Some Observations About Diabetes Treatments

[Guest guest]

GREETINGS --

The following is an article from the Diabetes In Control website

which lits a number of observations of the author (a Registered

Pharmacist and Diabetes Educator who spearheaded an educational

program in a rural section of Illinois. In my view his insights go a

long way towards explaining the importance of patients being

proactive.

wambo1941

How To Impact Your Patients Lifestyles In 20 Minutes!

Part 6 – My Observations

Special Feature by Freed, RPh, Diabetes Educator, Publisher

Traveling over 3600 miles in less then 30 days to rural towns in

Illinois and meeting with over 350 patients with diabetes and their

families, has provided me some insight that I would like to share

with you.

First of all, I would like to thank my partners in this program,

TheraSense and NovoNordisk. They provided the instant A1c tests,

monitoring exhibits and showed each patient the many different

options for them.

We met participants from all walks of life. Some were highly educated

and some had very little education. We met with working and retired

professionals, blue collar workers and farmers There were Native

Americans, African Americans, Mexican Americans, Caucasians, Asians

and many more. The ages ranged from 8 to 93 years.

These are the significant observations I made:

1. There are no 2 people with diabetes that are the same. Each person

dealt with his or her diabetes in a different way. Most of the

patients I spoke to had A1c's over 8.0%. Most had never gone through

an education program of more than 2 hours. Almost all of those with

Type 2 diabetes were overweight.

2. I could go into a small town and after the first couple of A1c's,

I could see a trend and tell what kind of medical care the local

physicians were providing. Most everyone in the town would be going

to the same doctor or medical practice in town. By providing some

basic information to the patients and telling them to be more

proactive with their medical team, I believe we made an impact not

only the patients and their families, but also on their doctors.

3. Most all of the patients thought it was their doctor's job to

control their diabetes. When I explained to them that Diabetes was a

LIFESTYLE DISEASE and that they had 95% control over it, they were

surprised. Interestingly they were open to the fact, and realized

they had to make the changes and be more proactive with their doctors

and nurses.

4. No one was reading food labels properly. They all were paying more

attention to the amount of sugars and not carbohydrates. Portion size

was rarely looked at. We can have a major impact with our patients if

we keep it very simple and make sure that they understand it is not

the sugars, but the portion sizes and carbohydrates that are raising

their blood sugars and adding weight.

5. Most of the patients thought they were doing was enough physical

activity, or they had excuses. No one realized just how important

physical activity was to controlling his or her diabetes. Everyone

knows exercise is good for you, but the question that needs to be

answered is WHY! Providing the patient with the knowledge to make the

right decision is what diabetes education is all about. It is not

about telling the patient what to do, but giving them the information

in a format they can understand so they will make the right

decisions. Don't just tell them to exercise! Explain to them what

happens when they increase their physical activity. They will make

the right decision. TRUST ME!

6. No one really understood the importance of the A1c result. We have

to be more proactive with our patients so they will request the

result. We need to make sure they can correlate the A1c number to the

Blood Glucose results. They need to understand that just lowering the

A1c, 1 point, will reduce their risks considerably. They need to

request an A1c test at least 4 times a year when they see their

doctors

7. Rarely did anyone understand the importance of checking his or her

blood glucose 2 hours after eating. Most were only doing fasting

blood sugars. We explained to them that checking blood glucose 2

hours after eating, will show us if their diet, exercise, or

medications are working. The reading 2 hours after they eat is 100%

in their control, They will learn something new every time they check

their blood glucose after they eat. Whether they ate too much, or

they ate the wrong foods, or is their medicine working? If it is too

high, they can go for a walk and drink some water. They can have an

immediate impact with those blood glucose readings.

8. Most patients have never gone through a full diabetes education

program. By making sure that patients go through an education program

we can have the greatest impact of all. Giving them the knowledge to

make the right decisions is giving them the power to self-mange their

diabetes. We need to know which programs are in are areas and refer,

refer, refer then follow up, follow up and follow up with every

patient to make sure they have completed the total program.

9. We need to approach diabetes as preventative medicine and not wait

until we have the complications to treat. Diabetes Education is all

about prevention and the patient needs to understand that it is up to

them to prevent the complications now or be treated later.

10. Patients have learned to be afraid of insulin. When I asked

patients to tell me what they think, when I mention insulin too them,

most all had a fear of insulin. They felt it was the final step

before they would see the complications. Most patients shared with me

that their doctors had threatened them with insulin shots if they did

not exercise and lose weight. In their minds Insulin was a punishment

for not doing what their doctor told them. Explaining to them that

insulin is a natural hormone and doesn't have the side effects of

some of the oral drugs and that controlling their blood sugars would

be easier, made them feel more comfortable. Insulin education needs

to be part of every diabetes education program to take away the fear

of self-injection.

11. We could have an impact and help our patients to change and take

control of their diabetes. But it must come from the patient

With every patient, I asked them: When was the last time you got up

in the morning and said: " My Diabetes Is Killing Me, I need to call

my doctor " ?

No one ever calls their doctors because their diabetes is bothering

them, Diabetes Does Not Hurt! If diabetes did hurt we would not have

the number of complications or out of control patients.