You decide as you roll over and pull yourself out of bed that today will be different. Today you'll stick to your diet, eat only healthy foods, start that walking program and remember to take all your pills or shots. Like clockwork.
By mid-afternoon, if not mid-morning, today becomes like every other day. Good intentions were only that. But it's not entirely your fault.
As a culture we worship personal responsibility. But as a society we create hurdles at every turn when it comes to health. Being a learned patient about health, diabetes, nutrition and fitness, I'm poised every day to make healthy choices. Then I fly from London to New York.
On my recent Virgin Atlantic flight my dinner was appalling. A sad looking piece of chicken, reconstituted rice, a small salad with Orzo for extra carb, a gummy white roll and dessert. No greens, no fruit, no nutrition.
The Virgin Atlantic website says, "We get all the details just right." They do if their measure is feeding people cheap, food-like substances to maximize shareholder profit.
Admittedly, personal responsibility would have had me bring my own meal onboard, which I often do. I had forgotten when flying international the food has become as pitiful as when flying domestic. Of course, finding a healthy meal at an airport would not have been easy.
Our government says it wants everyone to be healthy so we now have expanded healthcare accessibility. Yet all that ensures is as people grow sicker, more will have access to a doctor.
If the government supported health, it would farm out its farm subsidies differently. Rather than support the overproduction of corn -- that gets turned into inflammatory high fructose corn syrup and used as cheap sweetener in almost everything we eat -- it would subsidize farmers who grow vegetables and fruit.
There is a reason why every other TV ad today is for a diabetes drug. And it's not that people aren't trying. It's that personal responsibility will only succeed where there is societal support.
Unfortunately there was another big whack at my taking personal responsibility waiting for me at home. I had received a letter from my health insurance company denying my doctor's request for a new insulin. Toujeo, a new basal insulin recently on the market, lasts longer (5.2) than its predecessors Lantus and Levemir. This would flatten my morning blood sugar rise and reduce my chance for complications.
I felt betrayed. I pay for health insurance and am an informed patient doing my best. Yet my request for a medicine that can improve my management and quality of life was denied. Why? Shareholder profits -- the insulin that would give me better blood sugars is not on their formulary.
Next time someone makes a thoughtless comment like, "Why can't you control your diabetes? What's the big deal?!" I want you to know it is a big deal. There is little support out here. You're not necessarily struggling because of a lack of responsibility.
The weak link in personal responsibility are the many blockades society has erected. For a disease that requires food adherence, healthy food is often unavailable or unaffordable. We need to be active yet streets are not made for walking or bicycling.
Improved medicines are withheld by the insurance companies meant to safeguard our health. Medicare does not cover the cost of continuous glucose monitors for seniors, the very population prone to low blood sugar.
Diabetes care has always stressed "self-management." But self-management can only be successful for the many when people take personal responsibility and those who govern us support it.
Riva's latest book, Diabetes Dos & How-Tos, is available in print and Kindle, along with her other books, 50 Diabetes Myths That Can Ruin Your Life and the 50 Diabetes Truths That Can Save It and The ABCs Of Loving Yourself With Diabetes. Riva speaks to patients and health care providers about flourishing with diabetes. Visit her websites DiabetesStories.com and DiabetesbyDesign.com.