The Danger of Perfectionism in Diabetes Management

Diabetes management includes working on our blood glucose levels and to do this we need to monitor the way we eat, the exercise we do, our emotional health and many other variables.

We try, in every way possible, to maintain blood glucose levels in a range that has been determined to be suitable for us. Still, it is undeniable that this is a difficult and often exhausting task. 

Trying to be perfect in various aspects of our lives is inevitable, but how good of an idea is it to seek perfection in management when we live with diabetes

In this session, Kersti Spjut, Brigham University clinical psychologist, and Alexis Skelley, a licensed social worker, spoke to us about this very interesting topic.

Perfectionism, according to the speakers, has different definitions and we must not forget that it is not the same to seek perfectionism as it is to seek to be the best.

Perfectionists set very high standards. They are generally rigid and inflexible and thus face the inevitable negative emotional states by failing to achieve these lofty goals.

Being a perfectionist is not always only about ourselves, but perfection can also be sought in other people, we can seek these high standards in others, in a patient or client, in a family member.

Social perfectionism is perhaps the one we face most frequently these days, and it is the one that we interpret from the world around us: our school, our family, and it is often this type of perfectionism that feels like a burden because it is frequently treated as goals we set to feel accepted.

“Perfectionism is not the same as seeking to be the best. It is about the belief that if we live perfectly, look perfect and act perfectly we can minimize or avoid the pain of guilt, judgment and shame.” Brené Brown.

Perfectionism in Diabetes Management

There are different types of perfectionism when it comes to diabetes management and many of them can have negative consequences on our perception of ourselves as well as our management.

According to Skelley, these are two types of perfectionism that are frequently observed in those of us who live with diabetes.

1. Excessive approach: they are individuals who excessively analyze all the actions and tasks of their self-management. They are people who, for example, count all carbohydrates, check their blood glucose level excessively and are ready at all times. In reality, they are people who follow instructions and are proactive, but excess also causes harm. In diabetes, in this case, efforts based on fear of complications, failure and disappointing others are observed. People who are faced with this type of perfectionism have too high expectations for themselves and seek to meet the expectations of others as well, including social expectations.
2. Avoidance approach: these are individuals who avoid diabetes management. They are individuals who procrastinate their self-care. Sadly, there is a lot of frustration when goals are not met, particularly glycemic goals. Feelings of guilt and failure are very common in these types of people.

Both types of perfectionism must be identified in a timely manner to draw up work plans and interventions that help patients manage these fears and goals in a healthier way.

Why Perfectionism can be Harmful

Some aspects are useful in diabetes management (Fry & Debats 2011), but according to Kersti Spujt, there are some dangers including burnout, interrupting their management, stress responses, and of course, several emotional health disorders including anxiety and eating disorders.

Coping Techniques for People with Diabetes

1. Self-compassion: It’s not just about feeling good, it’s about embracing your experience without judgment. Validate our feelings, including negative emotions. “This is hard, and it’s okay.” Work on recognizing that pain is valid and that we are not alone. Also, be kind to ourselves and treat ourselves with the same kindness and expressions of love with which we would treat others.
2. Dare to be average Kersti shared this David Burns quote with us. Taking a break from diabetes is also not forbidden.
3. Set your mind on growing: You don’t have to feel scared; numbers are information, and the meaning of these numbers is assigned by you.

Techniques for healthcare professionals and loved ones of people with diabetes

1. Practice compassion: We must recognize that we do not fully understand what it is like to live with diabetes. Be understanding.
2. Identify when people with diabetes are at risk for perfectionism: Let people know that you are there to offer help. Make them feel that you are present.
3. Distinguish between optimal and dangerous control or management:  Let’s talk averages and the fact that people living with diabetes pursue HbA1c goals set by someone else, but that it is possible to set optimal goals and ranges for each of us as optimal and personalized goals.

Knowing all this information can help us to establish work plans for our health but without neglecting our emotional health. Diabetes treatment must be individualized, and this includes our blood glucose numbers, our starting points and our dreams.

WRITTEN BY Mariana Gomez, Diabetes Educator, B.A. Psychologist , POSTED 08/17/21, UPDATED 12/13/22

Mariana is a psychologist and diabetes educator. She is the creator of Dulcesitosparami, one of the first online spaces for people with type 1 diabetes in Mexico. She is the co-author of the children’s book Había una vez una Diabetes (Once Upon a Time There was Diabetes) with Eugenia Araiza and co-founder of Diabetes and Co, a diabetes education online platform for Spanish-speaking audiences with type 1 and type 2 diabetes. Mariana is currently the director of emerging markets at Beyond Type 1. She was diagnosed with type 1 diabetes more than 30 years ago and is the mother of a teenager