New to Meducation?
Sign up
Already signed up? Log In
Healthy living sugar diabetes

Common Not Benign - Let's Get It Under Control

Diabetes and Education

Written by Catherine Schuster Bruce · Monday 1st February 2016

Diabetes is a chronic health condition that is common in the UK. A common condition, but contrary to public assumption, ‘common’ and ‘benign’ are not necessarily synonymous; it is not unusual that a patient with uncontrolled type 2 diabetes will, ten years post diagnosis, find themselves losing a limb because of an ulcer that won’t heal or experience worsening of their vision.

The monetary cost of treating these complications is significant, at £5.5 billion a year. However, money is not all that is lost. Without sight or the ability to walk, there is the risk of losing independence; a luxury that many would argue is priceless.

However, a key word is ‘uncontrolled’.

Individuals with type 2 diabetes can hugely influence the trajectory of their disease with simple interventions such as a healthy lifestyle and good medication compliance. It boils down to how well patients are able to manage their condition.

This said, perhaps it comes as no surprise that last week the government was criticised by the Public Accounts Committee for being ‘too slow’ in preventing and treating diabetes, the finger specifically being pointed at ‘unacceptable variations’ in education, care and treatment of patients.

The government’s response to the criticism, an NHS Diabetes Prevention programme that will aim to limit the number of people becoming diabetic is important and seems a good idea, but perhaps the focus is not quite right. What about those who already have the disease?

Currently, it is the responsibility of any health professional that comes into contact with a patient to educate them about the management of their disease and any potential complications. This is usually the patient’s GP or a practice nurse. A consultation may go a bit like this:

In walks a patient, a relatively young woman, aged 45, with type 2 diabetes. BMI is 36 (in the obese range) and most recent HbA1c, an average measure of long term blood glucose levels, is 75 (high- 48 is the lower limit for a diagnosis of diabetes). She is here for her annual diabetic review.
Doctor smiles and greets the patient. ‘Hello, how are you?’ Yes fine. Standard response. The doctor may then explain to the patient that a ‘marker of their diabetes control’/ HbA1c is high, before subsequently asking whether the patient is taking their diabetes tablet, metformin. To which the patient may explain that they ‘don’t get on with it’ and would ‘rather not’. The doctor may then decide to do some more bloods and explain this to the patient, who may respond something like ‘oh you want to see how gloopy my blood is?’ To which the doctor will reply with another smile, ‘Yes I am afraid you are a bit too sweet’. They will then discuss changing the formulation of metformin to the ‘longer acting stuff’ in the hope of improving compliance. The doctor will type up the prescription request whilst reminding the patient that they will get ‘complications early’ if they continue with poorly controlled sugars. A follow up appointment with the nurse is arranged and the patient will go on their way.

This consultation probably gets 10/10 for rapport.

However, improving lifestyle is first-line in the management of diabetes and even when the patient is on medication, in an ideal world, health professionals should use any opportunity to educate patients with respect to their condition and encourage a healthy lifestyle. This is a patient with a high BMI, who does not get on with tablets… surely there should be some talk about weight loss and exercise.

I acknowledge that GP consultations are unique in that they are a bit like a television series, it can be tricky to understand the whole picture when you’re watching episode four without having watched episodes one, two or three.

Nonetheless, having spoken to a number of doctors, I can predict a likely response… ‘But if I mention that [weight loss], they may be offended, complain and won’t come back.’

This is where my concern lies. I worry that health professionals are inadvertently doing patients a disservice when they don’t remind them of simple interventions such as healthy living and weight loss when it makes such a difference to disease progression as well as a patient’s overall health, well-being and, perhaps most importantly, independence. Besides, surely there are ways of mentioning interventions such as weight loss that won’t offend?

During this example consultation, there was also a lack of patient education about the complications of diabetes.The doctor only mentioned that ‘complications will come earlier’, they did not say what they were, and they did not clarify the patient's understanding. I question whether this patient would have been ostensibly blazé about their ‘gloopy’ blood if they realised that their high sugar levels may lead to an infected foot ulcer and subsequent amputation in ten years time?

Patients have a right to understand the implications of their conditions. They need to be able to make informed decisions; a decision to run high blood sugar levels is okay if the patient knows and fully understands the implications of their decision. However, my worry is that patients are not fully aware of the implications of their disease.

Granted, there is something to the doctors' concern that offended patients are less likely to engage and the notion that this is worse than saying nothing as ‘at least they are being monitored’.

However, accepting this is not good enough and needs to be addressed.

