Assessing Information from Health Professionals: How I do it.

Melinda Seed

Inspired by some of the anxiety I have witnessed at health conferences/talks recently around filtering health information, I thought I might turn the tables a bit. Sure we all know we need to evaluate  health information on line but what about the health information we receive in consulting rooms/surgeries or hospitals. We all know it’s out there from missed opportunities to diagnose t1 diabetes (sometimes leading to death), to hospitals omitting insulin to not knowing cortisone injections will cause insulin resistance.  All this and more happens every day in the offices, consulting rooms and hospitals. How to protect yourself?

Here are some completely personal, non-medical, non-advisory thoughts on the topic from my almost 5 decades of type 1 diabetes.

Some of the ways I filter/assess things that are said to me be my health care professionals:

  1. Does the health care professional have t1 diabetes or have graduate level studies in diabetes or significant experience with t1 diabetes?
    If not be extremely wary of any advice or treatments being offered. Diabetes is complex and the field changes, medical school or nursing school spends very little time on t1 diabetes and just covers the basic theory-not the infinitely complex variables that affect blood sugar.  Ask yourself does generalist training in nursing or medicine provide sufficiently detailed knowledge of type 1 diabetes. The frequency of missed diagnosis of type 1 diabetes in GP offices suggests that ignorance even of the symptoms is rife amongst non-diabetes specialist physicians.
  2. How does the advice compare to what you know about your diabetes?Mostly it’s pretty obvious when the two don’t match.  Wanting to remove your pump in hospital without an explanation of the benefits in this situation of so doing?  Saying you don’t need insulin if you’re fasting. Stuff like this should make you wary, it’s your health and your diabetes. Own it!
  3.  How does the advice compare with the experiences of the peers you know and trust with diabetes IRL and on the net?I knew from chatting to pwd on line that a steroid shot would be hell on my sugars.  My GP said the shot was localised so it wouldn’t. I knew that was rubbish-and put my pump in overdrive accordingly. The information I received from other pumpers was great and pretty spot on to keep my sugars in reasonable line despite the steroids.
  4. Do you understand the professional’s advice or treatment and why it is the best course of action?I’m a firm believer that unless you can explain something in a way that a child would understand, then you don’t understand it well enough yourself. If a professional won’t or can’t explain things, be dubious. Informed consent is supposed to mandatory, so make sure that not only do you consent but you do so in an informed manner.
  5. Does the professional’s language reflect an understanding of type 1 diabetes?Questions like “how are your sugars?” and “do you comply with your doctor’s instructions?” or “how much insulin do you take?” indicate a lack of knowledge of the complexity and the intensity of diabetes “management”.  My sugars have their ups and downs, my doctor can’t possibly give me detailed enough instructions to comply with and I take as much insulin as I need.  Blah, talk to me intelligently, otherwise I’ll switch off.

What other advice or experience do you have in evaluating health information offered by professionals? I’d love to hear what you think, please share in the comments.


4 thoughts on “Assessing Information from Health Professionals: How I do it.

  1. Never take any advise on diabetes from a HCP who, having told them you have type 1, asks if you take tablets or insulin for that?! Lol.

  2. I’m having a gastroscoopy tomorrow. Had a call from the endoscopy centre. The gastro had written that I am to halve my Lantus tonight and not take my Humalog tomorrow morning. Great – except I’m on a pump, not MDI. I told this to the person from the centre, who laughed, and agreed when I said that I’d do what I usually do. Then asked if I had any dietary requirements apart from ‘diabetic’. I said not even diabetic (thinking especially not diabetic) and we rang off. I doubt that the doctor wrote those instructions; I think it was the staff who wrote them using their usual guidelines. Still not good enough.

    1. Good luck with the gastroscopy tomorrow Jane. I doubt the doctor would have any more idea re the insulin dose. Halving a Lantus dose seems a bit extreme-surely u r not going to halve your basal??

  3. No. I did what I always do in situations like this. Checked my BSL and in this case didn’t have to do a thing. Now to wait for the pathology.

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