Sex and Diabetes. Janis Roszler

score is below 16, don’t ignore your feelings. You can still speak with your health care team about how you feel.

      YOU MAY FEEL STRESSED

      The stress of living with any disease can affect your energy level, how you feel about yourself, and how you relate to your partner. Life with a chronic disease like diabetes can be exhausting. When you live with diabetes, you must focus on a number of factors at once. A few of these factors are:

      

food choices

      

medication

      

physical activity

      

blood glucose testing

      

foot care

      In order to have good diabetes control, you must monitor your life closely. If you are emotionally and physically exhausted from the tasks that you need to do each day to maintain your health, you will have less to offer your loved one. Bedtime will become a time to collapse and fall asleep. When you add other responsibilities to the mix, such as children, homework, carpool, elderly parents, shopping, cleaning, and working, it’s no surprise that you have little energy left to participate fully in the bedroom.

      Exhaustion From Daily Diabetes Maintenance

      “I hate sticking my fingers. I think about it most of the day. I test before meals to provide my doctor with the information that he wants and then test two hours after my meals so I can check if I balanced my insulin and food intake well. I check my feet each night and brush and floss my teeth so I don’t develop any oral infections. When I shop, I read labels to check out the carbohydrate content of the foods that I purchase. I watch the clock to make certain that I don’t miss a feeding or dose of medicine. Frankly, I’m pooped! After all of this, I can’t gather up any additional energy to go home from work and be a fabulous partner in the bedroom. When my head hits the pillow, I’m out for the night.”—Kim

      Reducing your stress level

      Here are some steps that you can take to help reduce your stress level:

       Adjust your job duties

      If your workload is overwhelming, try to share some of the load with a coworker. If your current position is too stressful, consider switching to a different one or see if the duties of the job can be altered in some way. You may feel additional stress if you don’t work in a diabetes-friendly environment. (see box)

      Does your supervisory staff permit you to test your blood sugar and have snacks during the day? Are they threatening to fire you because you have diabetes? If you feel your rights are not being respected, contact the advocacy department of the American Diabetes Association for helpful advice. Their website is www.diabetes.org or you can call 1-800-DIABETES.

       Eliminate some of the activities that you do

      If you volunteer for your church or another worthwhile organization, in addition to all that you do, step back for a while and invite others to do these tasks. If you wish to remain active, take positions that allow you to contribute something unique and important but perhaps take up less of your time. If you run yourself down and cannot care for your health, all who depend on you lose out.

       Try yoga or gentle stretching

      The style of movement that is taught in several types of yoga can help you recharge your battery, reduce your stress level, and help you deal with the challenges of life with diabetes. There are numerous types of yoga. Some, such as Iyengar and Hatha, are gentle and relaxing. Others, such as Ashtanga, are more athletic and aggressive. Before you sign up for a class, make sure that the style of yoga that is being taught is appropriate for your needs. Let the instructor know if you have any physical issues that may prevent you from participating fully. If you have neuropathy in your feet or hands or any other physical concerns, some of the poses used may not be appropriate for you. There are many websites that can introduce you to the practice of yoga. Two that are very helpful are www.yogafinder.com and www.yogajournal.com.

       Participate in regular physical activity

      Exercise releases endorphins and can help relax your muscles and make you feel less stressed. If you are especially stressed in a specific environment, such as your home office, leave the house to do your activity at a health club, community center, or at a park. Invite your loved one to join you and use this time to strengthen your body as well as your relationship. There are various things for a person with diabetes to keep in mind when building an exercise program. A list of risks and recommendations is contained in Table 1, opposite.

       Meditate

      Meditation is another wonderful stress-reduction tool. It is normally taught by an instructor, but you can try to do it on your own. It can help reduce your stress level, think more clearly, and even lower your blood pressure. All of us would love to come home to a loving partner who is calm and welcoming. Meditate a few minutes before your spouse arrives. As few as 10–20 minutes of quiet breathing can help you shake off a lot of the stress that you have accumulated by the end of the day.

      Positive Effects of Meditation

      on Stress Relief

      Here is a simple type of meditation that you can try right now. It is called focused awareness meditation.

      1. Sit in a quiet and comfortable location.

      2. Locate an object, such as a candle or a statue that is in your room.

      3. With your eyes half-open, gently stare at the object.

      4. As you watch the object, focus on your breathing. You can also do this lying down, in a chair, inside, outside, anywhere. It is a very soothing exercise and only requires a few minutes of your time.

      Other forms of meditation include mindfulness meditation, which focuses exclusively on breathing, and transcendental meditation, which uses a mantra, or a personal word or phrase that is repeated over and over. You should be able to find a type of meditation that feels right for you.

       Listen to relaxing music

      Soothing music, especially at bedtime, can help you calm yourself after a challenging day. Invite your partner to listen with you also. Intimacy doesn’t happen in the bedroom alone. The time that you spend together, even if it is only in the same room doing different projects, can strengthen your loving bond.

       Visit a friend

      The support of a friend can also be helpful. Even if you do nothing but laugh or chat about the weather, a meaningful friendship can help change your mood. It can also give you an opportunity to share your daily gripes and groans with someone other than your spouse, especially if you believe that he or she has become tired of listening to them. Don’t disclose personal issues without your partner’s permission, but you can certainly talk a bit about how challenging life with diabetes can be if your friend welcomes that discussion. This will give you an opportunity to discuss something other than diabetes with your loved one.

       Sit outside

      We often undervalue the benefit of quiet time. Our world moves so rapidly. Now that we carry cell phones, we are never alone. Take some time to get off of life’s treadmill. The fresh air is energizing and the quiet is calming. Some people relax by sitting in front of the television. This can be a helpful break,