Listen to this episode on Apple Podcasts, Spotify, and wherever you listen to podcasts.
Sticking to goals is hard, especially when you live with type 1 diabetes. With a 24/7 condition that demands constant attention, even well-intentioned goals can feel overwhelming. By mid-January, many people have already abandoned the changes they hoped to make. In this episode of Around the Circle, Scott Johnson talks with Carrie Matuzsan, a case manager at Blue Circle Health and a person living with T1D, about why realistic goal setting often fails and how the SMART goals framework can help.
Carrie shares practical, realistic ways to set goals that support diabetes management without adding shame or pressure.
Carrie’s Role at Blue Circle Health
Carrie is a case manager at Blue Circle Health. Her role focuses on helping people handle the non-medical challenges that make diabetes harder to manage, like access to food, housing, employment, and transportation. She regularly helps people navigate insurance barriers, financial stress, and other social determinants of health that directly affect diabetes outcomes. By helping with these barriers, Carrie creates space for people to focus more fully on their diabetes.
She also brings lived experience. Carrie has lived with type 1 diabetes for over 20 years, since being diagnosed at age 12. That perspective shapes how she supports others, not just clinically but also emotionally, especially when people feel stuck, discouraged, or overwhelmed.
Why Realistic Goal Setting Feels So Difficult
According to Carrie, most people struggle with goals because they were never taught how to set them. Instead, they are told to “do better” without being shown the steps.
This is especially challenging with type 1 diabetes, where goals often feel tied to constant evaluation and pressure. Many goals focus only on outcomes:
- Lower A1C
- Better blood sugars
- Improved time in range
Without clear steps, those outcomes feel far away and discouraging. This is especially true with type 1 diabetes, where data is constant and self-judgment can creep in quickly when numbers do not match expectations..
The Problem With Outcome-Only Goals in Diabetes
Diabetes care often emphasizes long timelines, such as six months between appointments. People are told to improve numbers without sufficient guidance as to how to get there.
Carrie explains that focusing only on outcomes makes it hard to recognize progress. It also ignores the reality that diabetes outcomes are influenced by far more than effort alone. Even when someone is moving in the right direction, it can feel invisible. This leads many people to give up before they see results.
What SMART Goals Are and Why They Help
SMART goals provide a structure that breaks large goals into manageable steps. Carrie reframes SMART goals as a system that supports the process, not a checklist meant to judge success or failure. She explains each part of the SMART framework:
Specific
A goal needs to be clear and concrete. “Be healthier” is too vague. A specific goal defines what action you are focusing on.
Measurable
You need a way to tell whether you met the goal. Measurement should allow a clear yes or no answer.
Attainable / Achievable
The goal has to be something you believe you can do right now. If it feels impossible, the goal should be made smaller.
Relevant
The goal should support your larger objective. If it is not along the path to what you actually want to improve, it may not be the right goal.
Time-bound
Every goal needs a timeframe. This creates a natural check-in point to reassess and adjust.
Carrie emphasizes that SMART goals do not have to be built in perfect order. The structure is flexible and meant to reduce pressure, not add it.
Finding Your “Why” Before You Start
Before setting a SMART goal, Carrie recommends identifying why the goal matters. She uses what she calls the “toddler approach,” repeatedly asking “why” until you reach the real reason behind the goal.
This process helps uncover a personal “North Star” that keeps goals grounded in values rather than numbers alone. Connecting a goal to personal values, like feeling better, managing blood sugars, or performing well at work, makes it easier to stay engaged when things get hard.
A Real Example of SMART Goals in Action
Carrie shares the story of a colleague who wanted to run a Turkey Trot in November. Instead of focusing on the final distance, they set a small January goal: alternating walking and running one mile.
Each month, the goal was reassessed and adjusted. Backup plans were built in for barriers like weather or other unexpected life events. By November, the larger goal was achieved through steady, realistic steps.
Adjusting Goals Without Judgement
Barriers are not failures. Carrie explains that when a goal does not work, it is a sign the goal needs adjustment, not criticism.
Life events, family responsibilities, and health challenges all matter. Carrie encourages treating yourself with the same kindness you would offer a friend, rather than becoming your own worst critic. SMART goals allow flexibility so people can adapt without feeling defeated.
Key Takeaways From Carrie
- Start by identifying why a goal matters to you
- Break big goals into smaller, achievable steps
- Use the SMART framework as a guide, not a rulebook
- Reevaluate goals with kindness, not judgement
- Focus on the process, not just the outcome
- Plan for barriers and setbacks, instead of being surprised and discouraged by them
