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Editor’s Note, DCMS #159

Oct 20, 2013

This past Saturday I was working with 11 patients in an interactive education class at a progressive doctor’s office in Palmetto, Florida. This office takes a very unique approach to diabetes and provides every patient who has an A1c of 5.7 or greater with education at no charge. None of the patients had an A1c greater than 7.2 and only four patients could be called prediabetic. For most of you a 7.2 would not even cause much alarm and certainly not a referral to a diabetes class.

In this class we talked about how family and friends sometimes think they are the experts when it comes to diabetes and how they often give misinformation or try to inflict uneducated ideas of care on patients. When I asked for an example one patient said, "When I go out to eat with my aunt she always gives me a hard time if I order any kind of desert because it has sugar in it. Last week I ordered a scoop of vanilla ice cream — she started to scream, ‘You can’t have that, it is way too much sugar!’ When I explained that the cup only had 26 carbs and I had skipped a potato and bread that had a total of 98 carbs she still said, ‘You can’t have ice cream if you have diabetes.’"

This kind of "family help" is called Miscarried Helping, and this week our Clinical Text from Joslin’s Diabetes Deskbook covers this and other problems associated with Psychological Issues in the Treatment of Diabetes.

Our Homerun Slides look at another successful PCMH and how ACOs work, and our Disaster Averted explains why beer can be icy cold but insulin should not be. Our Mastery In Minutes video will tell you all about a new test which can identify different types of diabetes quickly and accurately