Another year is almost over and this encourages those diabetes “experts” to share advice (like they need an excuse) that varies from the obvious to the onerously impractical! We should resolve to make doctors appointments, plan and shop for a complete weekly menu every Sunday afternoon, keep our a1cs in check (wow, I needed a reminder on that one-not!) and my particular favourite from a list of daily goals provided via Fbook page, talkondiabetes, “ bathe with mild soap and lukewarm water”. Really? If you need a New Years resolution to bathe daily then diabetes is the least of your worries.
Having been the “grateful” recipient of so much gratuitous advice I thought I’d reciprocate this year by providing a list of new years resolutions that health professionals (other than endos) who provide diabetes advice might like to adopt for a happier, more professional 2014.
1. Aim to see your patients within 30 minutes of their appointment time.
2. If you are a GP and a person of ANY age, BMI and family history of disease presents with flu-like symptoms, infections or other non-specific issues resolve to ask each such patient about frequency of urination and thirst. Administer a simple and cheap urine test for presence of glucose and ketones. If ketones and glucose are in the urine, this is a medical emergency do not send patient home to undertake an oral glucose tolerance test in a few days, do not prescribe oral diabetes drugs, do not refer for a non-urgent appointment with an endocrinologist.
3. Before you dismiss people with diabetes as being ignorant and/or noncompliant, read, mark and inwardly digest this article by an endocrinologist who knows far more than you ever will about diabetes. Bring it to mind next time you’re tempted to dismiss the Herculean efforts those of us with diabetes undertake daily as “poor” or “inadequate”. no longer playing the a1c blame game
4. Many people with type 1 diabetes were titrating doses and injecting themselves for years before you were even in medical school. Have some humility and be open to the notion that these people may have knowledge and understanding of their condition that you don’t.
5. Understand that managing type 1 diabetes is not about compliance with a regime, the way that taking antibiotics or blood pressure medications is. Don’t take my word for it, check out the work of Professor Jay S Skyla an expert with over 40 years experience in diabetes whose CV should silence any dissent from those who still use words such as “compliance” in relation to diabetes. At the World Diabetes Congress 2013, Professor Skyla said he preferred the term “unrestrained creativity” rather than “intensive insulin therapy”. This is the first time I’ve heard a doctor acknowledge that managing blood sugars is a complex art that requires creativity and lateral thinking, not a dogged adherence to a set of instructions.
6. Before you dish out any advice think about where and how you gained this “expert knowledge”. There is so much misinformaton and half-truths about type 1 diabetes, don’t destroy your credibility by being party to it. Here’s one small example to think about, there are countless others. Ever told a type 1 that exercise helps or improves diabetes control? You wouldn’t be the only one but this is untrue (although exercise is overall of benefit to everybody). The ADA points out “However, it must also be appreciated that several studies have failed to show an independent effect of physical activity training on improving glycemic control as measured by the A1C test in patients with type 1 diabetes. “ ADA Statement Of course exercise should be recommended for all its wonderful health benefits, particularly in reducing risk of atherosclerosis but consider how difficult it is for most people to regularly exercise, spare a thought for those of us with type 1 who face extra hurdles in doing this.
I do hope that helps all you health professionals have a healthy and productive 2014, remember sticking to these resolutions will soon become routine and your life will be better for it-trust me I’m a diabetic!
As for me and my diabetes, I have decided to follow the expert advice of English Occultist and writer, Aleister Crowley, sometime described as “the wickedest man in the world”.
Happy New Year!Tweet