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Joy Pape, MSN, FNP-C, CDE, WOCN, CFCN, FAADE

Joy Pape, MSN, FNP-C, CDE, WOCN, CFCN, FAADE
(Associate Medical Editor Diabetes In Control) Clinical Nurse Practitioner, CDE, Comprehensive Weight Control Center, Weill Cornell Medical College; President of EnJoy Life! Health Consulting, New York City, NY; co-author of the Real-Life Guide to Diabetes; Immediate Past President for the Metropolitan New York Association of the American Diabetes Association of Diabetes Educators (MNYADE). As an internationally known family nurse practitioner (FNP) and certified diabetes educator (CDE), Joy Pape specializes in diabetes, weight management, home blood pressure monitoring, sleep, and foot care. She is the co-author of the Real-Life Guide to Diabetes (The American Diabetes Association). She writes for several national magazines, is a dynamic national motivational presenter for both health-care professionals and the general public, and is a partner of Laugh it Off! a health edutainment team. Joy says, “Most important is that I still see patients. That is my passion…to connect with my patients so that together we can help them reach their optimum health.

Don’t Stop: Encouraging Patient Success

When prescribed lifestyle changes and or medication(s), patients who have diabetes, obesity, hypertension, or any chronic condition that is easy to monitor, even from home, may agree to these changes at first. They can almost immediately get improvements in their numbers. It can be encouraging. For some, seeing those numbers change for the better encourages them to keep on keeping on. However, others may think they are healed and stop treatment. Their numbers may go back to the same or even "worse" than before the treatment.

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Seasons, Reasons & Celebrations

We know treating and living with diabetes and excess weight or obesity takes a village, a multidisciplinary village, not only related to the patient and health care providers but truly the whole village or world. It also helps to remember the seasons and reasons why we do the things we do. We sometimes forget about how changes in weather, our personal cultures, living environment, even friends and loved ones who seemingly mean well can “sabotage" the greatest intentions.

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Weight Loss After Travel: When Should We Be Concerned?

Since I am a diabetes educator who also specializes in obesity medicine, I see a lot of different responses to travel. For all, I see both weight loss and weight gain after travel. The interesting thing is for people with obesity, I see both. What I also find interesting is a lot of my patients who go to Europe tell me they eat pasta, more bread and other carbs, but when they lose weight, glucose levels improve. Why? Usually because they also tell me they are more active.

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We Repeat: Teach To Remove The Needle Shield!

Last week I was teaching a patient how to self inject an injectable medication. As I was going through the steps, I told her twice of the importance of removing not only the outer cover of the needle, but also the needle shield. She gave me one of those looks like, "Why did you tell me this twice?" Then she said, "I know!"

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To Give Your Patients Hope, Listen Well to The Stories They Tell Themselves

I recently met a patient whose life is alternative medicine. Not complementary medicine but alternative medicine. A young woman in her early 30’s who was diagnosed with type 1 diabetes 10 years ago. Besides having an A1C of 10.5%, I could tell she was struggling. Her career is in alternative medicine. For years she has been looking for a way to stop taking insulin. She is looking for the cure, but as with many, has difficulty believing it’s not here yet. She has had diabetes education, but because she hasn’t really met the hcp she can relate to or who has given her the answer she wants to hear, she’s not really put things together yet.

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Travel: When Should You Not Avoid Pain?

I traveled to Europe, a continent with a lot of history and cobblestone streets. I was aware of the amount of walking I was going to do and reminded myself of what we teach, or should be teaching, our patients: Do not travel with new shoes only. Always bring a pair of tried and true. And when you do buy new shoes, buy them later in the day, make sure they fit well, and break them in before wearing for long periods at a time. Wear them about a half hour a day, then slowly increase the time you wear your shoes to avoid foot problems.

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How Do You Discuss Vitamins?

So many of my patients who have insulin resistance, type 1 or type 2 diabetes with hyperglycemia and/or obesity have vitamin D or vitamin B12 deficiency. Often they have never had their levels checked or, if they have, were diagnosed with either or both vitamin D deficiency and vitamin B12 deficiency and do not take their prescribed vitamins. Why?

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Do You “Make Room” for Your Patients?

Female, 67 years of age, type 2 diabetes, class 2 diabetes, depression, hyperlipidemia, vitamin D deficiency plus more. Her A1C is 6.8% and her lipids are within goal. Her random glucose 2 hours after eating cookies was 118 today. Her glucose lowering meds are Trulicity, metformin, and Jardiance. She takes them as prescribed. Her endocrinologist recommended she meet with me. She refused until he recommended she see me the same day she was coming in to see another health care provider for her monthly infusion for another disease process to make getting here easier.

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