Leaning into Spirituality as Part of Diabetes Self-Care

As one year ends and another begins, people often find themselves taking stock. They reflect on the past year, considering the good and the bad. They also look ahead to the new year, considering the opportunities ahead.

For people living with diabetes, the looking back and ahead is no different. However, what we focus on might be. There is all that tracking of glucose levels and lab test results, the calculating of carb counts and insulin doses, the days of exercise and the depressive episodes. We have changes in medication and routine to consider, along with the question of whether any changes in our health insurance may impact our access to care. It can all add up to a lot of stress, focused on the physical and logistical hurdles we face.

But what about the more abstract and intangible aspects of our lives — the spiritual side of life with diabetes?

No doubt, managing diabetes on a daily basis requires a high level of psychological and mood management.

DiabetesMine explored what to know about embracing spirituality as part of your diabetes self-care.

The authors of a May 2021 scientific study on diabetes and spirituality explain that “spirituality involves the search for meaning and purpose through which one establishes his/her relationship with time, oneself, others, and God.”

Spirituality is expressed through some combination of beliefs, rituals, and cumulative traditions. An individual’s belief system and worldview spring forth (at least in part) from their spiritual experiences. Spirituality is not synonymous with religion, although it certainly can take a religious form.

While some people may express spirituality through prayer, meditation, yoga, rituals, etc., how each of us practice our own form of spirituality is unique. Some people engage in a formal religious belief system with its worldview and rituals to engage their spirituality. Others engage in an ad-hoc collection of practices. Still, others land somewhere in between, combining the organized and the ad hoc, to express their spirituality.

A number of studies have reported that spiritual beliefs and faith-based initiatives can have a positive impact on the management of diabetes.

Spiritual belief and practice encourage two key behaviors that support the person’s mentality and lead to more consistent engagement in diabetes care. First, spirituality generates a positive attitude, motivation, and energy, which acts as fuel for a person’s diabetes care efforts over time. Second, spirituality increases our tolerance of unchangeable situations, valuable in managing our psychology while facing a chronic illness that requires daily attention for the entire span of our lives.

Spirituality and religiosity have been identified as more than just sources of emotional support. Incorporating them into daily routines yields specific, measurable health results.

Spirituality and religiosity have been shown to help support measurable improvements in glycemic control in people with type 2 diabetes by providing the underpinning that strengthens people’s likelihood and ability to consistently make effective decisions and take the daily actions needed for their diabetes care.

A 2018 study on type 2 diabetes and spirituality noted from older research that “the relation between spirituality and depression is statistically significant and inverse.” Meaning, people with higher levels of spirituality may be less likely to experience significant depressive episodes.

Furthermore, diabetes management programs led by healthcare professionals that incorporate spirituality and religiosity have proven effective in bridging cultural gaps in diabetes care. This has been demonstrated in both African American and Latin communities.

As more holistic approaches to health have become more common, we find more people including spiritual practices in healthcare and diabetes care.

These practices and approaches encourage spirituality and/or religiosity to be incorporated into daily diabetes care as a way to nurture calm and focus. When spiritual practices are done as part of a group, they can also provide social and peer support. Spiritual practice can ultimately build resilience, and coping skills help a person consistently take actions and make decisions that support better diabetes management.

Meditation and yoga are among the most common spiritual practices talked about in diabetes care. Faith-based health initiatives have also become more common.

Meditation

Meditation (sometimes referred to as mindfulness) is a process where a person calms their body and mind through a focusing exercise. While meditation is a part of many religious practices, at its core, it isn’t religious in nature.

During meditation, some people focus on their breath or a sound in order to train the mind, quiet their thoughts, and train the body to relax, all at will. The aim is to take a break from the constant stream of thoughts going through the mind and relax the body. Stress is released and the body’s natural stress response, which includes releasing stress hormones like cortisol, is interrupted.

The positive physical effects of regular meditation have been measured in a number of studies. One study published in 2018 divided a group of 60 people with coronary heart disease into two groups, and had one group practice meditation on a regular basis while the other group did not. At the end of 6 months, the researchers documented a “significant decrease” in daily blood glucose, A1C levels, and fasting insulin levels in the patients who practiced meditation compared to the control group.

