This document discusses how new diabetes technologies promise easier management but many people still struggle to maintain control or avoid burnout. While technology helps, people need breaks from the constant demands of diabetes care. The document contrasts unsafe breaks like ignoring treatment with safe breaks like occasional relaxed monitoring that don't compromise long-term health but provide needed relief. It encourages planning occasional breaks to sustain motivation and enjoying life with diabetes.

1. THE GLUCOSE GETAWAY
Diabetes Technology Meets the
Psychology of Real Life
William H. Polonsky, PhD, CDE
Behavioral Diabetes Institute
June 24, 2011

3. Behavioral Diabetes Institute
• Old products
• New products
• New online services
• Visit our first-ever ADA booth!
www.behavioraldiabetes.org

7. The Promise of New Diabetes
Technologies
• Insulin pumps, bolus advisors, CGM,
software, apps, social media
• So much more is coming, which should make
diabetes management easier, more
convenient and less isolating
• And all of this is needed!

8. Percentage of Patients Achieving
ADA Treatment Targets
100
% reaching ADA target
90
80
70
60
50
40
30 13.2%
20
10
0
A1c BP Chol All three
Ong et al. Ann Epidemiol. 2008;18; 222-229

9. Diabetes Tech is Cool, BUT…
• Many people, even those
using pumps and CGM, are
doing poorly.
• Many people have no
interest in trying an insulin
pump or CGM. In fact,
many even avoid blood
glucose monitoring.

10. So What’s the Problem?
• Having cool technology is not enough.
• The obvious missing ingredient: is that
technology being used?
• Recent JDRF-sponsored CGM study
• STeP study
• But WHY isn’t technology being used
effectively (if used at all)?

11. So What’s the Problem?
• Everyone is struggling with one major, often
invisible issue:
• How do you balance taking good care of diabetes
vs. having a spontaneous fun-filled life?
• How can you ever take time off from diabetes?

13. Why a Diabetes Break is Needed
• The “24/7” Problem

14. Why a Diabetes Break is Needed
• The “24/7” Problem
• Frustrating results

15. Frustrating Results
• I did everything I was supposed to, and my
blood sugars are still all over the place !
• I finally get my A1C down and now I m
having all these problems with lows.
• So now I m doing insulin like I m supposed
to, and I ve gained 10 lbs. This sucks!

17. The Glucose Getaway
“And you know, you can never take a vacation or
even the afternoon off from diabetes. Like a lot of
diseases, it is a 24/7 job. I wouldn’t mind a little
break here and there. To go for a hike or even just
a long walk and not have to worry about my blood
sugar…that would be pretty awesome.”
-- Ginger Vieira

18. The Glucose Getaway
• Pssst! Don t tell anyone, but…. everyone
does it!
• Often it is done unconsciously

19. Diabetes Care: Too Much To Do
• Eat more fruits and vegetables
• Limit sweets and saturated fat
• Eat 3 meals a day
• Cut your portion sizes
• Be more physically active
• Check blood glucose
• Take your medications on time, every day
• Have an eye exam at least yearly
• Check your feet every day
• Quit smoking
• Make sure you glucose doesn t get too high, or low
• Lose some weight, but not too much…..

20. You Can t Do it Perfectly
• Good diabetes care is a compromise:
• Have best blood sugars possible
• Have no distressing hypoglycemia
• AND have a spontaneous, fun-filled life

21. The Glucose Getaway
• Pssst! Don t tell anyone, but…. Everyone
does it!
• Often it is done unconsciously
• But there are two types:
• Unsafe getaways
• Safe getaways

22. The Unsafe (or Not Very Smart)
Getaway
• Leads to bad outcomes
• Leads to guilt, emotional discomfort and
more

23. The Unsafe (or Not Very Smart)
Getaway
1. Decide to completely ignore one’s diabetes
for several decades
2. Avoid blood glucose monitoring

24. The Unsafe (or Not Very Smart)
Getaway
3. A pound of chocolate
candies every night

25. The Unsafe (or Not Very Smart)
Getaway
4. Skipping doctor appointments for a year
5. “Winging it”
6. The seesaw syndrome

27. The Safe Glucose Getaway
• BG’s may not be perfect, but long-term outcomes
are good.
• Like any good getaway, it is mostly guilt-free,
enjoyable and restorative. It enables you to
return back to the “job” of diabetes

28. The Safe Glucose Getaway
1. “On Sundays, my mom pokes my finger for me,
then suggests what I need to do. For this brief
period, I don’t have to worry about it.”
2. “Every month, my spouse and I go out for a
ferocious pig out. I dose up ahead of time (as
best as I can), but for that one evening, I don’t
think about diabetes.”

29. The Safe Glucose Getaway
3. “I love my pump, but I get so sick of being
attached sometimes. So every month or so, I just
disconnect for a few days.”
4. “CGM is awesome, but it does get old. Every
couple of weeks is perfect for me.”

30. Everyone Deserves a Getaway
• Plan ahead. Taking a break shouldn’t mean that
your long-term BG’s have to suffer.
• Identify a single change. Don’t take a break from
everything!
• Be reasonable. Don’t make it so long that it
wrecks your long-term BG’s, but do it frequently
enough to give you something to look forward to.
• Don't do it alone. When you involve a loved one,
you are more likely to be successful.

33. So What about You?
• Tell us about some spectacularly BAD glucose
getaways
• Tell us about some safe and satisfying glucose
getaways that work for you
• Help us to inspire others!