Sex and Diabetes. Janis Roszler

highlights that are broadcast can change a soothing moment into one of great anxiety.

       Enjoy a great book

      When is the last time that you sat and enjoyed an engrossing book? The library and bookstore shelves are overflowing with stories that can engage you and take you to a different time and place.

       Pamper yourself

      Treat yourself to a massage, facial, or manicure. When you feel relaxed and good about your body, you will be more enthusiastic about enjoying intimacy with one you love. The time that you spend engaging in sexual activity should be mutually satisfying for both you and your partner. If you don’t feel positively about yourself, it is difficult to relax and fully enjoy the sexual experience.

       Schedule intimacy into your life

      The connection that you have with your partner can be a great source of support, especially when life becomes hectic. Schedule regular intimate moments with your partner. A weekly evening of bedroom activity or a midday tryst can help boost your spirits and alleviate some of your stress for the remainder of the week. Don’t expect your love life to always be spontaneous. Plan ahead and keep it healthy.

       Take on new health care behaviors in small, easy-to-do steps

      To do this, use the “Jump Start Pledge,” which was developed by one of our authors, Janis Roszler. See the Jump Start Pledge for more.

Jump Start Pledge

      The Jump Start Pledge is a way to slowly incorporate new health behaviors into your life without becoming overwhelmed. Here is how to do it:

      1. Choose a small health behavior.

      2. Pledge to do it for a single week.

      3. Keep that pledge.

      4. At the end of the week, review your progress.

      5. Renew the pledge for an additional week, change it, or add another.

      Make sure that your pledge is small and easy to accomplish. This will help you build your self-confidence as you improve your overall health and diabetes control.

      For example, if you drink five cups of coffee each day and want to cut back on the amount of caffeine that you consume, don’t stop suddenly. Your Jump Start Pledge would be to drink four cups rather than five for the next week. You can substitute that cup for a decaffeinated beverage. At the end of your week, if all is well, cut back by an additional cup.

      If you had difficulty achieving your initial goal, renew your pledge for another week. As long as you set a Jump Start Pledge each week, you are moving forward toward your ultimate goal of good health.

       Seek professional help

      If your stress comes from difficulties in your relationship that are more than you can handle on your own, don’t hesitate to contact a trained therapist who can help you work them out. To find a qualified therapist in your area, visit www.aasect.org, the official site of the American Association of Sex Educators, Counselors, and Therapists.

      YOU MAY FEEL ANGRY

      In his book, Diabetes Burnout, Bill Polonsky, PhD, CDE, coined the term “diabetes police.” These are the folks who decide that it is their task to hover over you and correct every diabetes-related move that you make. Although these comments are usually motivated by a combination of love for you and fear for your health, their good intentions rarely come across and can cause you to become quite upset.

      Tension From Attempted Weight Loss

      “My wife and I used to have a nice relationship. We disagreed now and then, but that happens in all marriages. When I developed type 2 diabetes, Saundra’s attitude toward me changed dramatically. She started to nag me constantly about my weight. I tried to lose weight, but really struggled with it. In her opinion, I had caused my diabetes to get even worse. Her friend had type 2 also, but was able to lose weight and control it with diet and exercise. I couldn’t do it because I wasn’t trying hard enough. I hate her constant nagging. She has turned into some sort of S.W.A.T. team that swoops in whenever I even think about taking a piece of chocolate. Maybe she’s correct—I’m not trying hard enough. Maybe I don’t care enough about my health and my family. When my diabetes educator asked if we were having any problems in the bedroom, I had to laugh. We are so angry at each other that we now sleep in separate rooms.”—Christopher

      If your spouse has become a diabetes drill sergeant, try the following:

      

Share how you feel and find out why he or she feels compelled to nag you all of the time. If talking about this issue is difficult, use the “Magic Pencil” exercise described in chapter 7 as a structure for your discussion.

      

Attend a diabetes class together so you both have up-to-date information about how to care for diabetes. Often, a spouse will nag if he or she believes that you aren’t caring for your diabetes properly or aren’t taking it seriously enough.

      

Visit your health care provider together so that you can both hear how he or she wants you to handle certain diabetes-related situations.

      YOU MAY WORRY ABOUT BEING REJECTED

      Diabetes goes with you wherever you go, including the bedroom. You may feel self-conscious about wearing a pump or worry about the mood swings that you experience when your blood sugar level enters an abnormal range. If you worry about how your mate feels about you and your diabetes, that can carry over into the bedroom where acceptance and communication should be guaranteed. This concern can affect your ability to enjoy and physically react to intimacy.

      Keeping Your Diabetes a Secret From Partner

      Carl wears an insulin pump. He loves the improved control that he gets with it, but doesn’t know what to do in an intimate situation. He read on an Internet message board that some people leave their pump attached to their bodies during sexual activity, but he can’t see doing that. Where would it go? He can’t picture the logistics of that. He knows that he could disconnect it and leave the small plastic infusion set attached to his abdomen or remove everything and hide the pump somewhere, but can’t figure out what to do about the adhesive marks that the infusion set leaves on his skin. He isn’t in a committed relationship with anyone who would understand. Sometimes his sexual experiences are with individuals whom he has only known for a short time. Many of them don’t even know that he has diabetes. “I don’t want to start giving a diabetes lecture when I am alone with someone. That is not how I want to spend my evening!” He is so worried about this.

      Dating can be traumatic as well. You may worry that your date will reject you if he or she learns that you have diabetes. Fortunately, some have discovered a way to handle this situation. See Jennifer’s story, opposite.

      Positive Attitude About Diabetes Boosts Confidence

      “I was always afraid to tell my dates about my diabetes. I used to hide it. I didn’t want them to think that I was damaged or that any future with me would be filled with doctors and hospitals. Then, it hit me. I was acting damaged, wasn’t I? I believed that having diabetes was something to be embarrassed about. It is part of me. Just like my red hair. It is who I am—a great lady who just happens to have diabetes. Now, when I date, I don’t flaunt my diabetes, but I don’t hide it either. If I have to take a shot, I pull out my pen and inject right through my clothes. No one even notices. If I need to test my blood sugar level, I whip out my meter quickly and do it. I’ve found that my attitude sets the tone for my date. If I’m relaxed about my diabetes, he will be, too. If I expect any romance to happen, even simple hugging and kissing, I definitely say something. I