There are countless examples of health professionals who don’t have adequate knowledge about diabetes. Here we give you some horror stories and 4 tips on how to trust health professionals with your diabetes.
Written by diabetes coach Hildegunn Fossheim
A while back, the high failure rate of graduating nursing students in Norway was discussed in Norwegian media. There was one case in particular where a frighteningly high percentage had answered incorrectly. This assignment was presented as a case about diabetes: a nurse on duty found an insulin-dependent patient with diabetes nearly unconscious on the floor, clearly effected by low blood sugar. Given the question “What would you do in this situation?” the majority of the nursing students answered that they would have given the patient insulin. To give a person insulin while they have serious hypoglycemia would have effectively killed this person.
Equally as alarming was a story I recently heard from a woman who had a kidney and pancreas transplant, due to complications of diabetes. Before the transplant she had to go through an assessment that required huge doses of sedatives, hence she would be unable to monitor her own condition herself. Prior to this assessment, she had told the nurses that she has diabetes and that she could quickly become hypoglycemic. The doctor and the nurse had then reassured by saying: “Don’t worry, if you get low we will just give you some insulin”. Considering that insulin could have killed this woman if she went hypoglycemic, it doesn’t get much worse than this.
Not understood by health professionals
Despite the horror stories about healthprofessional’s frightening lack of knowledge in diabetes, there are still many who have sufficient knowledge about the purely medical diagnosis of the disease. On the other side, I know of several people with diabetes that feel that healthcare professionals don’t understand the challenges that those with diabetes are struggling with every day. This is a completely different issue than the lack of medical knowledge.
For example, a lot of people with diabetes develop a form of anxiety about hypoglycemia. We know that 2 out of 3 people who are insulin dependent deliberately go to bed with too high levels of blood sugar in fear of becoming hypoglycemic whilst sleeping.This is in spite of the fact that they know this strategy drastically increases their chances of complications later in life. The problem occurs when your blood sugar is constantly at a higher level than recommended as this will affect your HbA1c-value. Depending on which country you live in, the health department have most likely set a recommended HbA1c-value. For example in Norway it is decided that everyone should have an HbA1c value below 7.0. When your blood sugar levels are continuously too high over a longer period of time, your HbA1c-value will certainly not be below 7.0.
Your doctor wants to do a good job, and will therefore strive for you to reach the national objectives, an objective that is perceived as a rather strict requirement for many with diabetes. Medical check ups are then associated with a periodic moral-lesson from the doctor, where the patient feels like they are getting lectured for not doing a good enough job, and must prepare a defense speech before their check-up. The result is that many fail to get examined regularly, which in the worst-case scenario can lead to organ failure, since early signs of complications weren’t discovered.
How to trust healthcare professionals with your diabetes
1. Open dialogue
When one is first diagnosed with diabetes, health care professionals will be crucial for how the patient is able to deal with their new illness. As you learn to know your diabetes, it is essential to have an open and healthy dialogue with your doctor on how your diabetes can best be controlled based on your own experience.
2. Be open about your challenges
It can feel frustrating that you have to educate your doctor about diabetes, but it’s important to remember that diabetes affects individuals differently. Because you adjust your own insulin doses it’s impossible for any healthcare professional to become an expert on your diabetes. Tell your doctor what kind of challenges you struggle with so they can try to understand what YOU are going through. You’re the expert on your diabetes! Healthcare professionals are there to help you in the right direction.
3. Take the initiative
Diabetes is a complex condition and to engage healthcare students, the lecturers must make a heavy and hard topic interesting. To become knowledgeable in diabetes you must be interested in the topic. Here is an opportunity for you living with diabetes to inspire and pique interest in the doctors, nurses, pharmacists and other healthcare professionals you meet.
4. Go to your annual medical check
Although you may still feel that diabetes check ups are a form of a periodic moral lesson, you miss important assessments if you’re absent from them. Regular medical checks are essential to detect early signs of complications.
Demand for medical knowledge about diabetes
It is genuinely sad that there are so many people living with poorly controlled diabetes, partly due to insufficient knowledge and follow-up by healthcare professionals. One of the reasons is of course that patients don’t show up to their diabetes check ups, but the healthcare professionals must also take their share of the blame, as they don’t understand how much of the everyday life of the patient that concerns diabetes, and all its challenges. We may well conclude that the level of knowledge must be raised at all levels in the healthcare system.