or ‘othered,’ making diabetes even harder. 

As a result of being “Other”, it is normal for people with diabetes to hide or minimize the challenges that are present when dealing with a condition that is 24 hours a day, seven days a week. Many people are unaware that, on average, 180-300 additional decisions each day are needed to manage blood sugar. These become invisible steps that are added to a day. Each step may appear small and easy to do, but over time, people with diabetes become exhausted, and the human need for ease evaporates.

Real-Life Examples

Recently, a friend texted, “I am running late.” When she got to my home, she explained, “It was just a series of missteps. I had a terrible low blood sugar before I was about to leave. I had to treat that before I could drive. Once that cleared, I realized that I was out of insulin and needed to change my pump.  Of course, when I got on the road, I had no gas.” 

“I avoid cookouts and parties. It is too difficult to keep my blood sugar stable.”

A client messaged me, “I am about to get on the plane, but my reservoir is almost empty. What do I do?”

“I can’t walk outside anymore because, with my neuropathy, I am going to fall.”

All of these situations illustrate the frustration, fear, and burden of having diabetes.

Ease is a basic human need. 

Without ease, your clients are nervous, worried, anxious, defensive, irritated, frustrated, and angry. These emotions are all tied to diabetes distress. Ease is a basic human need required for sustainable self-care because it is associated with safety.

Fostering a sense of ease is a step that is needed at all phases of diabetes care. From public health policies, insurance coverage, supplies, medication, and provider visits, people with diabetes typically miss the sense of ease.

Ease is not asking for things to be ‘easy.’ Ease can feel like a delicious moment of rest, a deep breath, a moment of release, relaxation, and calm. When people with diabetes advocate for ease, they are not lazy.  Diabetes Stigma obscures this truth because words like non-compliant, unmotivated, careless, and lazy are often used to describe people struggling with managing their blood sugar. This stereotype defines diabetes stigma, which the CDC states “are negative attitudes, judgment, discrimination, or prejudice against someone because they have diabetes. It comes from the false idea that people with diabetes made unhealthy food and lifestyle choices, which resulted in their diagnosis.”

Using the IDC Pyramid

IDC Pyramid is a conceptual understanding of inclusion that can be used within institutions or individual counseling sessions.  It is divided into five sections. On the left, list the challenges that people with diabetes face. The right side shows how providers and organizations can foster sustainable self-care. At any point in any conversation or interaction, you can respond to clients with diabetes by acknowledging that diabetes interrupts the basic human need for ease, or you can affirm that reaching for ease isn’t being lazy or unmotivated. It is simply part of sustainable self-care. 

If you are a health care professional, Inclusive Diabetes Care provides 14 continuing education programs to help you understand how stigma makes providing diabetes care harder. Enroll for our free course, Connecting the Dots.