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Systemic Coaching and Diabetes
by Martyn Carruthers

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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:

1. Frequent urination - particularly at night
2. Frequent hunger or thirst
3. Frequently feeling tired and drowsy
4. Frequent itching of skin and/or genitals.
5. Unexpectedly losing weight
6. Blurred vision
7. Tingling or numbness in legs, feet or fingers
8. Recurring skin, gum and/or urinary tract infections
9. 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.

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.

A person with diabetes may criticize family members, or suddenly announce an unusual decision to business associates ... and then quickly forget the conversations. Family members and business associates affected by such hasty decisions may respond with their own emotions, and stop trusting the diabetic person. Emotional conflicts can spiral to create relationship 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. For example:

• 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.

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.

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

We coach people to improve relationships and build emotional stability. We coach people to live fuller lives by promoting great relationships, emotional well being, educational and vocational goals and appropriate recreational activities.

Please consult a physician about any opinions or recommendations about medical symptoms.

Systemic Coaching - A Doctor's Perspective

Copyright © Martyn Carruthers 2003-2010, All rights reserved

Copyright © Martyn Carruthers 1996-2010 All rights reserved. Soulwork Systemic Coaching was primarily developed by Martyn Carruthers. We coach and train people to define and achieve goals, to resolve emotional blocks and to improve relationships. This information is for your general knowledge only. Please consult a physician about medical conditions and before changing any medical treatment. You must get Martyn's written permission to post or publish his work.