The Challenge that lies ahead

The Challenge that lies ahead

Two studies on very different subjects point to the challenges that lie ahead as we move towards interconnected diabetes management (IDM) becoming the standard of care. The first study was conducted by Tufts University which was published in American Journal of Clinical Nutrition on Sept. 7. According to the study;

“The glycemic index value of a food can vary by 20 percent within an individual and 25 percent among individuals, according to the results of a controlled feeding trial in 63 healthy adults. The findings suggest glycemic index has limited value in predicting how foods affect blood sugar levels.”

The second study was published in the British Medical Journal Open Diabetes Research & Care and “found that Noom’s diabetes prevention program helped 64% percent of completers lose more than 5 percent of their weight.”

According to an article posted on the British Medical Journal website;

“The research, published today in British Medical Journal Open Diabetes Research & Care, studied prediabetes participants from a large northeast insurance payer. Weight loss at 16 and 24 weeks was significant, with 64 percent of completers losing more than 5 percent of their body weight and 33 percent of completers losing more than 10 percent of their body weight.

Participants regularly logged their meals and tracked their weight, and with accessible human coaches, participants became more engaged through other in-app behaviors, such as posting messages to their group, which promoted social support and favored weight loss.”

Diabetic Investor finds both studies as significant as one shows the peril of IDM while the other shows its promise. Up until the Tufts study the glycemic index was thought to be a simple way to help patients gauge the impact food intake would have on their diabetes. Ask any insulin using patient what one of the most maddening aspects of diabetes management is and likely carb counting is on that list. It was thought that the glycemic index could make carb counting easier.

As we have been stating when it comes to helping patients the simpler the better. This is one reason HbA1c is used so frequently as it’s a number any patient can understand. 7 or below is good anything above 7 not as good, what could be simpler. It was thought the glycemic index had the same impact when it came to counting carbs. That it was a simple method that patients could use to understand the impact food has on their diabetes.

Yet as the other study notes given the right set of tools, access to coaching and the ability to share with others in the same situation IDM works. That patients don’t necessarily need information dumbed down when they have access to help. It also shows the importance of positive reinforcement, how by sharing with others it helps easy the daily burden of diabetes management.

Ask any patient with diabetes what drives them crazy and in top five responses will be the help offered by those who don’t have diabetes. Diabetic Investor has experienced this personally as has almost any patient whose taken an insulin injection or checked their glucose in a public setting. Sure enough there is some know it all who doesn’t have diabetes who will come up and offer their unwanted opinion on how we should be managing our diabetes.

The ultimate goal of IDM is really personalized diabetes management, helping each individual manage their diabetes. Having the ability to share their thoughts, concerns, failures and successes with others who are in the same boat helps. This is one reason websites like Children With Diabetes or TuDiabetes are so popular as they provide a forum for patients to share. It is also the premise on which OneDrop one of the newcomers to IDM is built on. That patients do want help but they want this help from people who actually understand what they going through each and every day.

The real lesson here is not new at all as it’s a matter of respecting the patient. Far too often the people who are trying to help patients treat them as if they were children incapable of understanding the complexities of diabetes. Patients aren’t stupid, they know diabetes is a serious chronic disease, they know it must be managed. Yet what falls on deaf ears what many so-called experts just can’t grasp is that for the majority of patients their diabetes, as important as it is, is not their top priority. They have lives to live and all they really want is for their diabetes management to be part of their lives not to run their lives.

As Momma Kliff used to say; “If you really want to help me, respect me, give me credit and most all don’t think you know what I am going through. Allow me to make mistakes, to learn from those mistakes. If I want help I’ll ask but don’t presume for a moment that just because I don’t do it the way you think it should be done that I am not doing what’s right. After all this is my life and I’m going to live it my way.”