Barriers to Care: Myself

As much as I don’t want to admit it, often times I am the biggest barrier to my health outcomes. I would like to point out that I am going to address this topic as my own personal struggle in an attempt to avoid the possibility of victim blame or ability shame. There is nothing fair about living in today’s world with any kind of chronic illness, and the blame we place on ourselves regarding our health outcomes can be debilitating.

Research has found that approximately 55% of women with diabetes experience anxiety vs 33% of men1. I am in this 55%. When I have to go to a new doctor, I will sit and fixate on excuses I can make for my personal accountability prior to meeting the doctor – I don’t even give them a chance to prove me wrong, I simply assume they will blame me. This is not healthy and keeps me from receiving the care I deserve.

Following the establishment of care with my first adult endocrinologist, I undeniably turned into my worst self. The defensive person I became couldn’t have possibly been open enough to hear the opinion of a medical professional that hadn’t lived my experience. As a result, I ended up with the eating disorder I wrote about last month. Instead of learning to cope with my emotions, I took control in a way I felt I could.

One of the most important changes in me taking responsibility for my care came in the form of a job that, frankly, sucked. By taking on the role of servant leader, I opened up my eyes to what I had the power to change by serving the people who were working for me. This personal development made it so I was able to connect those principles to my personal experiences in healthcare.


Looking at these principles, I wondered if there was a way for doctors to change their approach to in order to better serve their patients. After careful consideration, I realized that there was nothing I could do to make medical professionals change their methods of care. Instead, it was time for me to take these principles and apply them to myself and how I can help my own diabetes care.

  1. Doing whatever it takes to help people win: In this case, I am people. The win would be meeting my personal healthcare outcomes (which for me is simply a set time in range and standard deviation). I have control over the actions I take, even if I am not perfect.
  2. Set the example: Making myself successful in meeting my health outcome goals is difficult since diabetes is 24/7/365. Keeping in contact with my friends with diabetes helps me stay on top of my own health, especially because they understand the everyday struggle.
  3. Motivate others through thoughtful approach: One of the bad habits I have to address is my anxiety and making excuses. It is not possible to have a thoughtful approach to my own diabetes if I am not honest with what has happened as a result of my personal actions. I have become unapologetically honest with my healthcare providers – and as a result I have been kicked out of a couple practices. BUT this approach has helped me find the care providers I am comfortable being vulnerable with.
  4. Value and try to understand others: Even when I do not agree with the opinion of a healthcare provider, I will listen to them and try to make sense of their thought process. This goes for other PWD and their approach to creating their own goals.

As a result of addressing these principles, I am able to:

  1. Gain commitment through consensus rather than compliance: I hate the real C word. Compliance (*shudders*) is a trigger word for many people with chronic illness (shameless plug: look for next week’s Barriers to Care for more information about language and stigma in diabetes). Being honest with care providers and expecting a respectful and professional response from them should be achievable. Find the care team that will hear you and help you make accommodations in your life so that diabetes fits in, rather than changing everything in your life for diabetes.
  2. Engage with principles: For example, ask questions in terms of goals: “I would like to be able to (insert goal here). How can we make that happen?” The image above says without emotions, but that’s just not realistic. It’s perfectly normal to have emotions – it is up to us to be honest about those emotions and how they affect diabetes. “I do not feel great about (insert occurrence here). It makes me feel bad. What can I do to change this outcome in the future so that I am able to feel better about it?”
  3. Realize that your success comes from the success of others: This is a bit of a stretch, but it’s true. Finding a healthcare provider who will assist you in accommodating diabetes into your life is imperative for taking an active role in your personal health outcomes.

As strange as the comparison may seem, this is what has worked for me. Am I perfect? Absolutely NOT. I am far from it. I will always have setbacks, just like anybody else with chronic illness, but making this connection was imperative for me to create and achieve my personal goals.

Have you had a diabetes epiphany you’d be comfortable with sharing? Tell me all about it in the comments, on Twitter, or at This week, I encourage you to take an honest look at yourself and how you interact with your healthcare team. Is this relationship working? Are you looking for excuses? Do you have outlined goals you can use to question and motivate your care team? We got this, Fam!


1. Penckofer, S., Ferrans, C. E., Velsor-Friedrich, B., & Savoy, S. (2007). The Psychological Impact of Living With Diabetes Women’s Day-to-Day Experiences. The Diabetes Educator, 33(4), 680–690.

Endnote: Phoebe drug this tub toys to the “doggie couch” in the living room on her own. She knew what she needed to do in order to achieve her goal of relaxing with an array of easily accessible toys!

Published by

Sonja Cunningham

20 years survived with T1D, 2021 Executive MBA candidate at the University of Nevada, Reno

One thought on “Barriers to Care: Myself”

  1. First of all Servant Leadership is the best. Unfortunately, there are only a few examples of it being done in practice. Maybe because it is different than what we expect.

    My diabetes epiphany?

    These words were spoken by a doctor when my A1C was 12.1 –
    Rick when you are sick and tired of being sick and tired you will take care of your diabetes.

    He was right.



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