With Diabetes, it’s Not Always Easy to Take Care of Yourself

Author: Linda Gaudiani MD, FACE, FACP
With Diabetes, it’s Not Always Easy to Take Care of Yourself

“To live a long and healthy life, develop a chronic disease and take great care of it.” Sir William Osler (1849–1919) Easier said than done in the case of diabetes, which affects 34 million people in the United States. Adding in the pre-diabetics, the number reaches a staggering 40% of the US population!

“Taking care,” as Dr. Osler advises, can feel like an overwhelming task to someone with diabetes. While data shows you can live a long, healthy life with diabetes and avoid complications, it takes vigilance and consistency, making daily health decisions, adjusting food choices, exercising, taking medications, checking blood sugars, seeing health professionals. On top of routine stresses, family⁄work obligations, high costs⁄barriers to access of medications and supplies and treating other health conditions, keeping up with the demands of diabetes can feel like a fulltime job.

Since COVID-19, diabetics are experiencing additional stresses. Data shows the diabetic population is at highest risk for complications and poor outcomes of COVID infection!

According to Dr. William Polonsky, guest lecturer at the Braden Diabetes Fall Fest, “diabetes distress” is an unrecognized common complication of diabetes which threatens optimal outcomes and has its roots in the behaviors of both patients AND providers. In patients, this distress can result in loss of motivation, denial, and feelings that short-term efforts are burdensome and will not necessarily result in longer life or reduced complications. He noted in a recent study only 25% of patients with diabetes succeeded in meeting all three important treatment goals—A1C level, blood pressure, and cholesterol.

Providers can make headway against diabetes distress by first acknowledging it—by listening more, showing empathy, establishing collaborative not authoritarian relationships, offering education and support. In a meticulous observational study, Dr. Polonsky explained when doctors incorporated these skills in the first year after diagnoses, patients had a 40–50% reduction in all-cause mortality at 10 years!

If you missed this year’s Braden Diabetes Fall Fest: “Diabetes Distress in the Time of COVID,” please watch Dr. Polonsky’s fantastic CME lecture and our panel’s town-hall Q and A anytime at www.MyMarinHealth.org⁄BDCFallFest. Hear what we hope to do about diabetes distress at the Braden Diabetes Center and share your thoughts and suggestions on our website, www.MyMarinHealth.org⁄BDC.

… traveling through life well with diabetes…
In health,
Dr. G.