I could not sit still when reading Adam Brown's recent article, “How to Change Any Diabetes Habit, Part 2: Think Mini.” It was thrilling to see that our friends at diaTribe are encouraging their readers to start new diabetes habits by setting small "process goals with mini-milestones."
As emphasized in earlier blogs, when we vow to make big changes, "we fall short of reaching our goals because we raise the bar so high trying to give up lifestyle habits that are several years in the making."[i]
When diabetes patients decide to make a change in their lifestyle habits, this is what Brown calls "a precious moment." However, as Brown argues, we are susceptible to "a sneaky trap: thinking too big. If I’m not exercising at all right now, I’ll sign up for a marathon. If my blood sugars are in range 40% of the day right now, I’ll set a goal to be at 100%."[ii]
"Thinking big," Brown asserts, "can jump start motivation, but it can also crush it. When the mountain feels too high to climb from where I stand, it's easy to (i) never start climbing; or (ii) give up quickly."
Instead of shooting for the moon, Brown calls for making small incremental changes that focus on consistency and routine, not grand scale outcomes. This line of thinking is consistent with our New Year's Resolutions blog, by Kris Erdman, our Vice President of Clinical Services, in which we borrowed from the Continuous Improvement (CI) model that many businesses have adopted for streamlining their productivity.
Like Brown's "mini-milestones," Erdman's first step based on the Continuous Improvement model is to set improvements based on small changes, not major paradigm shifts.
There are two major advantages to thinking small, and I like the way that Adam Brown articulates these.
- First Advantage
"When something feels super easy and achievable, I don't need enormous motivation to do it; I feel a sense of accomplishment when it does happen, and I then can build on that over time!"
- Second Advantage
"'Small and consistent' beats 'big and infrequent' every time. I'd much rather do 10 minutes of exercise 7 days per week vs. 70 all-out minutes once on Sunday."
- As for this second point, I would go one further: big and infrequent has almost no health benefit whereas small and consistent routines can make a profound impact on your diabetes health and wellness.
Therefore, Brown's process goals with mini-milestones are not "the coward's way" but the smart, sensible way to improve diabetes health.
- Check blood glucose before and 2-3 hours after meals and take action on each number.
- Ride my bike on Tuesdays, Thursdays, and Saturdays.
These are small, attainable process goals. What a lot of us tend to do is set "outcome" goals like "get an A1c less than 7% by June 15th," or "cycle 1,000 miles this year." Outcome goals are fine but seem daunting if they are not defined by process goals. There is a lot less stress (and more incremental progress) when we focus only on the process goals.
Brown also asserts that the first step is the absolute hardest, so setting a small, specific goal that you can do in the next five minutes is the best start. Here are a few more examples Brown provides that are good "first steps."
- Go for a five-minute walk around the block right now.
- Check my blood sugar one extra time today.
- Eat one extra vegetable at my next meal.
When you repeat these small steps over and over again, I believe that you can build momentum and actually feel progress. What’s more, you have the confidence and stamina to make small incremental improvements, like increasing that walk to twice a day, or ten minutes daily after one week.
Another aspect of small changes that we recommend is to pick one thing and focus on it. I wrote a blog about this last January because having one focus area with process goals will make other health goals more attainable.
For example, as I wrote in the January blog, "if you have a hard time choosing, start with exercise, because it lowers blood pressure, raises the heart rate and keeps the brain young!"
Exercise will also curb your appetite and lower blood sugar levels, which will make you more prepared to set mini goals for improving your diet and blood glucose.
No matter what lifestyle change you choose, start small and move small. "Thinking mini" as Adam Brown puts it is not small-minded. It is smart, sensible and powerfully effective in helping you improve your diabetes health. Thinking out small changes is also liberating and is the best method to maximize your time.
Trust the process. Focus on what you can do now. As Adam Brown declares – referring to the old Chinese proverb, the journey of a thousand miles begins with a single step. Enjoy the progress of each step and the small changes in your journey to improved outcomes!
[i] https://blog.ccsmed.com/new-year-fresh-start, “New Year, Fresh Start,” by Kristine Erdman, RN, CDE, CPT, CCM, Vice President of Clinical Services for CCS Medical