Contributor: Dr Nicole Bereolos, Ph.D., MPH, MSCP, CDCES, FADCES
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The concept of empowerment is not new in diabetes literature. Research articles from over 30 years ago used this term when discussing the treatment of chronic conditions. In 2004 Dr. Funnell stated that empowerment is "a patient-centered, collaborative approach tailored to match the fundamental realities of diabetes care. Patient empowerment is defined as helping patients discover and develop the inherent capacity to be responsible for one's own life."

We all know that living with diabetes is challenging. There are so many variables in blood sugar management that we do not have control over, but there are many that we do!! You may have a choice in medication, ways of monitoring blood sugars, healthcare providers that you see, foods that you consume, physical activity that you engage in, getting adequate sleep, engaging in stress management, etc. Because you have these choices, you have some power. This is where feeling empowered comes into play! You do not have to feel stuck!

There are steps that we can take to improve our feelings of being empowered:

1. Explore the problem - Ask yourself, “which variables are under my control?”
2. Clarify emotions - Ask yourself, “how am I feeling about this?” Be honest with yourself and do not ignore any emotions; emotions are not bad!
3. Develop a plan - Ask yourself, “what is my plan of attack?” This is based on your answers to #1 & #2.
4. Follow through on the plan - Stick with your plan. It may seem impossible or “crazy,” but follow your instinct. Go for it; you can do it!!!
5. Change the plan as needed - Ask yourself, “did the plan work or does it need to be tweaked?” Be flexible, try again, and do not give yourself excuses!

Here is an example of a way to feel empowered:
A 55-year-old female living with type 2 diabetes in Dallas, TX, works full-time in a factory, lives with her 5-year-old grandchild, and is the primary caretaker for her elderly mother, who lives in a nearby town. Her PCP wants her to start taking insulin, and she worries about “carrying all that stuff” and the risk of hypoglycemic episodes.

Here are the steps she can take:

1. Explore the problem - She has a lot on her mind and doesn't feel knowledgeable about insulin or better food choices.
2. Clarify emotions - She worries about low blood sugars, especially while driving to visit her mom, when home alone with her young grandchild, or at work in a factory with a strict break schedule.
3. Develop a plan - She would like to speak to a provider that specializes in diabetes and discovered Diabetes Care and Education Specialists (DCES). She will talk to her job about getting appropriate ADA accommodations.
4. Follow through on the plan - She will call her provider's office on the next business day or reach out via the patient portal. She will search for a DCES in her area. She will visit websites related to diabetes, such as diabetes.org, diabeteseducator.org, niddk.gov, myplate.gov, and diabetessisters.org.
5. Change the plan as needed - Her PCP strongly recommends taking insulin. She will reach out to friends who take insulin and ask them questions. If that is not successful, she will reach out to the peer-support communities online to get support and hear some tidbits and tricks from others who live with diabetes.

Problem-solving is an essential tool in your toolbelt when it comes to thriving with diabetes. Sometimes, even with our best intentions, plans go awry. Being flexible, and open to new ideas, will only help you feel more empowered.

Dr. Nicole M. Bereolos, Ph.D., MPH, MSCP, CDCES, FADCES, is a Clinical Psychologist and certified diabetes care and education specialist with private practice offices in North Texas. She serves as the mental health and diabetes spokesperson for ADCES and has served on ADCES Board of Directors (2018-2021). Dr. Bereolos has been featured in Healthline, WebMD, Diabetes Forecast, etc. For over 28 years, she has been living with type 1 diabetes. She can be found at www.drbereolos.com and @DrNBereolos on Twitter.