Diabetes can be hard work, but you’re the best one to do it
When you care for someone with diabetes, it takes a lot of effort to work out the best strategy. How to motivate them, how to modify long-standing habits and how to develop your own confidence to try new medications can all be hard work.
Research has shown that people with diabetes trust their GP and community care team much more than the specialist diabetes team. You’re in the best position to educate and support your patient, and to motivate behaviour change.
These are some strategies that may help you make the most of your short consultation time.
How your communication style can help
The words that are traditionally used to describe people with diabetes are judgmental and negative. It’s easy to slip into this, but they help no one – least of all your patients.
Traditional words and what they might really mean:
Old fashioned description | A possible explanation |
Brittle diabetic |
The treatment isn’t working Hypo’s are caused by using the wrong insulin or sulfonylureas |
Non-compliant |
Patient doesn’t understand what is required of them – we need to explain it better They are having side effects, so stopped the treatment They can’t afford the treatment They are depressed or stressed with other priorities |
Poorly controlled or bad diabetic |
Our treatment isn’t working The patient stopped taking the medication through lack of understanding or side effects The patient doesn’t understand what is required of them They are depressed or stressed with other priorities |
Here are some tricks to create a safe environment for your patient to tell you what’s really going on, so that you can be more helpful with your time:
What it’s like for your patient
By the time your patient has diabetes, you already know a lot about them. The risk factors that predict obesity and diabetes may actually affect your patient’s ability to stick with the care plan and the lifestyle changes you recommend. Understanding this is the first step to helping your patient turn things around.
It’s a good chance that your patient:
You can see that judging your patient or being negative is going to be unhelpful. Bombarding them with instructions and information will be overwhelming.
Your patient may respond better to consultations that aim to:
This seems a lot, but it’s just about respect and understanding your patient.
Psychology of self-care and food
Self-care for chronic disease assumes that you care about yourself. It’s not hard to see that if you have a poor self-esteem or suffer depression, your commitment to self-care may be hard to maintain. Your patient may benefit from psychosocial support and counselling as part of their diabetes plan. Your diabetes plan is much more likely to be successful when your patient is able to care for them self.
When it comes to food, it can be a very emotional experience. Maslow’s Hierarchy of needs clearly defines food as the very foundation of someone’s survival. So, when we question what someone eats, or try to change it as part of their diabetes care plan, we are at it risk of attacking that person, not just the food. For some people, cooking food for someone is a way to show care and love. If we criticize or change their food, there is a chance that we affect more than the food on the table. It’s important to tread carefully, recognise the emotions involved and to include family members in any discussions about food.
Successful behaviour change
Having diabetes requires a range of new habits to manage it successfully. We ask people to check their glucose levels, take new medications, eat differently, go to bed earlier and start doing exercise. This is a lot to ask of someone, so it’s important to set things up for success.
For any new behaviour change to be successful, it needs to be achievable and meaningful. Your patient needs to be able to see the difference and know that it was worth the effort. Arrange follow-up appointments in 2-3 weeks to consolidate any new knowledge and reinforce the behaviour change.