Engaging Your Patients With Diabetes
When it comes to chronic conditions, type 2 diabetes often comes with shame and blame. In fact, health care providers in a number of surveys mention frustration that their patients with diabetes seem unwilling or unmotivated to take control. By the numbers, that sentiment may seem true: just 25 percent of people with diabetes meet all three “ABC” health targets: A1C (blood glucose), blood pressure, and cholesterol (Wong et al, 2013). Yet no one sets out to have poor health.
For your patients, there are ways to focus on the positive. Start by considering three broad characteristics of diabetes that make it challenging for people, according to William Polonsky, PhD, CDE. First, he says, diabetes is often invisible. Although people understand it is serious, they often don’t think it is urgent. Second, they may have heard all the dire warnings about blindness and amputation, and feel despair or hopelessness. Third, they may be discouraged, feeling like they are failing when they add pounds instead of lose them, have to add medications, or must increase doses to fight the progressive nature of the condition.
Thoughtful approaches power engagement and inspire a path to self-care. Here are examples for partnering with patients to meet these 3 challenges:
1. Make the invisible visible, foster A1C awareness. Urge your client to know his or her A1C target, a measure of blood glucose levels for the past two to three months. Rather than speaking about a high A1C, speak about an “unsafe” A1C. The goal is to get to a “safe” A1C. And because A1Cs may be assessed only quarterly or less often, it’s important to stay in touch with people to let them know you’re a champion for their daily efforts that contribute to the A1C.
2. Counteract despair, point out that controlling diabetes clearly helps to prevent and delay the severity of effects of complications that affect the eyes, brain, heart, kidneys, and nerves. According to a 2014 article published in the New England Journal of Medicine, rates of diabetes-related heart attack and acute high blood glucose problems (ketoacidosis and coma) fell by about two-thirds in the past 20 years. With good care and effort, it is possible to live a long and healthy life with diabetes.
3. Turn discouragement around with encouragement. Help people see the positive effect of what they do. Show that actions, through cause and effect, can make a positive difference. One way to do so is paired blood glucose testing. Unlike a single blood glucose test that’s just one point in time, paired testing can show cause and effect. By seeing a starting blood glucose level of 186 mg/dl, for example, taking a walk, and checking again to see a drop of 35 mg/dl, the individual receives positive feedback.
To hear more from William Polonsky and to find free Diabetes is Primary webcasts from the American Diabetes Association, visit https://ada.healthmonix.com/.