Case Study - Sexuality

“What a relief—the Life Puzzle provides me a great way to approach a very touchy subject with my older diabetes patients.” Amy said. We had just spent an hour exploring the Life Puzzle and how it relates to diabetes management. Obviously pieces in the Life Puzzle like nutrition correlate with diabetes management, but she was surprised to connect sexuality within the same context.

She acknowledged that for many men with diabetes sexual function becomes a very big issue. Few men understand that blood sugars, insulin levels, obesity and exercise can impact their sexual function over the course of a lifetime. Because of this lack of awareness, when men with diabetes begin having sexual function issues, they do not realize they should talk to their doctors or diabetes educators about this side effect of diabetes. Instead, they suffer in silence not realizing that it is as much an issue of their diabetes as some perceived failure on their part to be able to perform. Of course, this overflows into their relationships as well. Wives or girlfriends rarely know about this either so both parties are affected! This makes the ‘suffering in silence’ response a loss for more than just the diabetes patient!

Amy’s excitement about using the Life Puzzle for diabetes management with her clients (she’s a registered dietitian, Certified Diabetes Educator) only increased when she realized that it enabled her to open up and discuss with her clients this often sensitive and uncomfortable topic. It isn’t only the patient that has discomfort—just as often it is the health professional as well.

Using the Life Puzzle, it is easy for a health professional to show a client how important a part all 16 core areas of their Life Puzzle plays in their Diabetes management. This way they learn that diabetes management isn’t just about a blood sugar level or insulin, it is about living a life that accepts this ‘special challenge’ piece, but at the same time, realizes every other piece of their Life Puzzle is a part of their diabetes management too. Thus, nutrition and exercise not only are about blood sugar/insulin balance but about confronting obesity, keeping their energy up too. Feelings and thinking are definitely impacted by blood sugar/insulin but one’s feelings of say, depression, could also impact your focus on managing your diabetes. Communication is important—with your health professionals and as a patient, taking responsibility to communicate effectively with the health professional sets up a partnership where both parties have healthy respect and trust with each other. Diabetes plays a part in your family—whether you’re the parent with diabetes and your children have to learn what to do in the case of you going into insulin shock or its your child who has it so parents have to learn to help this child while not ignoring other siblings—diabetes impacts families too. Diabetes management hits every piece of the Life Puzzle in some capacity or another—diabetes will impact your financial piece too. It is costly to buy strips, needles, pills, doctor visits etc., thus, the more effectively you manage your diabetes, the less expensive it will be and thus more funds can go to other areas of your life.

Amy is happy to report that she has had many successful ‘sex talks’ with her patients. But the best result was when a client thanked her for addressing this up front because he never would’ve started this conversation, yet it was a very important piece of his life that had changed dramatically after diabetes. For him, knowing that good diabetes management could improve his sex life too was a strong motivator to eat well, exercise and keep his blood sugars in control. He truly did learn that; Every piece impacts the whole.