We need to find solutions to take the pressure off health professionals and empower patients. We need to inform without scare tactics. Patients need to be inspired, not fearful, to make positive movements to look after themselves and their chronic conditions. I consider that this may even have a snowball effect since the experience of friends and relatives is an important source of health information (and inspiration).

I question whether health professionals should hand the baton over and the emphasis of healthcare delivery should switch from educating patients in a one-on-one ‘nagging’ manner to aim to motivate patients to take control of their own health, perhaps through the use of multiple mediums to deliver the content.

I understand that not everyone is interested in their health, but most people are interested in their ability to function and their quality of life, and I would argue that this is essentially what the complications of diabetes can take away.

As the number of individuals with diabetes increases, we need to find solutions to educate these patients. Whether it be apps, informational plays or events, I think it’s time we went to the drawing board. It's time to switch the focus and get in control.

Reference: http://www.bbc.co.uk/news/health-35374588

Responses

alia
·
healthcare - new york
·
Posted 4 months ago
Like
(0)
Respond
Zapyaforpc
·
Posted about 1 year ago
Download Zapya for PC to share files and folders easily from PC to Mobile
Like
(0)
Respond
xander
·
Posted about 1 year ago
don't eat to much sugar, just change the sugar to the other sweetener like corn. just go to this Source
Like
(0)
Respond
joeychen
·
Posted 12 months ago
Like
(0)
Respond
instagramlikes
·
Posted 11 months ago
Like
(0)
Respond
EmilyBrown
·
dissertation help consultant - Dissertation Help UK
·
Posted 7 months ago
Thanks for sharing motivational and stimulating post on diabetes which is a chronic health condition common nowadays. Regards, http://www.dissertationhelp.uk/nursing-dissertation/
Like
(1)
Respond
Sunmugam Chidambaram
·
Defence - India
·
Posted 11 months ago
Good article about sweet control Download xender for pc for sharing picture. videos and files
Like
(0)
Respond
Sunmugam Chidambaram
·
Defence - India
·
Posted 10 months ago
eat less be healthy Download xender for pc Very good for share FILES ,PICTURES PC To any Android
Like
(0)
Respond
Zapyaforpc
·
Posted 10 months ago
Superb information it is. Thanks for this kind of information. Zapya apk
Like
(0)
Respond
miftah09
·
Posted 9 months ago
I was a diabetic, and I am 30 years old. I currently have reduced all sweet foods and start exercising regularly. I hope we can free from diabetes. Regards, upvc Jakarta
Like
(0)
Respond
Deleted User
·
Posted 9 months ago
Like
(0)
Respond
siteocean
·
Posted 9 months ago
Like
(0)
Respond
Zapyaforpc1
·
Student - Bristol university
·
Posted 9 months ago
Like
(0)
Respond
james
·
Posted 9 months ago
please be nice to make food or drink with sugar, use less sugar, not to much, and make your health keep healthy. download mario run for android
Like
(0)
Respond
Lynn Libbrecht
·
Posted 8 months ago
so sweet :) :) :) * google maps street view * email sign up
Like
(0)
Respond
Driving Directions
·
Staff - Company
·
Posted 8 months ago
Thanks for sharing, we should have the suitable diet to prevent from diabetes driving directions
Like
(0)
Respond
rithika
·
Posted 8 months ago
its a great blog and given great info Hyderabad Escorts Hyderabad Escort escorts in Hyderabad
Like
(0)
Respond
Terina
·
Posted over 1 year ago
Eating too much sweet and sugar-full things is not good, clash royale tips.
Like
(0)
Respond
EmilyBrown
·
dissertation help consultant - Dissertation Help UK
·
Posted 7 months ago
Thanks for sharing motivational and stimulating post on diabetes which is a chronic health condition common nowadays with me which is good to know for me as nursing dissertation tutor - http://www.dissertationhelp.uk/nursing-dissertation/.
Like
(0)
Respond
jurassicblog
·
Posted 7 months ago
thanks for sharing this healty information, this really good to know. find me on : jurassic world the game hack
Like
(0)
Respond
Jonh Cruise
·
Nurse - Queen Elizabeth Hopspital
·
Posted 7 months ago
Thank you for your post, I look for such article along time, today i find it finally. this post give me lots of advise it is very useful for me happy wheels
Like
(0)
Respond
jeremy cole
·
Nurse - Hospital
·
Posted 6 months ago
Let's get it under control! javascript obfuscator
