Taking Charge
One of the ways you can take charge of your diabetes is to learn to be assertive. Most conflicts do not arise out of differences of opinion but out of gaps in communication. If you are unable to assert yourself, you might find it difficult to talk about your diet or how much time you need to take care of your diabetes. Or you may be reluctant to have your needs interfere with those of the people around you. Assertive communication means that both your needs and the needs of the other person are equally important and respected. Assertive statements often begin with “I”. For example, “I find it helpful when you don’t keep chips in the house.” This statement is more effective than a blaming or aggressive statement (“You always try to undermine everything I do”) or reacting passively and being inwardly resentful.

Try out these skills that can help in the workplace, in social situations, and at home with your family:

• Learn to say no. A simple “no, thank you” communicates to yourself and to others that “I respect myself enough to act in in my own best self-interest, and I respect you enough to know that you will understand.”
• Maintain courtesy. Courtesy is the cornerstone of effective and assertive communication. It relays the assumption that you will treat your needs and those of others equally and that neither will suffer at the other’s expense.
• Be direct. Direct communication while maintaining courtesy is as important as saying “no” at the appropriate time.
• Meet your own needs. Hypoglycemia is an example of an urgent situation in which you must be assertive. Don’t put off treatment because you are afraid of offending someone with whom you are interacting.
• Be firm. It is important to be firm with both yourself and others. Make a plan about how you will handle certain situations. If pressured, explain your decision directly to others.
• Maintain self-respect. If you respect yourself, it will be easier to be assertive.

Making Choices
Diabetes is largely a self-managed illness. Unlike more acute illnesses, you give almost all of your own care. Even if they wanted to, the members of your health care team cannot manage your diabetes for you on a daily basis. Your provider, nurse, and dietitian do not live with you and cannot insist that you follow their advice.

As much as your family and friends can be of help and offer support, they cannot manage your diabetes for you either. It is up to you. You are free to decide how much or how little you do to care for your diabetes. Because you benefit from the results of your choices, you have the absolute right to make these decisions.

Many things in our lives are not of our own choosing. Diabetes is not something most people would choose to have.

But while you cannot change having diabetes,  you do have choices to make about how you live with it and your attitude toward it. No matter how constrained you may feel, there are always choices you can make.

Freedom brings responsibility as well. In fact, freedom and responsibility are two sides of the same coin.  Because the choices you make affect your outcomes, you have a great deal of responsibility for your own health and quality of life. It can be overwhelming. There are things that you can do to help you accept this much responsibility.