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Week 1. What is Diabetes?
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Why you have T2DM and what you know; client goals & wishes The role of sugar and the role of insulin Signs & symptoms of diabetes Confirming a diagnosis of diabetes Long term complications of diabetes
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Definitions: diabetes distress, perceived stress Introduce resilience resources; emotions associated with T2DM Practicing resilience; positive outcomes in the face of adversity Emotional regulation; adaptation to adversity; coping strategies Positive meaning: what good has come from your T2DM diagnosis?
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Week 2. Getting Your Glucometer to Work for You
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How to use your glucometer; challenges to testing blood glucose Desired values when testing - blood glucose and A1C Troubleshooting values that are too high or too low (self-efficacy
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Awareness of maladaptive coping strategies (e.g., denial, fatalism) Applying adaptive coping strategies (e.g., taking action, planning, reframing, social support, spiritual coping) to manage blood glucose
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Week 3. Carbs Count!
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Understanding the link between blood glucose and food intake What foods have carbohydrates & what foods are carb-free The technique of carb counting Glycemic index and load Troubleshoot values that are too high or too low
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Emotional regulation strategies for overeating, especially at family and social gatherings Applying adaptive coping strategies (e.g., taking action, planning, reframing, social support) in making healthy food choices Focus on cultural food preferences and diabetes self-management
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Week 4. Eating Made Easy! The Healthy Plate
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The carb section of the healthy plate The food groups and what each group consists of Number of servings per day & serving sizes for each food group Cultivating social support from family and friends for food choice Relationship between knowledge and self-efficacy in making healthier food choices
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Cultivating social support, with emphasis on healthier culturally preferred foods prepared (e.g., at socials gatherings) Continue applying adaptive coping strategies (e.g., positive reframing, planning, social support) in making healthy food choices Offer sample healthy, culturally preferred snacks while discussing portion control and other nutrition principles Link food choices to cultural context/preferences
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Week 5. A Step Towards Success
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The benefits of regular physical activity Strategies for adding steps (baseline, build) T2DM and physical activity: when to monitor your blood glucose How to create a supportive external environment (e.g., fitness partner(s), community resources).
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Explain the link between physical activity and emotional regulation Using physical activity to foster mindfulness (emotional regulation, positive meaning, adaptive coping, adaptation to stress) Accountability provided by peers (social support) for performing regular physical activity
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Week 6. Understanding Medications
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Understand each medication you take and why Important other powerful free medications (e.g. activity) A review of long term complications of diabetes
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Address the cultural belief that God will take care of one’s diabetes versus personal responsibility and spiritual coping Coping with discrimination in healthcare settings (e.g., don’t go to doctor, lack of access to medicine, feelings of intimidation)
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Week 7. Grocery Store Shopping and Dining Out
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Choosing healthier options at the grocery store Learning how to enjoy dining out while making healthy choices Simple nutritious recipes on a budget Reading food labels
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Emotional regulation strategies for reducing impulsive shopping Emphasize practical adaptive coping strategies (e.g., planning) for healthier food choices to serve at social gatherings Adaptation to stress: making healthy choices in social settings
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Week 8. Putting it All Together
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Daily and yearly diabetes self-management responsibilities Alcohol and diabetes; anxiety, depression and diabetes Taking care of yourself when sick
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Finding positive meaning in the adversity of being sick (e.g., reflection, renewal, reemphasis on self care) Self-efficacy for implementing resilience resources despite adversity
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Support Groups
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Assessment and knowledge gaps Setting short and long-term goals; Community resources Group problem solving of personal barriers to self-management Grocery store tour, recipe sharing, cooking demonstration
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Informal group discussions; problem solving framed within cultural preferences Historical cultural factors that influence health/health behaviors Continual application of resilience resources for ongoing life stress
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