Maslow's Hierarchy of Needs .. with Diabetes!

When we take Maslow’s hierarchy of needs and apply it to someone living with diabetes, we immediately know that we have someone whose physiology is compromised. They’re not getting great sleep and their blood sugars could be high. They also might be waking at night to urinate, or their blood sugars are low and they’re waking to CGM alarms. If they’re not taking insulin they are at risk for loss of life. So this physiology piece is compromised of varying degrees of severity.

This person with diabetes has compromised physiology and likely the stigma that goes along with it--so there goes their esteem! Their self-respect, as we see below, takes a big hit with a diabetes diagnosis, as well.

And below we see that they’re not feeling good about themselves, so they start to isolate from their family. After all, who wants to get together for family dinners if or you are going to be pressured to eat, or not eat, because of your diabetes.

Diabetes brings an increased risk to the safety of an individual who has low blood sugar--and sometimes leads to them feeling that their medication is putting their well-being in danger. They find now that they also are having to spend hundreds of dollars per month on medications they had not planned for in their budget, causing them to lose their sense of security.

At the top of all this crazy destabilization we, as clinicians, come into their lives and task them with managing their diabetes—effectively asking them to do more problem solving than they’ve probably ever done in their lives. This means every meal, every exercise, and every medication choice. Diabetes management, and this person’s whole world, now rests atop this precariously balanced hierarchy of needs. And when you see it drawn out like this it is clearly just a matter of time before something causes this tower to tip.

 

And because we are the ones who put this additional responsibility on their shoulders, we must also be the ones to help protect them from its impact. We can do this by reducing the burden of diabetes on the various levels of the pyramid, and helping to shore things up wherever we can.