Adam Brown, diagnosed with diabetes in 2001, serves as senior editor and columnist at diaTribe and Head of Diabetes Technology & Digital Health at Close Concerns. Adam writes an acclaimed column for diaTribe, Adam’s Corner, and speaks extensively about diabetes and chronic disease. His new book, Bright Spots and Landmines, is one of the wisest diabetes books I’ve come across. It’s a rich, honest, first-person account of living with diabetes that’s full of actionable advice to help you succeed, not just in diabetes management, but in life. If you don’t have a positive mindset about diabetes when you begin this book, you will be wholly changed by the end.
Below is an excerpt from Bright Spots and Landmines, The Diabetes Guide I Wish Someone Had Handed Me by Adam Brown.
I first encountered the idea of “Bright Spots” in the masterful book on behavior change, Switch, by Chip and Dan Heath. It’s radically different from what we typically do in diabetes: find problems and focus on what’s going wrong.
DIABETES BRIGHT SPOTS are positive behaviors and choices I want to replicate as often as possible. They are the things I’m doing right that I should try to duplicate: what helps keep my BGs in range, improves my mental state, and if repeated consistently, would improve my health and quality of life? Most of this book is focused on these Diabetes Bright Spots, such as eating fewer carbohydrates at meals (I aim for less than 30 grams), remembering why in-range BGs benefit me TODAY (I’m happier, more productive, in a better mood, and a kinder person to loved ones), walking after I eat, and getting at least seven hours of sleep.
DIABETES LANDMINES are the mistakes I make over and over again that drive my BG out of range, ruin my mood, or make life more difficult; I want to find ways to stumble on them less often. I first wrote about Diabetes Landmines on diaTribe after I noticed something important: I tend to make the same mistakes repeatedly, such as overeating treats to correct low BGs; eating white bread and potatoes; and asking unproductive questions like “How is this possible?” or “Why am I so terrible at this?” Clarifying these Landmines upfront has helped me develop a plan of attack: What safeguards can I set up to avoid them? How can I build routines that reduce the chances of stumbling onto them?
It’s easy to come up with a vague list of things I “should” and “should not” do, but Bright Spots and Landmines need to be useful. That means hitting three criteria:
SPECIFIC AND ACTIONABLE | “Eat healthy” does not count as a Food Bright Spot – it’s too vague. “Fill half my plate with vegetables” is much clearer.
REALISTIC AND SUSTAINABLE | “Not eating” does not count as a Food Bright Spot either – it’s impossible to sustain. “Eat slowly and stop before I’m 100% full” is more realistic.
IN MY CONTROL AND CHANGEABLE | “Bad weather” is not an Exercise Landmine – it’s out of my control. On the other hand, “overeating after exercise” is a Landmine that is changeable – I can find ways to avoid it.
BRIGHT SPOTS ARE MORE IMPORTANT THAN LANDMINES, BUT WE DON’T PAY ATTENTION TO THEM
Bright Spots outnumber Landmines in this book by more than 2:1. That’s intentional, because Bright Spots are so overlooked, so undervalued, and have had such a huge impact on me.
Many psychology books talk about the brain’s survival instinct, which looks for things going wrong and zeroes in on problems. In diabetes, this inevitably leads to negative self-talk: “I screwed up,” “I’m terrible at this,” “I can’t do anything right.” It also leads to finger-wagging advice from others: “Don’t do this,” “Stop doing that,” “You’re unmotivated,” “You just don’t care,” “You’re lazy.”
After my girlfriend and I adopted our dog, Sencha, I was surprised to hear only one piece of training advice from the shelter: use positive reinforcement to encourage good behaviors. In other words, focus on Bright Spots – what is the dog doing right that should be reinforced and encouraged? What a radically different approach from what we usually do in diabetes: focus too much on those negative Landmines.
Research from Dr. Barbara Fredrickson (author of Positivity) suggests that a ratio of 3 positive emotions for every 1 negative emotion is critical for human flourishing. 3:1! Focusing on Bright Spots is key for any of us to live well, and for me, they have redefined my daily journey with diabetes.
This is not to say we should all live in a land of false positivity – sometimes the best way to improve is to look at what’s not working and do less of it. Indeed, Dr. Fredrickson points out that a 3 positive to 0 negative emotion ratio is not in touch with reality – we all experience challenges. My approach has been to find and focus on Diabetes Bright Spots as much as possible, but not to ignore Landmines. This book is organized accordingly.
HOW TO IDENTIFY BRIGHT SPOTS AND LANDMINES
Reflect and question:
I often try to ask myself, “Is this behavior a Bright Spot I want to encourage or a Landmine I want to avoid?” It also helps to review my day or week: What did I do well for my diabetes and how might I do that more often? The questions at the end of each chapter and the end of the book will help you identify your Bright Spots and Landmines.
Check BG more frequently (if possible):
It’s hard to know what works and what doesn’t – particularly around meals and exercise – without knowing what my BG is and how it changes in response to different choices. Using a BG meter more frequently or wearing CGM helps find cause-and-effect relationships, and therefore, identify Bright Spots and Landmines.
“When I do ____, what happens to my BG?”
I’m painfully aware and frustrated that not everyone has the resources to check their BG more often. This book does not assume most readers are on a CGM, and I know insurance companies still make it difficult to access enough BG strips. This is criminal, as more frequent glucose data truly saves lives. If this applies to you, read the tips in chapter one on getting more strips.
Ask loved ones and friends to observe me:
“When I have in-range BGs after a meal, what did I eat? What foods do I eat when my BG goes high after meals or when I become moody and grumpy? What stresses me out and what helps me relax? What happens on days when I’m super motivated and take care of my diabetes?”