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Associate Publisher, Books, Abe Ogden; Director, Book Operations, Victor Van Beuren; Managing Editor, Books, John Clark; Associate Director, Book Marketing, Annette Reape; Acquisitions Editor, Jaclyn Konich; Senior Manager, Book Editing, Lauren Wilson; Project Manager, Wendy Martin-Shuma; Composition, Circle Graphics; Cover Design, Jenn French; Printer, Versa Press.
2019 by the American Diabetes Association. All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including duplication, recording, or any information storage and retrieval system, without the prior written permission of the American Diabetes Association.
Printed in the United States of America
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The suggestions and information contained in this publication are generally consistent with the Standards of Medical Care in Diabetes and other policies of the American Diabetes Association, but they do not represent the policy or position of the Association or any of its boards or committees. Reasonable steps have been taken to ensure the accuracy of the information presented. However, the American Diabetes Association cannot ensure the safety or efficacy of any product or service described in this publication. Individuals are advised to consult a physician or other appropriate health care professional before undertaking any diet or exercise program or taking any medication referred to in this publication. Professionals must use and apply their own professional judgment, experience, and training and should not rely solely on the information contained in this publication before prescribing any diet, exercise, or medication. The American Diabetes Associationits officers, directors, employees, volunteers, and membersassumes no responsibility or liability for personal or other injury, loss, or damage that may result from the suggestions or information in this publication.
Sean Petrie conducted the internal review of this book to ensure that it meets American Diabetes Association guidelines.
The paper in this publication meets the requirements of the ANSI Standard Z39.48-1992 (permanence of paper).
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American Diabetes Association
2451 Crystal Drive, Suite 900
Arlington, VA 22202
DOI: 10.2337/9781580407106
Names: Napora, Joseph, author.
Title: The mindful guide to managing diabetes : your path to reducing stress and living well / Joseph P. Napora, PhD.
Description: Arlington : American Diabetes Association, [2019] | Includes bibliographical references and index.
Identifiers: LCCN 2019002778 | ISBN 9781580407106 (soft cover : alk. paper)
Subjects: LCSH: Diabetes--Popular works. | Diabetes--Treatment--Popular works. | Self-care, Health--Popular works.
Classification: LCC RC660.4 .N37 2019 | DDC 616.4/62--dc23
LC record available at https://lccn.loc.gov/2019002778
To Granny, my wife and very best friend.
And in memory of Martin, a dear friend and a model of excellence.
Contents
ACKNOWLEDGMENTS
F irst, I want to express my gratitude to all of the individuals with diabetes who gave me inspiration and support over the years that I have worked in this field.
In addition, I am very grateful to Richard R. Rubin, to Chris Saudek of the Johns Hopkins Comprehensive Diabetes Center, to Bev Amsterdam Press of the Suburban Hospital Diabetes Center, Bethesda, MD, and to the many faculty and staff who gave me the opportunity and support in developing my work. Thanks, too, go to Marlys Rixey, Carrie Grady, Rachael L. Balter, and Nancy Glaser for their contributions to this endeavor.
Thanks also go to Victor Van Beuren of the American Diabetes Association. Victor has been an advocate of my work from the initial conversation we had about publishing the first edition, Stress-Free Diabetes: Your Guide to Health and Happiness (1). My appreciation goes to everyone who has played a role in the development, production, and promotion of the book, including Jaclyn Konich, Lauren Wilson, Wendy Martin-Shuma, and Annette Reape. Your commitment to making The Mindful Guide to Managing Diabetes the best it could be has been invaluable.
Once again, I am fortunate to have a loving family cheering me on during the process of writing this book. Their enthusiasm helped a lot. I have been blessed, too, by the spiritual guidance of Rabbis Steven Schwartz and Dana Saroken.
Last but not least, I am deeply appreciative of Linda, my wife and best friend, for her support, her patience, and her wise and tireless reaction to every written word.
FOREWORD
O dds are good that youve picked up this book because your personal experience has taught you that living well with diabetes is a lot more difficult when the everyday demands of life are driving you crazy. Not a big surprise, huh? Yes, stress and diabetes can be a toxic combination. And you no doubt know that the sources of stress are endlessyour job, your family, your worries about money, your worries about your health, your lack of free time, and, of course, the demands and frustrations of living with diabetes. As denizens of the U.S. in the 21st century, we are all aswirl in a sea of stressful experiences, and it is too easy for our lives to grow more and more burdensome and out of control. Unrelenting stress can make it so much harder to give your diabetes the attention and care that it needs. My colleagues and I here at the Behavioral Diabetes Institute have been researching this problem for decades, and we now understand how chronic stress can lead to dangerously high blood glucose levels, both directly (due to stress-induced hormonal changes) and indirectly (due to stress-induced changes in behavior, such as overeating). But what on earth can you do about all this? You probably cant just up and move to some idyllic South Pacific island; even if you did, youd probably just take many of your worries and concerns with you.
While you cant make all of the stresses in your life magically disappear, there are methods for directly addressing life stress and for alleviating the many stresses and aggravations of living with diabetes. So have hope; you can feel better and do better! One key solution is the application of mindfulness, and Dr. Joseph Napora does a terrific job of explaining the concept and showing you how a mindful approach can make a real difference in your life. In this book, he uses many real-life stories and examples to cut through the professional gobbledygook (the unnecessary jargon that we psychologists are too prone to use) and gets to the heart of the issue. Also, being the kind and compassionate psychotherapist that he is, he does it all with real heart. Ready to start feeling better? Get ready for your adventure with Dr. Joe!
William H. Polonsky, PhD, CDE
President, Behavioral Diabetes Institute
Associate Clinical Professor,
University of California, San Diego
INTRODUCTION
C hances are that what you have learned about diabetes management has focused on diet, exercise, medication, and checking your blood glucose levelscertainly four essential aspects of effective glucose management. However, you may not know that controlling stress is a significant factor in managing diabetes.
