I am so excited to have been invited to contribute to this blog and interact with the readers of Diabetes Self-Management! I am a clinical pharmacist and a certified diabetes educator, and I have specialized in helping people manage their diabetes in both the hospital and clinical setting for the past 25 years.
Working with people with diabetes is always very interesting, as well as incredibly rewarding. Each person brings his unique experiences, challenges, beliefs, and disbeliefs to his visits. I try to create an environment during each appointment in which my patients feel comfortable being honest with me about how they are managing their diabetes and the barriers they are encountering. When I am able to identify an area to work on and my patients experience positive changes in their blood glucose numbers as a result, it is so gratifying.
So many times I hear, “No one ever explained that to me” or “I didn’t know that.” One person told me that I “saved him from the fire of diabetes.” He shared with me that he had thought the diagnosis of diabetes was life-ending for him, or that at the very least that he would have to completely change his lifestyle. He thanked me for giving him the tools he needed to modify his life to fit diabetes into it. I am happy to say that that was four years ago, and he is still doing great! I hope to share some of those tools with you through this blog.
About 10 years ago, I began spending time in the hospital setting in addition to my clinic work. I was shocked to find that diabetes was basically ignored during hospital stays and that elevated blood sugar levels were considered acceptable. Luckily, much research over the past decade has been performed demonstrating a direct relationship between elevated blood glucose levels and poor outcomes during hospital stays. Many hospitals are now implementing protocols to control glucose levels during stays.
With the growing number of people being diagnosed with Type 2 diabetes, it is not surprising that some are receiving their diagnosis during a hospital stay. Sadly, many people end up in the hospital due to complications from poorly controlled diabetes. My goal for a newly diagnosed person is to get him started on the right treatment regimen and to provide the beginning foundation of his diabetes knowledge base.
For people with poorly controlled diabetes, it is necessary to identify any gaps in their knowledge base and to change their treatment regimen. Finding the right provider to take over a person’s care, or communicating with his current provider to ensure ongoing successful management after discharge, is also important. I will share more about how you can prepare for a successful hospital stay with diabetes in a future blog entry.
In addition to my work in clinic and hospital settings, I have also spent a great deal of time in academia training health-care professionals about diabetes, with a special focus on physician education. A common problem with physician prescribing in the area of diabetes involves something called “clinical inertia.” Simply put, it is the failure of doctors to start or intensify therapy when needed.
Doctors often tell me that not enough information was provided to them during their training regarding diabetes, and many lack a comfort level with prescribing insulin or else fear that their patients will be unhappy if they place them on insulin. People with diabetes can help avoid having this experience with their own provider by asking if their therapy should be changed if their diabetes is not well controlled. In future pieces, I will talk about how to improve your doctor visits.
While there is much more work to accomplish, managing diabetes today is much easier than when I first began my practice and we only had a few oral medicines and animal insulin available to us! There have been a lot of positive changes during my many years in the field, including the availability of newer medicines for diabetes and an increased recognition of the need to empower people with diabetes to actively participate in their care.
I look forward to sharing tidbits from my practice experience on managing your diabetes and working with your provider to achieve good results. And I’m eager to start connecting with DiabetesSelfManagement.com readers — I know I will learn a great deal from you!