Diabetes is a Marathon, Not a Sprint

Medical problems are often treated as brief events that need immediate, short-term treatment. A problem is diagnosed, a treatment is chosen, then the person with the problem follows through with the health-care professional’s recommendation, gets better, and all is well and good.


This “acute” model of care has been effective in many situations and is the model we continue to count on for most of our urgent health-care needs. It is how health-care professionals are trained and is also how many people have come to believe medical treatment is supposed to be. Unfortunately, when it comes to diabetes, this model of care leaves us with communication and treatment problems.

The first problem with the acute model of medical care is that it doesn’t leave much room for communication—you just get the treatment recommendations and follow them. You don’t need to discuss the treatment, there is no need to follow up with the health-care professional, he is not going to judge you on how you did with the treatment, and when you’re done, you’re done. In this model, the health-care professional doesn’t need to know anything about your life, your family, or your level of motivation. He really doesn’t need to know you. You also don’t need to let him in on how your life works and how it will affect the treatment he is suggesting. The acute model is straightforward and simple and works well for broken arms, colds, and the flu; for diabetes, however, we need a different model.

The “chronic” model of care for diabetes requires quite a commitment from both the person with diabetes and the health-care professional—a commitment to manage the condition jointly, with both parties willing to discuss treatment options and their expectations of one another. These discussions must also cover your specific lifestyle issues, so that there is an awareness of how diabetes interacts with your life. The partnership that is the basis of this model focuses on shared goals, rather than just your goals or the health-care professional’s, and you are likely to find it far more supportive than an acute-care model in helping you manage your diabetes.

The chronic-care model is recommended and used by diabetes educators. It fits best if you are also willing to be honest and share details about your life and how diabetes fits or doesn’t fit into it. So start a dialogue with your health-care professional about how you might plug this model into your care.

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  • Maggie

    Unfortunately my husband had an endocrinologist for 10 years who followed this acute method. My husband went from type 2 to type 1, didn’t even know it until he had heart by-pass surgery this summer. The doctor never had a plan and never controlled the blood sugar. My husband’s A1c was 12! Our new endocrinologist has us counting carbs and covering with insulin (novalog) and levimir. We write everything down and take in our figures at each appointment where they are evaluated and tweeked. After 3 months his A1c is 6.8!! This new Dr. offers to teach other endocrinologist this method of controling the sugar, but has few takers. Diabetic patients take too much of their time and they don’t make enough money off of them. My husband was a runner, never over weight, never smoked and doesn’t have high blood pressure. I feel if we had had the right method of control the last ten years, he wouldn’t have had to have 5 by-passes. The right doctor is SO important!