Yoga

Yoga engages the physical body through gentle movement and poses. While (in the West) it is often thought of as physical exercise, yoga also incorporates mental and spiritual aspects in its practice.

Along with stretching muscles and encouraging blood circulation, performing yoga poses includes controlled breathing and calmed thinking. Scientific studies show that with type 2 diabetes, yoga “improves flexibility, muscle strength, blood circulation, and oxygen uptake.” Also, mentally, yoga is shown in studies to measurably reduce anxiety levels and depression.

Yoga provides a holistic health practice, engaging the physical, mental, and spiritual aspects.

There have been a number of programs over the years that focus specifically on yoga for diabetes, and again, studies have shown that yoga therapy helps reduce blood glucose levels and helps in the management of other conditions — heart disease, hypertension, and depression — associated with diabetes.

Faith-based initiatives

Faith-based interventions (FBIs) are health education programs and support groups connected to religious communities. They marry health education with social support and embrace religious practice and belief as part of self-care.

FBIs can take a number of different forms. The religious community can be a path for recruiting participants in already-established health initiatives. Or key members in the religious community, like a pastor or elder, can participate in delivering part of the health intervention. Generally, some spiritual elements, like Bible verses or parables, are included in the message delivered.

Clinical trials have shown that presenting diabetes education in a faith-based setting is an efficient approach, increasing access and allowing time for health education in a manner and setting that also increases many people’s receptiveness to the self-care messages.

According to an older study on reaching African Americans with diabetes education through FBIs, “religious involvement is associated with better adaptation to chronic diabetes by improving attendance at scheduled medical appointments, and better compliance with medication.” Through religiosity, people find a belief system that provides them with support, confidence, and hope. It’s a trifecta of coping skills for managing the daily demands of diabetes self-care.

If you’re looking for a faith-based guide to the spiritual aspects of life with diabetes, consider “Living Well with Diabetes 14-Day Devotional” by Constance Brown-Riggs, an award-winning registered dietitian, certified diabetes educator, and national spokesperson for the American Dietetic Association.

The book offers a tool for stepping away from the daily hustle and bustle of managing life with diabetes to reflect and meditate, and maybe even experience some positive feelings. Each section includes an inspirational essay, along with a related Bible verse, affirmation, reflective prompt, and gratitude prompt.

Brown-Riggs tells DiabetesMine that she wrote the devotional to help people living with diabetes to give themselves more grace. Being well aware of the stress, depression, overwhelm, and burnout that can come with diabetes, she wants to give people an opportunity to step back from their daily routine and challenges.

Two-week’s worth of reflections she feels is ample for giving people a chance to reset and refresh their relationship with diabetes, encouraging them to move ahead taking life one day at a time, and one step at a time.

The reader can choose how they use the book. Each section is independent, so there is no need to work through it front to back. And the reader can choose the material they want to focus on. Brown-Riggs is quick to point out the devotional’s flexible structure, acknowledging that not everyone is a religious person but that many people do acknowledge some kind of higher power.

In short, diabetes touches every aspect of our lives: physical, mental, and spiritual. Because of this our reflections and self-care need to also address every aspect. Too often the spiritual gets left behind. But experts have found that engaging in the spiritual can have tangible positive effects on diabetes. And we can choose what works best for us when engaging in the spiritual nurturing of our health.

When we asked Brown-Riggs for any top line advice for people with diabetes about how to effectively include a spiritual aspect to their diabetes care, she shared three thoughts for reflection:

Nourishing the Body. Your physical being is at the foundation of your overall health. If you are ill, it is difficult to be mentally well and spiritually light. So, staying physically well is vital. Wellness requires the fitness triad — nutrition, exercise, and relaxation.

Feeding the Mind. The mind is synonymous with mental and emotional being. A healthy mind enables you to think prudently and make choices that will enable you to live well with diabetes. A healthy mind is dependent on a healthy body.

Elevating Your Spirit. The spirit is the home of the ideal self. Prayer, meditation, and worship can foster a healthy spirit — and it’s the fruit of that very prayer and meditation that aids in the healing of the mind and the body.

https://www.healthline.com/diabetesmine/leaning-into-spirituality-as-part-of-diabetes-self-care

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