Starter vs Maintainer and Diabetes Management

Starter vs Maintainer and Diabetes Management

Are you a “Starter” or a “Maintainer” and does that impact how you deal with your diabetes? Do you remember when you were told that you were a diabetic? Some of us shut down, some of us absorbed information like a sponge, or many of us did both. But how you dealt with the new reality may signal a natural tendency in your diabetic life.

Right after the rush of information we were called on to set up new routines, learn about testing, and learn the difference between good and bad results. In my day it was urine testing and the dreaded 4+. Today thankfully it is finger sticks, numbers on a meter and logs or electronic records.

We might call this first phase the “Starter” phase of diabetes. It can be exciting, in a strange sort of way. If we were children likely parents, teachers and nurses paid extra attention to us and it may have been thrilling. IF we were adults chances are we threw up defenses, decided who to tell and when not to tell. Different feelings, the same start up process.

But then things wound down, we hit a routine. We settled into doctor appointments, CDE discussions and the ups and downs of being diabetic. We might call this the “Maintainer” phase. It is a long, and for some of us a boring routine. As a “Maintainer” you now know what to do, how to do it and who to report results too. It is a more stable environment.

Turns out some people adapt better to the first part the “Starter” phase and others adapt better to the second part the “Maintainer” phase. There are some academic papers that explored this phenomenon and it was found to be real, in at least one environment.

The setting was 1970’s Atlanta and there were many problems. The city was strapped with rapid expansion, a population explosion, a sustained lack of adequate infrastructure and if that were not enough the transit system had failed. With these systemic problems it was decided that the Metropolitan Atlanta Rapid Transit (MARTA) would be created. It had a many fold mission but is often summed up in two approaches, it was established to rapidly build and then manage a modern well financed transit system (Golembiewski & Kiepper, 1976).

Notice the two parts, the “Starter” (build) and the “Maintainer” (maintain). Some academics have commented on this dual role and the dichotomy it presents mainly for MARTA but also in other environments (Golembiewski, 1994; Golembiewski & Kiepper, 1976; Poister, 1975; Smith, 1987). It is an amazing collection of mostly interview style information which explore (at least in part) the differences between “starter” and “maintainer” systems.

Here is a bit of an explanation of what happens when “starters” are suddenly shifted to being “maintainers”:

“It seems to have had mixed effects on the non-work life of MARTA executives. One respondent reported some improvement in these terms (personal time): ". . . the time that I had to devote to my family ... has been a very serious concern to me over a number of years-the little time spent with my children. I am enjoying that now. It’s been fortunate. That's a big plus for me." For all respondents, however-and for some to an intense degree-the additional time remains a gap to be filled. When they suddenly had more time, they could not easily fill it. A lot of old contacts were gone, people moved on and interests changed. “ (Golembiewski & Kiepper, 1983, p. 247).

“Relatedly, more time did not imply "quality time." example, several informants reported they now more often "fly off the handle" at home. "I used to get mad at my work, and at my work," one respondent explained. "Now, my wife's a more available target, and my work is almost placid." To a similar point, one respondent noted that he and his wife were spending an unprecedently large amounts of time together during the transition: "We're kind of-oh-slipping into middle age together and tolerating each other better than we used to.” This restrained reapproachment did not last as the parties soon separated.” (Golembiewski & Kiepper, 1983, p. 247).

You see the transition for most of us is not natural. When we shift from diabetic “Starters” to diabetic “Maintianers” we shift into a different skill set. Yes for many the role of “Maintiner” is a more natural state. For others it is boring and serves only to frustrate us.

Which are you by nature? Are you more a “Maintainer” or more a “Starter”? You are likely both, but you also likely have a tendency to enjoy one role over the other. I am more “Starter” than “Maintainer”. I see maintenance as drudgery something to be tolerated. So I have to bend my natural tendency and assume the role of maintainer of my diabetes.

If you are more of a “Maintainer” you may have to bend your tendency to try new things. I suppose only you know your own tendency and yes it can change day by day. But here is the thing recognizing the difference can help push you forward. Most days I have to put on my maintainer hat. Guess what flexing a new muscle is not so bad. It just takes getting used too.

So whatever your tendency try something new out. You may find a whole new muscle is well suited to your personality.


Golembiewski, Robert T. (1994). MARTA IN THE 1990s: THE CHALLENGE CONTINUES. Public Administration Quarterly, 18(2), 151-175. doi: 10.2307/40861617

Golembiewski, Robert T., & Kiepper, Alan. (1976). MARTA: Toward An Effective, Open Giant. Public Administration Review, 36(1), 46-60. doi: 10.2307/974741

Golembiewski, Robert T., & Kiepper, Alan. (1983). Perspectives on a Fast-Paced Public Project: Personal Reactions of MARTA Executives. Public Administration Review, 43(3), 246-254. doi: 10.2307/976333

Poister, Theodore. (1975). Urban Transportation Planning and Policy Making. Public Administration Review, 35(1), 94-98. doi: 10.2307/975212

Smith, Robert G. (1987). Reorganization of Regional Transportation Authorities to Maintain Urban/Suburban Constituency Balance. Public Administration Review, 47(2), 171-179. doi: 10.2307/975591