Like
(0)
Respond
Zapyaforpc
·
Posted 5 months ago
Like
(0)
Respond
raj kumar
·
Posted 5 months ago
Like
(0)
Respond
html color
·
Posted 4 months ago
Your article is easy to understand, the simple way of communicating is accessible to the majority of people. I will keep track of your posts regularly. fb login
Like
(0)
Respond
markottwain
·
Posted about 1 year ago
sugar is good but we must eat it with a good portion to make us healthy. by clashroyalegemstool.com
Like
(0)
Respond
alia
·
healthcare - new york
·
Posted 4 months ago
Like
(0)
Respond
Jason Borne
·
Developer - Echelon
·
Posted 4 months ago
Nice Post and great content. Keep doing good work. Avast Customer Support Norton tech Support
Like
(0)
Respond
MaryMiller86
·
Nurse - Lenox Hill Hospital
·
Posted 3 months ago
Your post contains a lot of useful information for me. Thank you very much for that. run 2
Like
(0)
Respond
Cricket Betting Tips
·
Cricket Betting Tips - Cricket Betting Tips
·
Posted 3 months ago
Like
(0)
Respond
html color
·
Posted 2 months ago
Thanks for the information your article brings. I see the novelty of your writing, I will share it for everyone to read together. I look forward to reading many articles from you. html color
Like
(0)
Respond
Susan Nelson
·
food technology - agriculture university
·
Posted 2 months ago
• I realize that this content is worth to read. I expect to see more posts from you that makes me impressed just like this one. Good job!! * gmail.com login
Like
(0)
Respond
flipdiving
·
Posted 2 months ago
This bakery taste of it is very special very tasty. I often do it on weekends for my husband and children. Thank you! flip diving
Like
(0)
Respond
Deleted User
·
Posted about 1 month ago
Like
(0)
Respond
Deleted User
·
Posted about 1 month ago
Very good, I think I found the knowledge I needed. I will see and refer some information in your post. thank you. slither
Like
(0)
Respond
flipdiving
·
Posted 25 days ago
Thank you for your sharing. Thanks to this article I can learn more things. Expand your knowledge and abilities. Actually the article is very practical. Thank you! lucky patcher
Like
(0)
Respond
teraz
·
medical - oxford
·
Posted 25 days ago
Besides, surely there are ways of mentioning interventions such as weight loss that won’t offend?
Like
(0)
Respond
teraz
·
medical - oxford
·
Posted 24 days ago
Really welcome this amazing post that you have suited us.Great site and a dazzling point what's more I genuinely get secured to look at this. ntts
Like
(0)
Respond
color switch
·
Posted 23 days ago
Wow – what an informative blog site – i need to spend more time here and intend to do so color switch
Like
(0)
Respond
Dedi Galih Wisnumurti
·
Doctoor - Gunadarma University
·
Posted 20 days ago
Enjoy and Visit : 1. MP3 2. MP3 Download 3. Sewa Villa di Puncak 4. Villa Puncak
Like
(0)
Respond
ID TECHR
·
Doctor - UNVI
·
Posted 15 days ago
Very interesting thank you for making the article useful for me
New information for you :
1. Jasa SEO
2. Jasa Pembuatan Website
d
Like
(0)
Respond
certvalue111
·
Posted 14 days ago
amazing blog thank you for soo much information really loved it looking forward to more blogs like this http://www.certvalue.com/iso-9001-certification-bangalore/ | http://www.certvalue.com/iso-27001-certification-bangalore/
Like
(0)
Respond
certvalue111
·
Posted 14 days ago
amazing blog thank you for soo much information really loved it looking forward to more blogs like this ISO 9001 Certification in Bangalore
Like
(0)
Respond
Rahul digital
·
Posted 13 days ago
Checkout full list of Bharat Ratna award winners and know about some interesting facts about them.
Like
(0)
Respond
Wings Io
·
Posted 11 days ago
Yes, the article I was looking for. Your article gives me another approach on the subject. I hope to read more articles from you. usps tracking
Like
(0)
Respond
Bless
·
Posted 11 days ago
Thanks for this informative post: http://vitalhealthrecipes.com/benzonatate
Like
(0)
Respond
Parul Sharma
·
Marketing Executive - SurveillanceKart
·
Posted 9 days ago
Like
(0)
Respond
teraz
·
medical - oxford
·
Posted 5 days ago
I saw looking post and watched it to be crucial and to the subject. Much appreciation to you for not turning unendingly just to fill the page. manabadi results 2018
Like
(0)
Respond
teraz
·
medical - oxford
·
Posted 1 day ago
It joins splendid and fundamental posts. I've examined a central number of them other than got such a striking entire from them. phenq consumer reviews
Like
(0)
Respond