Lesson 5: Understanding Affects of Change


Understanding Affects of Change


  • Read the following material
  • Activity


In disease prevention/management programs we have been told:

  • You need to change your diet
  • You have to start an exercise plan
  • You have to take pills/insulin

The doctors are right.   Changing the type of foods we eat, including some type of exercise daily, reducing our stress levels, and getting proper rest can reduce our chances of getting diabetes, reducing the levels of blood sugars in our blood, reduce ongoing damage, all positive improvements, but change can be stressful in itself, but necessary.

If you have been diagnosed with diabetes this change can be stressful adding to your daily stressors and the increased burden to your body to try and keep up with the level of stress you are experiencing.

Marvella Jones, Umatilla member, 66 and legally blind, shares her experience with diabetes and stress.

WOE: Great. Great.  Is there anything that I haven’t asked you that you would like to say about your disease or what, what you can say to help other people with theirs?

Marvella: Well, I always seem to get stressed out so easily about it, you know.  And I used to always wish that they had some kind of counseling for us at Yellow Hawk, because there’s times that I really needed somebody to talk to, you know.  I have my friend, Delphine.  We talk about it a lot, you know.  But that being frustrated and depressed and, and stressed out a lot (background noise) about the disease is, is um, but really is my downfall, you know.  So I try to learn to be a little more optimistic about it.  But like I say, I’ve got somebody to talk to (chuckle), my friend.  And we talk a lot about our disease, you know.

WOE: What is it, if I may ask a little, to go into this a little more.  I don’t know how you feel about it, if you don’t want to go there just tell me.  What is it that really depresses you about, is it thinking about dying?  Or is it thinking about just having to do this?  Or what is it?  Can I ask you that?

Marvella: Yeah.  Because, like I say, it’s so depressing to have to stay on a real tight schedule, which we do, you know.  You like get up in the morning and take your pills, or your shot, whatever.  And then you have to um, try to eat um, within your diet, you know, what, what foods you like.  And sometimes you don’t really eat the foods you like.  It’s just what you have to eat.  (chuckle)  Because you know, I’d rather have bacon and eggs instead of just hot cereal.  Um, and um, and just staying on a tight schedule, (background noise) you know.  You can’t really go anyplace until you take care of yourself first, you know. And you have to plan your daily routine around  your diabetes, really.

WOE: Are there any other things that contribute to the depression?

Marvella: Well, there’s living on a fixed income.  And I have a child that’s in college right now, and there’s never enough money.

WOE: So, just sort of daily life, just the stresses of daily life, for you, they really hurt your health because they affect the fact the way your body reacts to the disease.

When asked about some things Marvella does to control her diabetes her responses were:

WOE: Well, tell me what you’re doing, exercise wise now.  What’s your regimen?

Marvella: A lot of it is working with our arms, doing the abs, rowing.  (chuckles) A lot of rowing and a lot of leg work…Oh, and we have to do a lot of pushups against the wall.

WOE: Now you said you do some exercises in the pool?

Marvella: Yes, I jog in the pool because I can’t run on the ground.

Although Marvella is legally blind, 66 years of age, has felt the stress and frustration of the added responsibility of diabetes, and found herself with limited counseling support, has managed to utilize her limited resources to support her stressful situation.

Changes in schedule allowed her:

  • To make regular visits to the clinic for checkups
  • Change her diet
  • Get plenty of exercise
  • Work on having a positive attitude
  • Talk therapy with her good friend Delphine
  • Support from Delphine (her driver)

We all experience different types of situations that influence changes in our lives, like getting married, a new job, having children, returning, death and divorce, and many of these changes can be very stressful and over time our habits and health behaviors change.  We are no longer active, lack the time or energy.

Gerald Bouchard, Cowlitz member, shares his experience with changes in life and how it affected his health.

I went into the Army. I weighed 170 pound when I went in and I weighted 170 pound when I got out. And of course I had physicals in the Army and nothing showed up as far as the diabetes was concerned. And I maintained a weight of around until 200 pounds until 1977.

April 1977 I was injured on the job and consequently I became very sedate…I wasn’t doing the things I used to do, the fishing and the hunting, and the working hard, I started to gain weight. And I continued to gain weight until about 1985.

In 1985, my appendix was ruptured, during the blood work at that hospital where I had my appendix out, they discovered that I had some high blood sugars…at first they controlled my blood sugars with pills. Now one of the things I struggled with at that time, and I continue to struggle with today is my diet. And of course they put me on a real rigid diet.

Learning from change

Although we want to use traditional ceremonies for spiritual and physical health we need to be careful about what we do and the things we may ingest with our medications.

Gerald: Now there is another oddity that happens to me and that is when I do Indian ceremony, my blood sugars go down. And I don’t quite understand why that is so, but I have to be very careful especially in sweat ceremonies that I don’t take insulin before hand, because if I do, I will get hypoglycemic. And when I get hypoglycemic, I get sick in the sweat lodge and I have to leave it and go get some sugar in my system.

Gerald: The other thing that happens is I went to sun dance and I was allowed to dance. In fact, I was encouraged to dance and when I dance, then my blood sugars goes back to normal again. So the activity definitely has a bearing on my blood sugars, and the walking shows that as long as I am fairly physically active, when I was dancing at sun dance, I think I was able to skip many doses of insulin. In fact, one night, I decided that I needed to take insulin, my blood sugar was up just a little bit, and I took just a small minimal dose and I got hypoglycemic at night, so it shows that when I am in ceremony, for some reason, my blood sugars stay pretty close to normal.

Marvella and Gerald have made positive changes in their lives while dealing with stressful situations that could’ve escalated into more serious problems.  They had to learn to apply balanced activities along with following their doctor’s treatment plans.  Change is not easy for everyone, in fact it quite difficult when you have developed habits and a lifestyle over years and years.


Need piece of blank paper and pencil (Download a PDF of the Planner Sheet)

  • First write down all the things you did the day before and the foods you ate.
  • Second take the Planner Sheet and place your regular activities in their time slots, things like taking medications, eat snacks and meals, work, etc.

Group Discussion or Individually write

Exercise is important to maintain a healthy weight and keeping your glucose levels under control, but what other benefits are there from maintaining a proper diet, reducing stress, and getting daily exercise?


Time Task or Activity Length of Time Priority Rate

Low, medium, high

7:00am Medication 5 minutes High
7:05am Start Breakfast 45 minutes med
9:00am Dr. Appointment 1 hour High