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Behavior Change: Where Are You

Posted by Marilyn Csernus -

Have you heard the phrase "a goal without a plan is just a wish"? This is especially true when it comes to diabetes self- management. Anyone managing diabetes is very well aware of the time and effort required for most people to maintain good diabetes control. The best plan for diabetes management is an individual plan, as no two individuals with diabetes have the same pancreas function any more than they have the same lifestyle or medical history.

There is an important reason we refer to diabetes care as diabetes self-management. Although one's health care provider or diabetes educator prescribes medication and provides education regarding lifestyle changes and skills necessary for diabetes care, the majority of the time individuals with diabetes manage their own condition. It is just not realistic to seek advice from a health care provider every time you eat, check blood glucose levels, take medication, or deal with minor illnesses.

In addition to gaining the knowledge and skills required for diabetes control, behavior change is key for long-term successful diabetes control. James Prochaska's "Stages of Change" model is helpful in understanding why some areas of behavior change come easier than others and helps evaluate one's readiness for change. These stages of change are:

  • Precontemplation - being unaware that change is needed or having no intention of changing
  • Contemplation - aware of benefits of change and plan to change in next 6 months
  • Preparation - taking steps to change in the next 30 days
  • Action - making changes within the last 30 days
  • Maintenance - has successfully made a change within the last 6 months and working on not regressing to past behaviors

Any type of change takes time and often it comes with a step or two forward and few steps back. Give yourself time to move through these stages of change. Trying to identify changes that will lead to the most positive health outcomes is a great place to start. For some this might be cutting out sweetened beverages and for others it might be starting to monitor blood glucose on a regular schedule. "I will try to drink more water and cut out regular soda to help my glucose control, but I just don't know if I can give up my Mountain Dew" is an example of someone in the Contemplation stage of behavior change. This person is aware of the benefits of cutting out Mountain Dew and is thinking about changing this behavior, while realizing how difficult it may be. A statement reflecting the Action stage of behavior change might sound like this: "I am so proud of myself for totally giving up Mountain Dew and only drinking water or other sugar free beverages for the past month." In this example the behavior has actually happened over the last month.

It is difficult to work on too many changes at once so prioritize your goals, starting with those that will have the greatest health impact. Congratulate yourself on those behavior changes that have successfully reached the Maintenance stage.

Visit Your Guide to Diet and Diabetes at for more diabetes resources and for diabetes friendly recipes.

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