For some time, I have been reflecting on the parallels between my challenges with diabetes and man’s challenges with climate change. Today seems like a good day to share those thoughts.
I have had diabetes for 17 years now, all of my adult life. I studied biology at university; my sister is a diabetes research nurse; and I have some of the best medical care in the world. It’s fair to say I have all the knowledge, support, and medication needed to get it under control. But despite all this, my sugar levels have remained erratic and my doctors scornful, warning of the risks if I continue as I do. The only thing to blame is me and my bad habits.
And that’s where the biggest irony lies: I’m an expert in behaviour change, yet I can’t change my own behaviours.
So I thought it might be worth reflecting on those parallels, and what I’ve learned from my own personal battle with behaviour change — and how it could be applied to the wider issue of sustainability. Here we go.
1. Lack of motivation
Day-to-day the main risk of diabetes is around having hypos and hypers, and the dizziness, lethargy, and general inconvenience that they bring, but these you can easily learn to live with. Much like the cost of oil or a bit of elevated air pollution, they aren’t quite enough to motivate you to cut out the better things in life: fast cars, mini breaks, and the latest gadgets — or in this case, chocolate, booze, and spontaneous adventures.
2. Distant, far-removed threats
However, as with climate change, the real risks are longer term and far more serious. The long-term complications of diabetes include kidney disease, blindness, and foot amputations — pretty severe really, and should easily be enough to motivate me to keep my levels in check. But they’re so far removed and hard to conceive happening to me that the mind doesn’t really connect to it when deciding whether or not to eat that extra square of chocolate.
Similarly, it’s hard to connect our small every day actions to increasing the risk of catastrophic climate change. The scales are just too disproportionate for our brains to process.
The likelihood, timing and severity of these complications are largely unknown. Research shows that good control of your sugar levels massively decreases the risks of developing complications, but the details are uncertain. How low you need to get your HbA1c — the measure of your sugar level control — in order to be ‘safe’ is debatable: in Canada they recommend getting below 6%, in the UK anything in the 7–8.5% region is heralded as fantastic.
6% or 7%; 2°or 3°? That uncertainty, in its sneaky way, leads to a little apathy.
4. Technology vs. behaviour
It’s all too easy to get transfixed on tech solutions being the cure — a new pump with multi-wave boluses; new insulin with more natural absorption characteristics; a cutting edge blood tester that doesn’t require any finger pricks. Yes, these things help but, in truth, they’re all a distraction from what really matters: my behaviours.
It comes down to the age-old rebound effect: if going onto this fancy new pump gives me the freedom to eat more cake, then the net impact is going to be nil. Technology is only ever as effective as the user makes it.
Russian heat waves, the Pakistani floods, Australian bushfires — these disasters all inspired renewed efforts in the battle against climate change. They scared people, reminded them of the reality that we could be creating for ourselves if we carry on as usual.
For me, my scare came last summer when I found out I had the early signs of kidney disease, a side effect of my diabetes. Suddenly life seemed so fragile, so important. I was scared, worried, stressed — but it made me pull my finger out, at long last, and take diabetes seriously.
6. Broader benefits
It turns out that controlling my diabetes benefits more than just my diabetes, just as reducing your carbon footprint benefits more than just climate change. After my scare, I got my levels in better check than ever before and started to feel noticeably healthier, my moods stopped swinging so wildly, I lost weight, and I became more productive.
So just like living more sustainably, it simply makes sense.
7. Data helps
Quantified-self enthusiasts clocked onto this long ago: when it comes to changing behaviours, being able to clearly track your progress really helps. Despite taking multiple blood tests each day, until recently I had no system set up to track these over time, aside from with good old fashioned pen and paper.
But then I heard of Mumo Active, an app to record and visualise sugar levels as you go. Seeing the patterns and fluctuations in real time was so helpful, allowing me to tweak and fine tune my treatment in response to peaks and troughs. Perhaps most importantly, it also allowed me to see when I had stayed on target for several days in a row — you can’t underestimate how motivating that was.
8. Sharing and comparing
I often wanted to know how I was doing compared to others — how did my HbA1c sit on the spectrum of diabetics of my age? Sadly, the NHS can’t share this kind of data. But in the energy world, utility companies have found sharing and comparing such data incredibly effective in motivating households to reduce their energy bills.
9. Regular reminders
I’ve learned this lesson through my work at The DoNation as much as I have with my diabetes: if you don’t keep clocking in with people about their behaviours and performance, they’ll let it slip. Regular reminders or check-ins are critical for maintaining motivation.
That’s why my doctors insist that I go in for a check up every four months (even if, like today, they send me home again within five minutes).
And that’s exactly why we send carefully timed reminder emails to our users.
10. Making it social
The power of making a public pledge was the topic of my Masters thesis, and one of the big inspirations behind The DoNation. Once you’ve shared your commitment to do something with people you know, that commitment is massively strengthened.
And so it should have come as no surprise to me that as soon as I started talking about my diabetes more openly with my friends, I found it easier to stick to my plan and be a diligent, good diabetic.
The good news is that thanks to a bit of a scare, some good data management, talking more openly about my challenges, and fantastic NHS support, I have been more committed to changing my habits. And those good behaviours are now becoming innate, and are paying off: today I got a PB in my HbA1c — a corking 7.0%. And my kidneys have been given the all clear.
So there is hope. Behaviours can be changed, even mine.